- Novartis launched its promising heart failure drug Entresto in July 2015, but sales to date have disappointed, confounding more optimistic forecasts. Sales in the first six months were $21 million, with only $5 million coming in the fourth quarter.
- This is far short of the $126 million predicted by analysts, according to the Wall Street Journal.
- Part of the delay may be tied to extended review time by payers before putting newly approved drugs on formularies. In January, Novartis’ pharmaceutical head David Epstein suggested slower reimbursement by payers and Medicare in the U.S. slowed sales.
Despite the disappointing start, Novartis expects newly signed agreements with U.S. payers should help drive sales and expand access beginning in early 2016. Entresto also offers superior results to the standard-of-care for heart failure, which affects 5.1 million Americans.
In clinical trials, Entresto was tested head to head with the beta blocker enalapril. The new drug significantly lowered CVD-related hospitalization and death risk, along with a drop in all-cause mortality by 16%.
Novartis is clearly confident about Entresto’s long term prospects. The Swiss drugmaker recently signed two pay for performance deals with the major U.S. insurers Cigna and Aetna. In Novartis’ agreement with Cigna, the price of Entresto will be tied to the reduction in the proportion of Cigna customers with heart failure hospitalizations. The details of the Aetna deal were not specified, but it was similarly value-based.
Milton Packer, an investigator in the Entresto trials, told the WSJ that cardiologists in general tend to be slow in taking up new heart meds. It took five years for physicians to fully adopt beta-blockers, despite the fact that they had been proven effective.
Things may be looking up, however. Three-quarters of all eligible U.S. patients are covered in the event they are prescribed Entresto. Priced at roughly $4600 a year, the drug is also cheaper than other new classes of drugs entering the market.
Novartis needs a win, and it's looking to Entresto, as well as its new psoriasis drug Cosentyx to bolster the company against lost revenues from Gleevec. The blood cancer drug generated more than $4.5 billion in revenues last year but is facing generic competition.