The list price for evolocumab (Repatha) will drop to $5,850 per year, a roughly 60% decrease from the original list price of $14,523, .
The move was billed as improving patient copays, especially for Medicare patients.
"Concerns over out-of-pocket costs have proven to be a barrier to its use for too many patients," Robert Bradway, chairman and chief executive officer at Amgen, said on a conference call.
However, the price cut won't take effect immediately for all patients. To ensure a "smooth transition," evolocumab will continue to be offered with the current drug code and price, Bradway noted, with the hope that demand will shift so that the changeover is complete by the end of 2020.
Fully 75% of patients prescribed the PCSK9 inhibitor never actually fill the prescription, mainly due to high out-of-pocket costs, he said. Copays have been in the range of $280 to $370 per month for Medicare Part D patients but should drop to $25 to $150 per month, Bradway said.
The new price point would put evolocumab within the $5,404 to $7,735 that the non-profit Institute for Clinical and Economic Review (ICER) initially said would be cost-effective when the drug was approved. However, after the FOURIER outcomes trial showed relatively small reductions in major adverse cardiovascular events and no reduction in mortality with the drug, ICER said that the price would need to be dropped to $4,215 per year to meet a willingness-to-pay threshold of $100,000 per quality-adjusted life-year.
PCSK9 inhibitor manufacturers have announced a variety of deals with payers that discounted the original list price of $14,523 in exchange for formulary access or exclusivity. While that has brought the average price down to the same range as Amgen's new list price for many insurers, it couldn't tackle the copay problem for Medicare Part D beneficiaries.
The change will be effected by rolling out new national drug codes for evolocumab in the coming days, leaving the drug identical in every way to that currently available but with new product shipped out in boxes with a new bar code that will ring up at the new price.
Medicare Part D plans are designed in the spring, so the announcement may have missed the boat for 2019. But off-cycle changes are a possibility, Murdo Gordon, executive vice president of Amgen's global commercial operations, noted on the telebriefing.
The move comes as the Trump administration and Health and Human Services have been pushing for lowering drug list prices, including a proposed rule forcing companies to include the list price in TV advertising for costlier drugs.
While Gordon said Amgen's decision "predates the most recent actions and discussion from HHS or administration," Amgen's press statement played up the move as supporting the Trump administration's goal.