Teva's new Copaxone formula could be a hard sell with payers

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Teva ($TEVA) doesn't have much time left to switch patients over to its new, thrice-weekly Copaxone injection before generics jump on the current product. And while the company is working feverishly to market its new drug to patients, insurers may be the most difficult to persuade.

As Bloomberg reports, Teva has contact with 85,000 multiple sclerosis patients, and it's milking other resources, including records from its 24-hour support hotline in the U.S. The Petah Tikva, Israel-based company needs to reach as many patients as possible if it hopes to salvage much of Copaxone's $4.3 billion in sales before its remaining U.S. patents expire in May.

But as the news service notes, persuading insurers to cover the new version could be a challenge with cheaper copies around the corner. "Some payers are viewing this as Teva's strategy to avoid losing patients, and they may take an aggressive stance," consultant Gary Owens told Bloomberg. "It's going to be a wrestling match between two 500-pound gorillas."

Payers have been exercising more control as of late; pharmacy benefits manager Express Scripts ($ESRX) made headlines last year when it excluded some of Big Pharma's hottest up-and-comers, like Novo Nordisk's ($NVO) diabetes med Victoza, from its 2014 national formulary. PBMs are demanding that drugmakers make a case for their high-priced new drugs over cheaper alternatives. With a sticker price of $60,500, the new version of Copaxone provides neither a low-cost option nor a clinical advantage over its predecessor, some figure.

"We are going to assess first of all if this agent, relative to the daily agent, offers a significant clinical advantage," David Lassen, chief clinical officer of pharmacy benefits manager Prime Therapeutics, told Bloomberg. "And by that I mean any safety or efficacy uniqueness that will offer a true clinical outcome advantage versus the daily drug."

If Teva intends to bank on the new Copaxone's more convenient dosing schedule, it will also have to contend with a handful of new oral treatments, including Biogen Idec's ($BIIB) soaring Tecfidera. With the impact of rival branded meds and generics combined, analysts expect Copaxone's sales to tumble 56% by 2016, Bloomberg notes.

That sales decline will spur Teva to the negotiating table with insurance companies, Joseph Sinopoli, president of reimbursement and consulting services company PreLaunch Strategy, told the news service. Generics could turn up at 20% cheaper than the original, at which point "Teva is going to be cutting deals."

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