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Cholesterol Drug Price Competition

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by Jenny Bingham, PharmD, BCACP; Heather Lee, PharmD Candidate; Mitchell Welton, PharmD Candidate

In such a competitive cholesterol medication market, manufacturers have been forced to make drastic cuts to their medication costs. Amgen lowered its product by 60%, followed by a 45-70% reduction from Regeneron. The price reductions occurred in response to the national consumer’s options to trial a multitude of more affordable options for cholesterol management, based on their clinical goals.

To better understand each product, a comparison should be made between each medication’s indication, effectiveness, and price.

Praluent

Praluent is an adjunct for patients who have uncontrolled cholesterol levels despite the presence of high intensity statin therapy.1 It is indicated for patients with atherosclerosic cardiovascular disease (ASCVD) who would benefit from an additional reduction of low-density lipoprotein (LDL) cholesterol. Praluent has been reported to reduce cholesterol levels by >=40% of patients who taking a maximally tolerated dose of statin.2 It was also reported to be effective at reducing cardiovascular outcomes and all-cause death by 15% in patients who have acute coronary syndrome.3 The primary patient population that would obtain the most benefit from Praluent are patients who have high LDL cholesterol levels.3 A recent price reduction by Regeneron and Sanofi occurred in May 2018. The price decreased from $14,600/year to a range of $4,500 to $8,000/year via rebate.4

Repatha

Repatha is indicated for the treatment of hyperlipidemia and has been reported to reduce the risk of heart attack and stroke.6 Evidence demonstrates the potential for plaque reduction if used with statin therapy. Amgen recently followed suit with lowering the price of Repatha after competitors Regeneron and Sanofi lowered the price of their competing product as mentioned above. Prior to the lowered cost in October the annual price of Repatha was $14,100/year. Amgen initially offered a prescription savings card for eligible patients, however patients with federal, state, or government-funded healthcare insurance were excluded. The new cost is $5,850/year, a nearly 60% decrease in cost. Amgen recently announced new opportunities for Medicare patients to benefit from therapy as the result of the price cut. 7

What to Ask Your Provider and/or Pharmacist

With the new, more affordable prices, you might be curious if these medications are best for your cholesterol management and cardiovascular health. It’s important to maintain routine appointments with your provider to ensure your cholesterol levels are monitored appropriately. Based upon your lab results and medication history, your provider and/or pharmacist may deem it appropriate to trial one of the above noted medications. However, it’s also important to adhere to provider recommendations about lifestyle changes, like diet and exercise.

References:

  1. Accessdata.fda.gov: https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/125559Orig1s000lbledt.pdf. Published 2018. (accessed 29 Nov 2018)
  2. Alirocumab (Praluent) to Lower LDL-Cholesterol. JAMA. 2015;314(12):1284. doi:10.1001/jama.2015.11372
  3. American College of Cardiology: https://www.acc.org/latest-in-cardiology/articles/2018/03/05/15/53/sat-9am-odyssey-outcomes-cv-outcomes-with-alirocumab-after-acs-acc-2018 (accessed 29 Nov 2018)
  4. CNBC. https://www.cnbc.com/2018/05/01/regeneron-sanofi-chop-cholesterol-drug-price-in-express-scripts-pact.html. Published 2018. (accessed 29 Nov 2018)
  5. Repatha (Evolocumab Injection, for Subcutaneous Injection): Side Effects, Interactions, Warning, Dosage & Uses. (n.d.): https://www.rxlist.com/repatha-drug.htm#indications.
  6. CBS News: https://www.cbsnews.com/news/drug-repatha-with-a-statin-could-help-reverse-heart-disease/ (accessed 4 Dec 2018)
  7. CNBC: https://www.cnbc.com/2018/10/24/amgen-cuts-price-of-cholesterol-drug-by-almost-60percent.html (accessed 4 Dec 2018).

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