Regeneron in Express Scripts’ Sights for Price War

After igniting a price war over hepatitis C medicine that has roiled the pharmaceutical industry, Express Scripts Holding Co. is looking to reap savings from expensive new treatments for cancer and high cholesterol.

A highly anticipated set of medications that aggressively reduce cholesterol, known as PCSK9 inhibitors, will be the next big opportunity to pit drugmakers against each other to reduce costs, Chief Executive Officer George Paz told investors today. That represents a threat to the revenue of companies like Amgen Inc. and Regeneron Pharmaceuticals Inc. that are developing the drugs. Drugmaker stocks sank lower today on Paz’s comments.

Just as hepatitis C treatments by Gilead Sciences Inc. and AbbVie Inc. were approved by regulators within a span of weeks last year, the cholesterol drugs are likely to debut about the same time, Paz said. That would give an advantage to Express Scripts, which negotiate prices on behalf of insurers and corporations.

Paz’s company negotiated an undisclosed discount with AbbVie to include only its hepatitis C drug on its national list of covered medications, leaving out Gilead’s treatment. Gilead has fought back by winning its own exclusive deals with CVS Health Corp. and Anthem Inc.

Yesterday Prime Therapeutics LLC, which manages medicine for non-profit Blue Cross and Blue Shield plans, said it didn’t bother negotiating an exclusive discount with either company because prices for both drugs had fallen so much below their list prices -- $94,500 for a full course of Gilead’s treatment and $83,319 for AbbVie’s.

Gilead’s Fall

Gilead slumped 4.2 percent to $96.99 at 2:39 p.m. in New York. The shares are down 11 percent since Dec. 19, when AbbVie announced it would sell its hepatitis C drug at a discount.

“If it weren’t for our moves, we wouldn’t be realizing the savings that will come to all of our competitors,” Paz said at the JPMorgan Healthcare Conference in San Francisco.

It’s premature to speculate on prices, Cuyler Mayer, an Amgen spokesman, said in an e-mail. Alexandra Bowie, a spokeswoman for Regeneron, didn’t immediately respond to requests for comment.

“We’re seeing payer activism for the first time,” said Tim Mayleben, CEO of Esperion Therapeutics Inc., which is working on a competing cholesterol medication. “It’s changing all the dynamics.”

Mayleben said Esperion’s drug will be priced in between PCSK9s and cheaper generics, helping insulate it from Express Scripts’ move. The company’s treatment is more attractive for some patients because it’s taken orally, while PCSK9s are injected, he said in an interview.

Cancer Next?

Express Scripts, the biggest of the drug-benefits managers, is also looking further ahead to high-priced medicine for cancer after it tackles the cholesterol market.

“That’s the short-term, and cancer is the long-term,” Paz said.

Amgen’s leukemia drug Blincyto will cost $178,000 for a standard course of treatment, the company said last month. Merck & Co. plans to charge about $150,000 a year for cancer drug Keytruda.

Shares of Amgen, based in Thousand Oaks, California, and Regeneron, based in Tarrytown, New York, slipped after Paz’s comments. Amgen fell less than 1 percent to $154.93, down from a 3 percent gain earlier in the day. Regeneron slid 1.2 percent after having traded as much as 2.9 percent higher. The S&P 500 Pharmaceutical Index fell 0.9 percent.

Express Scripts, based in St. Louis, rose less than 1 percent to $83.31.

(Corrects to show Prime didn’t negotiate for an exclusive discount in fifth paragraph.)
Before it's here, it's on the Bloomberg Terminal.
LEARN MORE