Regeneron boosted, rival Esperion slammed as investors scramble to catch up to a PCSK9 price war

The big news over the weekend headlined at #ACC18 in Orlando, as Regeneron $REGN and Sanofi $SNY pulled the covers off of data showing that their PCSK9 drug Praluent saved lives, while significantly cutting cardio risks for patients. And they immediately followed up with a major price discount for insurers which would drop the various boobie traps meant to stop members from getting their hands on the drug.

Shareholders loved it. Regeneron stock was boosted by 2.6% early Monday in pre-market trading.

Amgen $AMGN, which has been struggling to sell Repatha and failed to show a mortality benefit in its big cardio outcomes study, likely didn’t like it at all. Leerink put out a note this morning that the pharma giant is prepping a marketing counterstroke, likely offering a discount as well as the price war gets serious. Praluent may have the better data now, but both drugs are considered remarkably alike in many respects.

The big loser so far Monday morning is Esperion $ESPR, which made the unusual decision to start competing on price well ahead of the wind-up to its Phase III later this year for its rival LDL drug. Its share took a beating, dropping 14% — and that’s after the first successful Phase III study was released a few days ago, showing that it could cut LDL, but not as well as the PCSK9s.

But we already knew that.

Esperion is working to carve out a big niche for itself among payers who prefer a less expensive pill to take, but with Regeneron/Sanofi going down as deep as $4500, Esperion may have to dig deeper on the price.

Finally, there’s The Medicines Company $MDCO, which is all in on their own experimental RNAi LDL therapy — inclisiran — that could prove effective with just a couple of shots a year. Given insurers’ willingness to put up with any inconvenience for patients required to rein in costs, The Medicines Company is also under added stress as prices plunge, but its many supporters cheered the validation on effect and had no problems that ICER endorsed a $4500 to $8000 price for high-risk patients with LDL greater than 100 mg/dL.

The first response was good. The biotech’s shares were up about 4% in pre-market trading.

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