TWO BIRDS OF A FEATHER: BIG PHARMA PRICE HIKERS TO JOIN FORCES IN LARGEST HEALTH CARE MERGER OF THE YEAR

Amgen and Horizon Therapeutics Eye Merger As Both Continue to Hike Prices on Blockbuster Prescription Drugs

On Monday, Big Pharma giant Amgen announced plans to acquire Horizon Therapeutics for $27.8 billion, making it the largest healthcare merger of the year. Horizon Therapeutics is known for several rare autoimmune and severe inflammatory disease drugs, including Tepezza, which treats thyroid eye disease, and Krystexxa, which treats gout. As the Wall Street Journal reports, Amgen’s motivations in making the deal may be related to the fact that the company is set to lose patent protection on several blockbuster treatments later this decade, including best-selling osteoporosis drugs Prolia and Xgeva.

The move comes as Amgen shares recently hit an all-time high. In 2021, the company brought in a whopping $25.97 billion in revenue and has a current market capitalization approaching $150 billion. Horizon Therapeutics is no small player itself, having brought in $3.22 billion in revenue in 2021 – a 46 percent increase from the previous year.

According to reporting in STAT News from Matthew Herper and Jason Mast, “[t]he prize in the deal is Tepezza.” Herper and Mast write, “Tepezza’s story is characteristic of those of treatments for ultra-rare diseases… they have become among the most profitable bets in the drug business… the company has charged $14,900 per vial for the drug.”

According to Horizon Therapeutics’ third-quarter earnings report, Tepezza brought in $490 million for the company in the third quarter alone, and is on track to bring in just under $1.5 billion for the full calendar year.

As they say, birds of a feather flock together. Both Amgen and Horizon Therapeutics share a history of hiking prices on their best-selling products, price-gouging consumers on brand name treatments and engaging in anti-competitive tactics to undermine more affordable alternatives.

Amgen

In January of this year, Amgen hiked prices more than a dozen times and raised prices on nearly 20 more drugs this July.

In 2020, the U.S. House Committee on Oversight and Reform released an investigative report highlighting internal company documents that shed light on Amgen’s pricing practices, in particular around blockbuster immunology drug Enbrel and thyroid treatment Sensipar. Takeaways from the report include:

• Since Acquiring Enbrel, Amgen Has Raised Its Price 27 Times, Including By Nearly 30% Within One Year. Amgen Also Has Raised The Price Of Sensipar More Than 20 Times Since Launching The Drug. “Since acquiring the rights to Enbrel in 2002, Amgen has raised its price 27 times, including by nearly 30% within one 12-month period. A 50 mg dose of Enbrel is now priced at $5,556 per month, or $72,240 annually—a 457% increase from the date Amgen acquired the drug. Amgen also has raised the price of Sensipar more than 20 times since launching the drug in 2004. These price increases have inflated the cost of a typical yearly course of Sensipar from $2,956 in 2004 to $9,814 today.” (Staff Report, “Drug Pricing Investigation: Amgen – Enbrel And Sensipar,” S. House Committee On Oversight And Reform, 10/1/20)
• “Internal Communications Show That Pricing Decisions By Amgen Executives—Including Executive Vice President Anthony Hooper—Were Driven Primarily By The Need To Meet Increasingly Aggressive Revenue Targets.” (Staff Report, “Drug Pricing Investigation: Amgen – Enbrel And Sensipar,” U.S. House Committee On Oversight And Reform, 10/1/20)
• “Amgen’s Price Increases For Enbrel And Sensipar Led To Higher Bonuses For Its Executives.”(Staff Report, “Drug Pricing Investigation: Amgen – Enbrel And Sensipar,” U.S. House Committee On Oversight And Reform, 10/1/20)
• “Amgen Leveraged The U.S. Patent System To Limit Biosimilar Competition For Enbrel And Prevented U.S. Patients From Accessing Lower-Priced Versions Of The Drug Available To Patients In Other Countries,” And “Entered Into Settlement Agreements To Delay Entry Of Generic Equivalents” For Sensipar.“Internal strategy documents indicate that Amgen used minor changes to Enbrel’s design— including a new version of the injection device called Enbrel Mini with Autotouch—to drive sales and limit competition. For Sensipar, Amgen entered into settlement agreements to delay entry of generic equivalents. Amgen also attempted to gain additional market exclusivity for Sensipar by showing that it could be used in children, despite knowledge that the FDA was unlikely to grant approval.” (Staff Report, “Drug Pricing Investigation: Amgen – Enbrel And Sensipar,” S. House Committee On Oversight And Reform, 10/1/20)
• “Internal Data Show That Amgen’s List Price Increases For Enbrel Outpaced Any Rebates Paid.”“From 2015 to 2018, price increases allowed the company to maintain net revenue from Enbrel at levels well above 2014, despite the volume of sales declining and total rebates paid increasing. Internal data reviewed by the Committee show that Amgen’s rebates and discounts for Sensipar remained relatively steady from 2015 to 2018 (between 23% and 29%), while Amgen raised the price of the drug five times. As a result, Sensipar’s yearly net revenue rose by 34% over this period.” (Staff Report, “Drug Pricing Investigation: Amgen – Enbrel And Sensipar,” S. House Committee On Oversight And Reform, 10/1/20)

Horizon Therapeutics

Horizon Therapeutics has its own extensive history of hiking prices and engaging in anti-competitive tactics to block competition.

The company was recently featured in a report from the Institute for Clinical and Economic Review (ICER) showing Big Pharma companies hiked prices on seven of the top 10 most popular drugs in 2021 with no accompanying increase in clinical value – costing patients $805 million. Horizon Therapeutics’ gout treatment Krystexxa was the costliest drug in the list, having increased by 12 percent, raising out-of-pocket spending by $3,210 on average per patient.

In 2018, Horizon Therapeutics received attention around its price hikes on rheumatoid arthritis drug Vimovo. According to Fierce Pharma, the company hiked the price of the drug at least 11 times, “from a starting point of $138,” to “$2,979 per 60-pill bottle.”

In 2016, Horizon Therapeutics was featured in another Fierce Pharma piece examining how the drug maker had developed a pattern of combining cheap generics into new patent-protected drugs and then charging exorbitant prices. Horizon’s arthritis drugs Vimovo and Duexis were highlighted.

The merger between Amgen and Horizon Therapeutics is just the latest example of Big Pharma companies with histories of egregious price hikes and anti-competitive practices joining together. Earlier this year, pharmaceutical company Indivior announced plans to acquire Opiant Pharmaceuticals as part of an effort to consolidate market power over opioid addiction and opioid treatments and undermine access to more affordable alternatives. In 2020, Big Pharma giant AstraZeneca announced plans to acquire rare disease drug maker Alexion Pharmaceuticals in a $39 billion merger. And as the Wall Street Journal reports, many Big Pharma companies are “sitting on big piles of cash,” and looking to, “acquisitions as a key strategy to expand sales.” So, stay tuned for more potential deals on the horizon.

Learn more about how Big Pharma targets mergers and acquisitions to keep prices high, extend monopolies and boost profits HERE.

Learn more about bipartisan, market-based solutions to hold Big Pharma accountable HERE.