Sandoz Sets Ziextenzo Price 37% Below WAC for Reference Neulasta

According to reports, Sandoz has set a price of $3,925 for a 6- mg dose of its new pegfilgrastim biosimilar Ziextenzo™. Based on this pricing, the third biosimilar pegfilgrastim will undercut the wholesale acquisition cost (WAC) of Neulasta® by 37%.

Of course, WAC pricing does not include further discounts or rebates, so we evaluated the average sales price (ASP) (which does) for each of the biosimilar products and reference Neulasta. The Centers for Medicare and Medicaid Services’ latest ASP list (released October 30) was based on data through the second quarter of 2019. This includes Coherus Bioscience’s Udenyca®, as 6 months of sales data were now available to list its initial ASP.

As shown below, Mylan’s Fulphila possessed the lowest ASP pricing, at $3928.92 (calculated as $327.413 for 0.5 mg dose, multiplied by 12 to obtain pricing for equivalent 6-mg doses). The WAC price for Ziextenzo is therefore just below the ASP for Fulphia and 9% below the WAC for both Fulphila and Udenyca.

PRICING COMPARISON FOR PEGFILGRASTIM REFERENCE AND BIOSIMILARS

Product WAC* ASP
Neulasta $6,231 $4,432
Udenyca $4,175 $4,165
Fulphila $4,175 $3,929
Ziextenzo $3,925 N/A
*WAC information for Neulasta, Udenyca, and Fulphila from Prime Therapeutics. ASP information from CMS, calculated based on 6-mg dose.

UnitedHealthcare announced earlier this year that it has decided to cover Amgen’s filgrastim and pegfilgrastim reference products and exclude the biosimilars. Speculation is widespread that this coverage was achieved through a portfolio contracting approach (i.e., even greater discounts and/or rebates were offered by Amgen for covering their short-acting and long-acting agents). Sandoz is now the sole biosimilar source for both filgrastim and pegfilgrastim and could also potentially utilize the portfolio approach.

The real question is whether Sandoz’s entry into the pegfilgrastim market will spur further discounting by Mylan and Coherus, the latter of which recently announced it reached 19% marketshare and hopes to maintain its sales momentum into 2020.

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