Monday, September 20, 2010

Merck's Vytorin®/Zetia® Reimbursement Rates Halved -- in New Zealand

Online news sources in New Zealand are reporting this morning that Merck has agreed with PHARMAC, the government regulator in that country, on a new, much lower pricing scheme for Vytorin® and Zetia® (branded as Ezetrol®, in New Zealand) as second-line -- or third-line -- therapies, (i.e., only after normal statins don't do the job in some patients at risk for heart disease).

This will almost certainly crimp worldwide earnings for the franchise -- though it staves off an effectively complete shut-down of the revenue-stream from New Zealand. Wow. Here's the snippet:

. . . .And from 1 October, PHARMAC will also provide greater access to the cholesterol absorption inhibitor ezetimibe (Ezetrol), plus the ezetimibe/simvastatin combination product (Vytorin). The agreement with Merck Sharp & Dohme (MSD) will see the price of ezetimibe reduce by up to a half.

The changes in access will give general practitioners the ability to prescribe ezetimibe, and also widen the type of people who would be eligible for treatment. For atorvastatin, the significantly reduced cost means the restriction on prescribing could be removed.

"As the price of these drugs has come down, this has given us opportunities to make them available for greater numbers of patients," says PHARMAC’s Medical Director Dr Peter Moodie. "[The previously-] higher prices meant having to target access to those patients with greatest need. More than 300,000 New Zealanders are currently prescribed statins and for many of these people atorvastatin will now be an option."

Ezetimibe will continue to be restricted to people whose cholesterol levels haven’t reduced sufficiently using statin drugs alone. PHARMAC estimates about 18,000 people will be using ezetimibe within three years. . . .

And, significantly, all of this price-slashing comes almost three years before IMPROVE-IT results are scheduled to become avalable. The net Vytorin/Zetia revenue swoon continues.

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