(Bloomberg) — Amgen Inc. (Nasdaq:AMGN) and Sanofi SA (NYSE:SNY), competitors in the market for a new class of cholesterol-fighting drugs, will both have their medications covered by Express Scripts Holding Co. (Nasdaq:ESRX), a decision that ends weeks of uncertainty over whether the benefits manager would cut an exclusive deal to cover only one in exchange for big discounts.
Express Scripts, the largest manager of prescription drug benefits for employers and insurers in the United States, said it would cover both Praluent, from Sanofi and Regeneron Pharmaceuticals Inc., and Repatha, from Amgen, starting Oct. 12. It’s the first major coverage decision for the drugs on a national basis in the United States, and could be a bellwether for determinations by other insurers and benefit managers.
The drugs belong to a class called PCSK9 inhibitors designed to help people with high levels of bad cholesterol who can’t get their condition under control with statins such as Pfizer Inc.’s Lipitor. Payers of insurance benefits have worried they could become one of the costliest drug classes ever, with the potential for $100 billion in annual sales if widely used.
Sanofi and Regeneron’s drug Praluent won approval from U.S. regulators on July 24, while Amgen’s PCSK9 drug Repatha was approved on Aug. 27. Since then, doctors, patients and investors been speculating on how insurers would cover the drugs and what restrictions would be imposed on their use.
The drugmakers aimed to avert the fate of Gilead Sciences Inc. (Nasdaq:GILD), whose hepatitis C treatment Harvoni was excluded in December from Express Scripts’ main list of covered drugs this year in favor of a competing treatment from AbbVie Inc. (Nasdaq:ABBV). That move set off a price war over hepatitis C drugs, with several other insurers and payers covering only the Gilead medicine.
‘Confident in value’
In a statement, Sanofi and Regeneron said they are “pleased that patients in the United States now have increased access to Praluent” and “are confident in the value” their drug provides.
Amgen said in a statement that it was “delighted that Express Scripts has chosen to preserve physician and patient treatment choice.” The company plans to “engage constructively with other payers” over coverage of Repatha, according to the statement.
For months before the drugs were approved, Express Scripts had openly discussed the possibility of only covering one of the drugs if that was what was needed to obtain big-enough discounts. That proved not to be necessary, Chief Medical Officer Steve Miller said.