Novo prices oral Rybelsus on par with injectable rivals, ending discount fears

Monday morning, Bernstein analyst Wimal Kapadia echoed what many industry watchers were probably thinking about Novo Nordisk’s Rybelsus price: “Finally we can stop talking about it.”

After a Friday FDA approval, the Danish drugmaker unveiled the oral GLP-1’s list price of $26 per day, or $772 per 30 tablets across all doses—a price that’s “in-line with injectables” from that same class, Kapadia wrote in a note to clients.

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The reveal ends a two-year debate and “removes the concern that the company would have been forced much lower on price,” Kapadia noted. With Ozempic, the once-weekly, injectable version of Rybelsus, bearing a similar list price of $770 and older GLP-1 drug Victoza sporting a $920 sticker, Novo executives had “previously implied injectable GLP-1-like pricing would be their preference” to avoid cannibalizing the company’s other products.

While the list price may have raised some eyebrows around the field—it “exceeds the near-unanimous investor feedback we received anticipating a discount to injectable GLP-1s,” Jefferies analyst Peter Welford wrote in his own investor note—the key figure for Rybelsus’ launch will be Novo’s price post-discounting. That’s one the company won’t be disclosing, of course.

So far, though, Novo says it’s gotten positive feedback from payers on the drug’s clinical profile and the company’s own cost-effectiveness research, Welford wrote. And given Novo’s “aspirations to position Rybelsus early in the Type 2 diabetes treatment paradigm for metformin failures,” he and his colleagues assume the drugmaker will be open to bigger rebates for Rybelsus than for Ozempic.

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Novo will be working to secure payer coverage as quickly as possible as part of the “strike model” it intends to use for Rybelsus’ rollout in the U.S. As it did with Ozempic, the company will start out targeting specialists, only moving to primary care physicians after market access in their region hits a minimum threshold, it said on a Monday conference call. Two years after Ozempic’s launch, Novo has market access topping 90%, Welford wrote—and that’s success it wouldn’t mind replicating with Rybelsus.

Meanwhile, Novo’s rep ranks won’t be seeing any major changes, Kapadia wrote. The company intends to use a combination of Ozempic and insulin reps to promote Rybelsus, a strategy that should provide “good flexibility without impacting Ozempic’s trajectory.”