(Adds Amgen and analyst comment, in paragraphs 6-7)
Aug 1 Express Scripts Holding Co, the
largest U.S. pharmacy benefit manager, said on Friday it will
remove an additional 25 products from its list of preferred
drugs in 2015, including anemia drugs Epogen and Aranesp, sold
by Amgen Inc.
But it will still cover Procrit, a similar anemia drug sold
by Johnson & Johnson, on the list, known as a formulary.
"The products we have chosen to exclude from our formulary
are those that cost significantly more than other available
options but that fail to provide additional health benefit," the
company said in an emailed statement.
Express Scripts, which like other pharmacy benefit managers
administers prescription drug benefits for employers and health
plans, said patients who fill a prescription for an excluded
drug will pay the full retail price.
Epogen and second-generation drug Aranesp have been hugely
profitable for Amgen. Their use has waned in recent years due to
safety concerns, including increased risk of heart problems, but
they still generated U.S. sales of $2.7 billion last year.
Amgen, in an emailed statement, said it does not contract
for Epogen in the retail sector, and use of Aranesp in the
retail setting is significantly less than in hospitals or
RBC Capital Markets analyst Michael Yee estimated that
Amgen's anemia drug sales through Express Scripts account for
less than 1 percent of U.S. sales.
Amgen contracts directly to supply Epogen to kidney dialysis
providers DaVita Healthcare Partners Inc and Fresenius
Medical Care AG. Aranesp, like Procrit, is used to
treat anemia in cancer patients and chronic kidney disease
patients who are not undergoing dialysis.
All three are bioengineered forms of a human protein that
stimulates production of red blood cells.
Express Scripts has been a vocal critic of rising
prescription drug prices. For 2014, it excluded coverage of
certain specialty drugs from five therapeutic categories,
including multiple sclerosis. It has also criticized the $84,000
cost of Sovaldi, the hepatitis C treatment introduced in
December by Gilead Sciences Inc.
For 2015, Express Scripts said, it will no longer cover
Incivek, an older hepatitis C drug sold by Vertex
Pharmaceuticals Inc, and plans to make a determination
on Sovaldi "once clinically equivalent competitors" are approved
by regulators in coming months.
Other drugs excluded next year are a testosterone gel and
extended release Zohydro, a long-acting opioid painkiller sold
by Zogenix Inc.
"Of the more than 4,000 drugs available to patients, only 66
will be excluded from our 2015 formulary," the company said.
Express Scripts said it knows that there are rare instances
when a patient may require one of the excluded drugs, and it has
a process for physicians to pursue in those cases.
The company, which has nearly 25 million people on its
preferred formulary, can drive enormous revenue toward
drugmakers whose products it selects.
(Reporting by Deena Beasley; Editing by Jonathan Oatis and