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Shortly before Regeneron Pharmaceuticals won the right last year to sell a new drug for severe eczema, the company’s chief executive promised to price the medicine “responsibly” in order to avoid the anger over high drug prices. At first blush, he appeared to have succeeded – the $37,000 price tag for Dupixent was in line with an evaluation by a closely followed cost-effectiveness watchdog.

But a year later, the effort has not produced all of the desired results. Regeneron has, indeed, escaped public criticism for its pricing, which is something of a moral victory for Dr. Len Schleifer, the outspoken chief executive. However, a majority of physicians report that access to the medicine is still being “tightly controlled and restricted” by payers, according to a newly released survey of dermatologists by Leerink analysts.

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The struggle over patient access is significant because Dupixent is a major growth driver for Regeneron — and its partner, Sanofi — and the payer roadblocks prompted some on Wall Street to lower sales estimates for the medicine. Leerink looks for Dupixent sales to reach about $4 billion by 2021. Meanwhile, the pushback has also weighed on Regeneron stock.

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