J&J looks for Xarelto boost in real-world cost data

Janssen's Concetta Crivera

These days, sometimes it's not enough to prove your drug is more effective than the standard of care. As rising drug costs continue to trigger concerns and pushback among payers, providers and patients, it's not a bad idea to prove your drug can beat the old guard on cost--or at the very least, match it. And that's just what Johnson & Johnson's ($JNJ) Janssen unit says it's done with Xarelto.

In a recent study, Janssen researchers took a look at the effect of their next-gen clot-buster versus standard therapy warfarin on number of hospitalization days, healthcare resource utilization and cost in more than 4,500 patients with nonvalvular atrial fibrillation. Their findings? On average, the number of hospitalization days, the number of outpatient visits and total costs were "significantly lower" for Xarelto patients, suggesting it's cost-effective compared with warfarin--despite its higher price.

"There's been this conception that warfarin costs pennies," lead researcher Concetta Crivera told FiercePharmaMarketing. "We wanted to take it a step further by holistically including all the healthcare costs."

Now, it'll be up to Janssen to use the data to convert patients away from warfarin--and to potentially leverage the results with payers to build its lead on the competition. A Janssen spokesperson told FiercePharmaMarketing the company "may use the information and share with population health decision makers."

Xarelto currently tops Boehringer Ingelheim's Pradaxa and Pfizer ($PFE) and Bristol-Myers Squibb's ($BMY) Eliquis on the new-age anticoagulant market, and all three drugs enjoy preferred status on major national formularies from pharmacy benefits managers like Express Scripts ($ESRX) and CVS Caremark ($CVS).

But that can change quickly. Just ask GlaxoSmithKline ($GSK) and AstraZeneca ($AZN), who have taken turns bumping one another's respiratory behemoths--Advair and Symbicort, respectively--out of PBMs' top coverage tiers with aggressive discounts.

And if Xarelto can match warfarin's cost of care while beating it on efficacy, then Janssen can not only justify the drug's price, but possibly make a case for exclusive formulary placement. "I think it's informative data to payers … because cost is always a big issue in the healthcare system," Crivera said.

Janssen isn't the only one trying to generate that kind of data now that PBMs are growing increasingly balky. Last month, Novartis ($NVS) announced cost-study results for a heart failure drug that it hasn't even submitted yet for regulatory approval. Its highly anticipated LCZ696 cut ER visits by 30% and reduced hospitalizations by 16% compared with an older standard treatment, elanapril--results the Swiss pharma thinks can eventually help vault it into the blockbuster category.

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