Express Scripts Is Already "Talking, Razor Sharp" -- On Keytruda® Pricing -- Even BEFORE Any US FDA NSCLC Approval(s)

In a cleverly nuanced, but multi-faceted approach, the PBMs/payers are already sowing the seeds to drive down immuno-oncology medication (think Anti-PD1L monoclonal antibodies like Merck's pembrolizumab, branded as Keytruda^®) pricing in the US. And those prices are presently very heady. No doubt about it. [Just as Gilead's Hep C pricing was very, very high, for Sovaldi^®, when it entered the US market as a world class life saver.]

So FiercePharma's Tracy Staton makes a great story, this morning -- of the accelerating, muscular and relentless effort to rein in pricing -- perhaps even in advance of first approvals in lung cancer, for our friends at Kenilworth, NJ. Here's a bit:

. . . .The fact that Miller is talking about a "slower" effort doesn't mean it's not imminent. In January, Miller told Bloomberg that Express Scripts wants to see results by next year. "We want to be able to start influencing the market by 2016," he told the news service. "We are accumulating all the keys to the puzzle to be able to do this."

Ironically enough, Miller's comments come on the heels of some pharma earnings reports that include big sales for expensive new cancer drugs. Merck & Co.'s Keytruda is off to a roaring start with $83 million in Q1 sales, and the $150,000-per-year melanoma drug is up for a much bigger use in lung cancer.

Rival Bristol-Myers Squibb already won a second nod in lung cancer for Opdivo, which brought in $40 million for the quarter; it's also a $150,000-per-year med. And Pfizer's Ibrance, launched in February for relapsed breast cancer at $9,850 per month, brought in $38 million in what was left of the first quarter, and it's already making inroads for first-line use.

And these are just three of the newest cancer drugs on the market; as Reuters points out, Amgen's Blincyto for a rare form of leukemia has a list price of $178,000. . . .

We will keep a close eye on all of it. Trust that.