- Major U.S. health insurer Cigna has signed value-based pricing deals for two new cholesterol drugs, adding to market momentum for tying drug prices to patient outcomes.
- The deals, signed separately with Amgen, and Sanofi/Regeneron, will link the prices of the PCSK9 drugs Repatha and Praluent to patient cholesterol levels. If patients’ LDL-C levels fail to decrease by at least as much as the reductions seen in clinical trials, the companies will further discount the drugs.
- Both drugs have shown significant efficacy in reducing “bad” cholesterol, but list for roughly $14,000 in the U.S.
While these two deals are the first value-based agreements for the PCSK9 drugs, pay-for-performance deals have been gathering steam for some time.
Earlier this year, Cigna and Aetna both struck a similar agreement with Novartis for its heart drug Entresto. And last year, AstraZeneca signed a deal with the pharmacy benefit manager pegging the performance of its lung cancer drug Iressa to patient adherence, according to The Wall Street Journal.
Value-based pricing could be one effective solution to counteract steadily increasing prices and prescription drug spending, which hit $425 billion in the U.S. last year according to IMS data.
“If Cigna's customers aren’t able to reduce their LDL-C levels at least as well as what was experienced in clinical trials, the two pharmaceutical companies will further discount the cost of the drugs,” the company said in a statement. “If the drugs meet or exceed expected LDL-C reduction, the original negotiated price remains in place."
Repatha and Praluent were approved by the FDA last year for treatment of hypercholesterolemia which cannot be controlled with high-potency statins. In clinical trials for both drugs, patient LDL-C levels declined by roughly 60%.
Despite the high efficacy, both drugs have seen sluggish sales since their respective launches. In the U.S., some insurers and benefit managers have been leery of their high prices.