Amgen escalates PCSK9 pricing war with permanent 60% price cut on Repatha

Amgen made a splash a year ago with its announcement that it was cutting the list price of its PCSK9 cholesterol drug Repatha from $14,520 to $5,850—even though it maintained the pricier option for insurers who preferred to take it, along with what were likely steep discounts. At the time, Amgen vowed to do away with the $14,520 price tag altogether by the end of 2020.

Now, Amgen is making good on that promise earlier than expected.

The company said Thursday that as of January, it will sell Repatha exclusively at the $5,850 price. Murdo Gordon, executive vice president of global commercial operations at Amgen, said the company is making the change now primarily to benefit Medicare patients, some of whom still face unaffordable out-of-pocket costs for the drug.

“We have seen significant improvements in access and affordability, but not all Medicare patients are benefitting from these improvements because some Medicare Part D plans have not transitioned to the lower list price option of Repatha,” Gordon said in a statement. “Almost half of all Medicare patients who are prescribed Repatha will have an affordable co-pay of less than $50 in 2020, but that means that the other half will still face affordability challenges that need to be addressed.”

Perhaps, but there’s another good reason for the permanent price-slashing on Repatha: competition. Amgen has always been locked in a battle for market share with Regeneron and Sanofi’s PCSK9 drug Praluent—a war that escalated earlier this year when the two companies slashed Praluent’s price to match Amgen’s $5,850 list price.

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Amgen has so far managed to outpace Sanofi and Regeneron in PCSK9 sales. Repatha scored $293 million in sales in the first half of this year, while Praluent brought in just $135 million. Still, the PCSK9 class as a whole has underperformed the blockbuster expectations that Wall Street analysts once had.

And now, both companies are facing the prospect of even more competition. The Medicines Company is in phase 3 testing of a long-lasting PCSK9 inhibitor, inclisiran. In September, the company said the drug slashed levels of bad cholesterol by 54% when added to statins in a trial with more than 1,600 patients. That performance matched up with data from trials of both Repatha and Praluent.

Meanwhile, whether Amgen can boost volume enough to make up for Repatha’s lower list price is a serious concern. In the second quarter of this year, Amgen reported a double-digit increase in prescriptions of the drug, but only a 3% sales increase. The company acknowledged that the 60% discount was cutting into revenues.

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Analysts have been discouraged about Repatha’s growth prospects since the beginning of the year, in fact, when Repatha’s first-quarter sales fell well below expectations despite 90% volume growth in the U.S.

Will Repatha’s third-quarter performance show signs of a bright future for the drug? Stay tuned. Amgen will release its quarterly earnings report on Tuesday.