What is Repatha?

Repatha (evolocumab) is a monoclonal antibody designed to inhibit PCSK9 and in turn reduce levels of low-density lipoproteins (LDLs) in the cardiovascular system. PCSK9 is a proprotein that is involved in the breakdown of LDL receptors, which impedes the liver from removing LDLs in the bloodstream (Weinreich and Frishman, 2014). A clinical trial (NCT01764633) showed that Evolocumab reduced LDL cholesterol by 59% compared to a placebo across 48 weeks (Hamilton, 2017). Repatha is recommended to be used alongside statins for the most effective treatment in reducing cholesterol.

Repatha vs Praluent

In October 2018, Amgen announced that it would be cutting the list price of its PCSK9 inhibitor drug Repatha from $14,520 to $5,850 by the end of 2020 (FiercePharma, 2019). One year later, Amgen has now announced that this price change will now be effective as of January 2020 (Amgen, 2019).

This comes amidst a pricing battle with Amgen facing fierce competition from Sanofi and Regeneron who have also announced price cuts to their own PCSK9 biologic, Praluent (Pagliarulo, 2019). Both drugs have failed to meet the revenue expectations since their launch four years ago, this is mainly due to their original high list price.

The following data shows how revenue of PCSK9 inhibitors have varied over the past 2 years. Despite units sold increasing substantially, the graph shows that this has been offset by the heavy discounts awarded to the drugs. Repatha has maintained around a 70% market share of the PCSK9 class.

Sales of Repatha and Praluent Final

References:

Amgen (2019). Amgen To Make Repatha® (evolocumab) Available Exclusively At Its Lower List Price Option In 2020.

FiercePharma. (2019). For sale: Amgen chops 60% off Repatha's $14,520 retail price. [online] Available at: https://www.fiercepharma.com/pharma/amgen-discounts-repatha-due-to-competition [Accessed 12 Nov. 2019].

Hamilton, P. (2017). Evolocumab and clinical outcomes in patients with cardiovascular disease. Annals of Clinical Biochemistry: International Journal of Laboratory Medicine, 54(4), pp.511-511.

Kazi, D., Moran, A., Coxson, P., Penko, J., Ollendorf, D., Pearson, S., Tice, J., Guzman, D. and Bibbins-Domingo, K. (2016). Cost-effectiveness of PCSK9 Inhibitor Therapy in Patients With Heterozygous Familial Hypercholesterolemia or Atherosclerotic Cardiovascular Disease. JAMA, 316(7), p.743.

Pagliarulo, N. (2019). Regeneron, Sanofi cut PCSK9 list price, matching earlier move by rival Amgen. [online] BioPharma Dive. Available at: https://www.biopharmadive.com/news/regeneron-sanofi-cut-pcsk9-list-price-matching-earlier-move-by-rival-amge/548147/ [Accessed 12 Nov. 2019].

Weinreich, M. and Frishman, W. (2014). Antihyperlipidemic Therapies Targeting PCSK9. Cardiology in Review, 22(3), pp.140-146.