Credit: Shutterstock photoPharmacy benefit manager Express Scripts ESRX announced that it will include two new cholesterol-lowering drugs - Regeneron/Sanofi's REGN / SNY Praluent and Amgen's AMGN Repatha - on its National Preferred Formulary.
Both the drugs are first PCSK9 inhibitors that were approved earlier in 2015 in the U.S. The drugs are approved for use in patients with clinical atherosclerotic cardiovascular disease and heterozygous familial hypercholesterolemia who need additional lowering of LDL cholesterol.
Repatha has also been approved for the rarer homozygous familial hypercholesterolemia. Patients suffering from high cholesterol had been dependent on statins. However, the long-term effect of lowering LDL with the usage of these drugs has yet to be proven.
Inclusion of the drugs in the formulary will give approximately 25 million Americans access to the drugs at the best possible price. Express Scripts stated that it has implemented its Cholesterol Care Value (CCV) program using clinical documentation, whereby needy patients can have access to drugs with minimal risk and at an appropriate cost.
While Praluent is priced at an annual cost of $14,600, Repatha comes at a cost of $14,100. The company will have access to the drugs at a discounted rate. Consequently, National Preferred Formulary clients will spend approximately $750 million on PCSK9 inhibitors in 2016 on a collective basis, much lower than industry estimates. Meanwhile, Express Scripts plans to cap the entire plan cost in 2016 for PCSK9 inhibitors for clients enrolled in the CCV program, thereby providing additional long-term protection to its payers and patients.
The news will be a big boost for both the drugs as Express Scripts decided to include both in the plan. Consequently, a large number of patients can access both the drugs at better prices. We remind investors Express Scripts chose hepatitis C treatment Viekira Pak over Sovaldi in Dec 2014 leading to a pricing war between the two.
Express Scripts believes that there is urgent need to tightly manage pharmacy benefit, implement smarter formularies, control compounded medication use and offer appropriate clinical support to ensure best possible treatments for patients at lower prices.
Express Scripts currently carries a Zacks Rank #3 (Hold). A better-ranked stock in the health care sector is Abbott Laboratories ABT , with a Zacks Rank #2 (Buy).
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The views and opinions expressed herein are the views and opinions of the author and do not necessarily reflect those of Nasdaq, Inc.
