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Frustrated by tepid sales and practical stumbling blocks, Regeneron and Sanofi are offering a huge discount on their treatment for bad cholesterol in exchange for a promise that health care’s biggest middleman will make it easier for patients to actually get the drug.

Starting in July, the two companies will sell their cholesterol-lowering drug Praluent, which carries a $14,600 list price, at roughly 60 percent off to clients of Express Scripts, the nation’s biggest pharmacy benefit manager. In exchange, Express Scripts will make their drug the only cholesterol-lowering injection available to the 25 million patients on its formulary, freezing out a rival therapy from Amgen. And, most important, Express Scripts will scrap the weeks of paperwork now required to approve a prescription, and implement a simple form that will allow doctors to get an immediate answer.


ICER, an independent nonprofit that studies whether drugs are worth their price, concluded that Regeneron and Sanofi’s treatment is cost-effective at between $4,500 and $8,000 per year. Express Scripts has negotiated a price “on the low end” of that range, said Dr. Steve Miller, the company’s chief medical officer.

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