Valeant's Siliq price undercuts rivals to offset black box warning

Valeant is to offer its new Siliq psoriasis drug at a lower price than rivals - largely because it carries black box warning of risks for patients with suicidal thoughts or behaviour.

Siliq (brodalumab) is in the IL-17 inhibitor therapy class and a direct rival to Novartis’ Cosentyx (secukinumab), which is considered to be the best psoriasis drug on the market and the benchmark against which most rivals are being judged.

Valeant said the US list price of Siliq will be $3,500 per month, or $42,000 per year. Although Novartis has not published pricing information for Cosentyx, estimates from the trade body America’s Health Insurance Plans (AHIP) published a year ago suggest the wholesale cost paid by insurers for Cosentyx is more than $70,000 per year.

The lowest publicly paid price for Cosentyx, paid by the US Department of Veterans Affairs, is almost $54,000 per year, according to AHIP.

Siliq is also thought to undercut the price of Eli Lilly’s more recently launched IL-17 inhibitor, Taltz (ixekizumab).

Valeant said the price of Siliq was decided by its Patient Access and Pricing Committee, set up a year ago, to ensure the company’s drugs are affordable and prices comply with relevant laws, regulations and guidance.

But it's clear that Siliq's black box warning, which no other drug in the therapy area carries, will be a major disadvantage, even with the lower price.

Amgen pulled out of developing brodalumab with AstraZeneca in 2015 because of reports of suicidal ideation among patients on clinical studies.

AZ then sold development and marketing rights for brodalumab to Valeant in a deal worth up to $445 million plus a share of profits, as part of its strategy to sell of its unwanted drugs.

Valeant is also trying to draw a line under a pricing scandal that became a focal issue during presidential elections last year, at a time when industry is waiting to see how president Donald Trump will act on a promise to tackle high drug prices.

The company was investigated by members of Senators after it increased the prices of two generic heart drugs by 525% and 212% a couple of years ago after acquiring them from Marathon.

This, and a federal investigation into fraud relating to Valeant’s relationship with online pharmacy Philidor caused the company’s share price to crash.

Former CEO Michael Pearson quit following the scandal and has been replaced by Joseph Papa, who is attempting to put the company on an even keel.