Analysts expected Eli Lilly’s Forteo to be the big challenge standing in the way of new Radius bone drug Tymlos. But Express Scripts apparently has other ideas.
On Monday, the PBM giant said Forteo would get the boot from its 2018 national preferred formulary, and it listed Tymlos among its preferred alternatives.
It’s a big win for the Massachusetts biotech, which recently brought on Novo Nordisk vet Jesper Høiland as CEO to guide its transition into a launch-phase company. Back in May, Jefferies’ Eun Yang wrote that despite Tymlos’ $19,500-per-year, cheaper-than-Forteo price tag, he saw “limited upside” from the newcomer thanks to “significant commercial challenges.”
But if anyone loves a good discount, it’s PBMs—and Express Scripts in particular, which has long been vocal about lowering drug prices and has amped up its formulary management strategy accordingly. It made waves back in 2014 by cutting a discount deal with AbbVie that would exclude Gilead’s pricey hep C meds, and the list of meds excluded from its top formulary numbered 80 or more for 2016 and 2017.
Express Scripts has been "very open to this responsible pricing strategy as a way to kind of make sure that the lower price benefits actually got to the patients," Radius chief commercial officer David Snow said in an interview. "They made an independent decision here around their own formulary, but they were very responsive early on to the message and you see it playing out here.
"Early on in launch, this kind of opportunity doesn’t come very often. I’ve been in the industry for 30 years, and it’s always been a challenge with the payers," he added.
Meanwhile, the Forteo lockout isn’t the first big break Radius has gotten since its Tymlos’ April FDA approval. Last month, U.S. regulators handed Amgen—maker of candidate romosozumab, a med industry-watchers thought would give Tymlos a run for its money—a complete response letter, asking that the Big Biotech and partner UCB resubmit their application after submitting more data.
And there’s one other issue: The data the FDA wants come from a study pitting romosozumab against Merck’s Fosamax that turned up an imbalance in “serious cardiovascular adverse events,” Amgen said in May. Evercore ISI analyst Umer Raffat at the time called the news “clearly negative, and very surprising” at the time, while Leerink Partners’ Geoffrey Porges set the probability of an eventual romosozumab approval at 50-50.
Editor's note: This story has been updated with comments from Radius' chief commercial officer.