Amgen Announces 60% Reduction in List Price of PCSK9 Inhibitor Evolocumab

In alignment with the American Heart Association’s Value in Healthcare Initiative, Amgen has announced that the price of its proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor, evolocumab (Repatha), will be reduced by 60%, from an annual price of $14,100 down to $5850.

Evolocumab was approved in 2015 for use in addition to diet and maximally-tolerated stain therapy in adult patients with heterozygous familial hypercholesterolemia, homozygous familial hypercholesterolemia, or clinical atherosclerotic cardiovascular disease, such as heart attacks or strokes, who require additional lowering of low-density lipoprotein cholesterol. It’s staunch competitor, Sanofi-Regeneron’s alirocumab (Praluent), was approved just a month prior to treat patients with familial hypercholesterolemia, as well as high-risk patients with demonstrated heart disease whose cholesterol has not been controlled with maximally tolerated statins.

However, the launch price of these drugs was a point of contention and debate for a while. Alirocumab also had an annual price tag of over $14,000.

An early report from the Institute for Clinical and Economic Review (ICER) proposed that the PCSK9 inhibitors should cost 85% less than what they were listed at. “Our draft report suggests that $2177 is the price that should serve as an alarm bell—if the cost is more than $2177 a year, drug companies, doctors, insurers, and other parties may need to work together to determine ways to limit the use of these drugs, find savings in other parts of the health care system, or adopt other measures to help make these drugs more affordable,” Steven D. Pearson, MD, MSc, the founder and president of ICER, had said about their analysis.

Earlier this year, Sanofi and Regeneron announced a deal that the companies struck with pharmacy benefit manager (PBM) Express Scripts, under which alirocumab was included in the PBM's National Preferred Formulary and would cost much less than it's $14,000 annual price tag for patients who purchase the drug through Express Scripts.

In a press release, Amgen’s chairman and CEO, Robert A. Bradway pointed out that patient out-of-pocket cost burden is a big barrier to access for the significant number of patients who suffer from cardiovascular disease—including 75% of Medicare patients who are prescribed a PCSK9 inhibitor but never fill the prescription because of the price burden. “We want to make sure that every patient who needs Repatha gets Repatha,” Bradway said.

Amgen has been offering payers significant rebates on Repatha in exchange for improved patient access through tactics such as healthcare utilization management criteria. Additionally, agreements with payers representing greater than 65% of Repatha's commercial revenue are currently in place, according to the release.

“Higher rebates don’t typically result in lower out-of-pocket costs for patients, especially for Medicare patients,” said Murdo Gordon, executive vice president of Global Commercial Operations at Amgen. “We are confident today's action will address this challenge.”

Evolocumab’s original list price of $14,000 is expected to be phased out by late 2020.