Savient Pharmaceuticals ($SVNT) has announced a bureaucratic breakthrough that could help increase sales of its new gout drug Krystexxa. The Centers for Medicare and Medicaid Services gave Krystexxa its own billing code, effective Jan. 1. That dedicated code is expected to speed up reimbursement for the injectable drug, which could persuade more doctors to use it in their patients.
Savient cautioned that the new code won't be an overnight boost to Krystexxa sales. It could take up to 6 months for the code to make its way through the system, the company said. "I would just caution everyone not to expect a large group of patients coming in on January 1," CEO John Johnson said. "While many patients will be brought in, there is the process of going through secondary insurance verification and making sure that the patient is still appropriate for therapy."
Savient hasn't had a lot of luck with Krystexxa so far. The company had been hoping to sell itself after winning FDA approval, but that didn't happen, and so the company was caught a bit flat-footed on engineering its own launch. Over the first 6 months of this year, the drug only generated about $1.4 million in sales. Johnson has been promising improvements by the second quarter of next year, aided in part by some new data Savient plans to take into the primary-care setting.
Will the new Medicare code deliver as Savient hopes? Well, cost could be another hurdle: Krystexxa runs $60,000 per year, and Part B drugs carry a 20% co-pay, with certain limits.
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