AstraZeneca's flat pricing model for Crestor has helped the company secure positions on managed care formularies that apply to more than 50% of covered lives, VP-Primary Care Cardiovascular Adele Gulfo said Oct 2.

"We did an extensive amount of research with our customers, they are very pleased that we listened to them, we have a responsible price, and...by Sept. 15, we had secured positions on national plans and PBMs that influence over 50% of lives," Gulfo said at the company's business review in Wilmington, Del.

Crestor's "value proposition" is "resonating extremely well" with managed care, Gulfo said. "Almost every plan has shown an immediate receptivity 'yes, we like what we see and we see the efficacy value and we also see the cost value that you're bringing to us.'"

"They still have to go through their formulary process to land on the actual tier one, tier two, tier three. The early read is that they see us, certainly not being disadvantaged in any of the plans, and perhaps even advantaged in some."

Wellpoint is one payor that has already determined coverage; the health insurer has designated non-formulary status for Crestor based on lingering concerns over liver enzyme levels.

AstraZeneca launched Crestor (rosuvastatin) at an average wholesale price of $2.63 per pill across the dose range of 5 mg-40 mg. The company calculated the cost as 12% less than the average weighted price per day of $3.10 for Pfizer's top-selling competitor Lipitor (¹ Also see "AstraZeneca Crestor 10 Mg Starting Dose Priced At 12% Discount To Lipitor" - Pink Sheet, 18 August, 2003., p. 3).

"While the majority of patients will be controlled at the low 10 mg dose, those patients who need higher doses are not required to pay a premium to reach their target cholesterol levels," she said. "This is not so with other statins."

"Crestor has a lower average cost to achieve a 1% point reduction in LDL-C across the dosage range," she said. "Crestor combines clinical and economic value for payors, providers and patients."

The average annual cost per unit of LCL-C lowering for Crestor 10 mg is $16.72, compared to $19.66 for Lipitor 10 mg, $27.11 for Merck's Zocor 10 mg and $44.04 for Bristol-Myers Squibb's Pravachol 10 mg, according to AstraZeneca's calculations.

Pre-launch activities enabled AstraZeneca to quickly launch Crestor, Gulfo said. "Within five days of approval, we had orders from over 90% of pharmacies and had reached fully stocked status in just eight days," which surpassed the company's internal benchmark set by its last major primary care product launch, Nexium .

"This was critical, as it enabled us to capitalize on our early managed care wins and catch the competition off-guard," she said. At the end of the first week of launch, more than 18,000 prescriptions had been written for Crestor, representing a 1% share of new prescriptions.

The prescription numbers go beyond AstraZeneca's sampling effort, which delivered 30-day samples to three-quarters of the "highest-opportunity prescribers" between Crestor's Aug. 12 approval and Sept. 15 field sales force launch.

The "Reach for Crestor" program has since ended. "Within the next few weeks or so, those patients will be completed with their full month supply and will be back in the doctor's office," Gulfo said. AstraZeneca has since moved to a more traditional seven-day pack.

In the pre-launch period, Crestor had roughly double the share of detailing voice than other cholesterol-lowering drugs, Gulfo said. For the week ending Aug. 29, Crestor held a 30% share of voice, compared to about 18% for Zocor, 16% for Lipitor, 12% for Merck/Schering-Plough's Zetia and 7% for Pravachol.

While Crestor scripts have been picking up, CEO Tom McKillop acknowledged that "Lipitor isn't going to fall off a cliff," since most patients who are stabilized on Lipitor will continue using that product.

AstraZeneca is developing a consumer-directed promotional campaign that will highlight "the feeling of compromise and failure many consumers apparently experience" when needing to titrate up doses of other statins to reach cholesterol goals, Gulfo said.

AstraZeneca's APOLLO continuing medical education program to increase the "level of knowledge around the need for more aggressive treatments based on new cholesterol guidelines" has reached more than 100,000 health care professionals, Gulfo said. AstraZeneca has also trained 1,200 speakers through the "Crestor National Educators Network."

Crestor Flat Pricing Helps AstraZeneca Secure Coverage For 50% Of Lives

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