Esperion Targets $10 a Day for Heart Pill to Undercut Rivals

(Bloomberg) -- Esperion Therapeutics Inc., racing to bring its first product to pharmacy shelves, may have found a way to jolt the stagnant market for heart-disease drugs: by undercutting the price of its more powerful rivals.

Even before Esperion knows whether bempedoic acid is effective, the company has formulated a strong position on the drug’s potential price and discussed it with insurers, Chief Executive Officer Tim Mayleben said in an interview Friday. The upshot: It will cost $9 to $10 a day, or less than $4,000 a year.

That’s a fraction of the $14,000-a-year list price of Amgen Inc.’s Repatha, or Praluent from Regeneron Pharmaceuticals Inc. and Sanofi, two injected medicines that are significantly more potent than bempedoic acid. The demand for those medications has stalled, in part because of roadblocks from insurers concerned about the impact the price will have on their budgets, Mayleben said. It’s a hurdle he wants to avoid.

“Patients can’t benefit from therapies they don’t have access to,” Mayleben said. “It’s a challenging environment. If we don’t price appropriately for the long term, our industry isn’t successful and patients can’t get access.”

Pharmaceutical costs have been surging for years, outpacing inflation and drawing the ire of lawmakers and health policy officials. Most companies have continued to push the envelope, pricing innovative new medicines at ever-higher levels. But bempedoic acid is easier to make and more convenient for patients because it’s a pill rather than an injection, which will enable Ann Arbor, Michigan-based Esperion to buck the trend, Mayleben said.

Other oral drugs taken once a day to lower cholesterol levels have been cost-effective for payers, physicians and patients at about the $9 to $10 a day mark, and provided a good return for the companies that introduced them, he said. “We think that’s the right range for us to be in,” he said.

Esperion will report data from five different phase 3 trials of bempedoic acid between now and the end of September, with the first coming before the middle of March. Analysts anticipate that readout to set an optimistic tone ahead of the more important data coming in May, which includes longer-term safety information that will help them gauge the value of a drug they say has the potential to generate $2 billion in annual sales.

Bempedoic is far less powerful than Repatha or Praluent, which can slash levels of LDL, the so-called bad cholesterol, by 60 percent or more. Repatha has also been shown to reduce complications such as heart attacks by 15 percent, with data on Praluent expected to come next month at the American College of Cardiology meeting. Esperion’s bempedoic acid is half as powerful, reducing levels of LDL by less than 30 percent in initial trials.

Amgen declined to comment, and Regeneron didn’t immediately respond to a request for comment.

Studies Underway

Doctors aren’t likely to embrace Esperion’s drug until longer studies that definitively prove it reduces complications including heart attacks and deaths are completed. Those studies won’t be completed until early 2021 or 2022, Mayleben said.

The CEO said that most of the 13 million people with high cholesterol levels the company is targeting don’t need the power of PCSK9 inhibitors like Repatha and Praluent, and shouldn’t overpay as a result. In fact, 9.5 million of them could hit their target cholesterol levels with a drop of less than 30 percent, he said.

“Not everybody needs an additional 60 percent LDL lowering,” he said. “That’s not a cost-effective solution for most patients. The PCSK9s are great drugs for people who have dramatically high LDL levels and can tolerate the therapies, but they certainly aren’t for everybody.”

--With assistance from Bailey Lipschultz

To contact the reporters on this story: Michelle Fay Cortez in Minneapolis at mcortez@bloomberg.net, Rebecca Spalding in New York at rspalding@bloomberg.net.

To contact the editors responsible for this story: Drew Armstrong at darmstrong17@bloomberg.net, Mark Schoifet

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