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The report says Esperion, which plans to set a $3 500
list price for bempedoic acid, believes it can play interloper.
The list prices of PCSK9 treatments, which currently exceed
$14 000 a year, have limited their use in the three years since
they hit the market. Esperion’s drug doesn’t lower LDL
as well as PCSK9 blockers, which can roughly halve bad
cholesterol levels, but it would be cheaper and wouldn’t
require an injection.
But cracking the market may not be so simple. Earlier
this year, Sanofi and Regeneron struck a deal with Express
Scripts in which they’ll discount their drugs by more than
50% in exchange for an easier path to patients. And, last
week, Amgen made an unprecedented move to slash the list
price of its treatment to $5 850 a year by 2020. According
to the report, that could create a difficult market dynamic
for Esperion. Zetia prescriptions, like statins, are practically
free for patients with insurance, and each has an established
effect on preventing heart attacks and strokes in the long
term. The PCSK9 treatments have demonstrated dramatic
long-term benefits of their own, and their impending price
decreases could put them within reach of more patients than
ever before.
Bempedoic acid has established that it can reduce LDL
cholesterol levels, but its effects on cardiovascular health
won’t be known until a 13 000-patient trial reads out in 2022.
That could leave Esperion struggling to make its case in a
crowded market.
‘I’m still not totally convinced that there’s an obvious
place for this drug,’ said Dr Ethan Weiss, a cardiologist at
the University of California – San Francisco Medical Centre,
who wasn’t involved in the study. ‘We have a good drug with
modest efficacy in statins, and then two drugs with significant
efficacy in PCSK9. If you’re a marketer, I don’t know where
you aim your gun at this one.’
The report says Esperion believes bempedoic acid will
have plenty of room to compete. Despite the established
benefits of PCSK9 therapy, only about 20 000 people are
getting the drugs, Esperion CEO Tim Mayleben said. And
that suggests there’s pent-up demand for an alternative.
‘There are 13 million people in the US who have elevated
LDL cholesterol levels and have had a cardiovascular event
and need more cholesterol lowering,’ Mayleben said. ‘The
fact that the price of PCSK9s is being lowered, that’s great.
But it’s still almost twice the list price of our drug.’
Source: Stat News report 2018