Insurers Brace For Pfizer's $225K Heart Drug And Whether To Pay For It

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Insurers Brace For Pfizer's $225K Heart Drug And Whether To Pay For It
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Pfizer won U.S. approval for its drug tafamidis to treat a rare heart disease, but whether the treatment that costs $225,000 year will be covered by heath insurers and employers remains unclear

for its drug tafamidis to treat a rare heart disease, but whether the treatment that costs $225,000 year will be covered by heath insurers and employers remains unclear.

“This drug is currently excluded from our National Preferred Formulary until our Pharmacy and Therapeutics Committee reviews and provides guidance,” a spokeswoman for the PBM Express Scripts, a unit of health insurer Cigna said, referring to the board of doctors that reviews clinical research for medications and advises whether the medicine should be included on preferred lists of drugs known as a formularies. “We don’t have a timeframe on that at the moment.

No matter whether the drug is covered or not by health insurance companies, the industry says the cost of such drugs will eventually hit consumers directly and that comes as a result of drug maker pricing decisions.

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