Health and Healthcare

Will a PCSK9 Inhibitor Price Cut Help Drive Lowering LDL-Cholesterol Drug Use?

Jon C. Ogg

Published: May 1, 2018 12:15 pm

Last Updated: January 12, 2020 12:13 am

Regeneron Pharmaceuticals Inc. (NASDAQ: REGN) and Sanofi S.A. (NYSE: SNY) are committing to lowering the price of the anti-cholesterol drug Praluent. The move may sound right up the lines of political pressure to lower drug prices, but the reality is that this may be taking aim to increase market share and to expand the market for the new PCSK9 inhibitor. Unfortunately for Regeneron, its shares hit a 52-week low on the same day.

Praluent inhibits the binding of PCSK9 to the LDL receptor to ultimately lower LDL-cholesterol levels in the blood. Praluent is jointly developed and commercialized by Sanofi and Regeneron under a global collaboration agreement and it is approved in 60 countries.

The prior list price of more than $14,000 per year was a barrier that was preventing as large of an uptake in use. What matters here is that Praluent will become the exclusive PCSK9 inhibitor therapy on the Express Scripts national formulary. According to an earlier report from Dow Jones, the new range will be roughly $4,500 to $8,000. And the agreement only applies to certain Express Scripts customers, covering roughly 25 million total people.

Under terms of the agreement, Express Scripts Holding Co. (NYSE: ESRX) will begin passing on a portion of the Praluent rebates in July of 2018 that it receives from Sanofi and Regeneron directly to people enrolled in participating commercial health benefit plans.

According to the joint Sanofi-Regeneron release:

The agreement significantly simplifies the documentation necessary to secure insurance coverage and may help reduce out-of-pocket costs for eligible patients. Despite having the broadest U.S. formulary coverage of any PCSK9 inhibitor, many patients have been unable to access Praluent because of the complicated utilization management process required by some insurance companies and high patient out-of-pocket costs.

Praluent may be approved in 60 countries, but in the United States it is approved for use as an adjunct to diet and maximally tolerated statin therapy for the treatment of adults with heterozygous familial hypercholesterolemia or clinical atherosclerotic cardiovascular disease who require additional lowering of LDL-C. The press release also reminds readers that the effect of Praluent on cardiovascular morbidity and mortality has not been determined.

The market drop may be limiting some of the hope here, but the price drop also looks severe considering that it may take as many as two Praluent patients under the new pricing to equal the same revenues as one Praluent patient prior to the announcement. Also, this again only pertains to the Express Scripts pool of patients.

Regeneron shares were last seen trading down 2.7% at $295.48 midday Tuesday, in a 52-week range of $295.05 to $543.55. The stock hit a 52-week low on the news.

Sanofi’s American depositary shares were last seen down 0.8% at $39.00. The 52-week trading range is $38.80 to $40.51.

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