Price war begins for Novartis cardiac drug as JB Pharma cuts rate by 50%

JB Pharma on Monday likely kicked off a price war after it cut by half the price of Azmarda, a cardiac drug patented by Novartis.

The ~500-crore market of sacubitril va ls art an. the combination used in Azmarda, has a CAGR of around 30 per cent. The Mumbai-based firm said that the combination was currently prescribed to 30-35 per cent of patients suffering from heart failure, and doctors believed that 50-60 per cent of patients could be prescribed this drug if it became more affordable.

Novartis-patented Vymada, which JB Pharma sells under the brand name Azmarda, is set to go out of patent in January, and currently only four Indian companies are marketing the drug here including JB Pharma, Mankind, and Dr Reddy’s Laboratories. Azmarda will now be sold for ~39.6 per tablet for the 50 mg variant, down from ~78 per tablet earlier.

At present, Azmarda is the third largest brand in the category, and commanded 17 per cent market share with moving annual turnover (MAT) sales of ~93.5 crore in October, according to market intelligence agency IQVIA. In April 2022, JB Pharma acquired the Azmarda brand for ~ 246 crore from Novartis Switzerland for sales in the India region.

Dilip Singh Rathore, president, domestic business, JB Pharma, said, “Being a leading player in the cardiac segment, JB has decided to take the lead in making their Azmarda drug more accessible and affordable for heart failure (HF) patients in India… With this move, the overall monthly treatment cost will reduce significantly from ~4,500 to ~2,200. The HF drug also helps in reducing hospitalisation cost by around ~1 lakh at the minimum.”

The drug will likely be prescribed twice as much as it becomes affordable, Rathore said. It is estimated that 8-12 million Indians suffer from heart failure — a chronic condition in which the heart doesn't pump blood as well as it should. It is a progressive chronic syndrome characterised by a decrease in function and quality of life, in which blood often backs up and causes fluid to build up in the lungs and in the legs.

JB Pharma also plans to institute over 300 ‘Heart Failure Clinics’ across the country so that patients are able to detect the condition early, Rathore added.

The condition often remains undiagnosed, and patients become aware of it mostly at the final stage. Given incidences of hospitalisation and high mortality, HF is a condition where people mainly see doctors with a specialisation – 50-70 per cent of the patient pool is with cardiologists, and 5-10 per cent with diabetologists. In India, HF affects a relatively younger population compared to the western world. Several Indian drug firms are in the fray to launch the generic version of this heart failure medicine. This is likely to cause a churn in the ~23,000-crore cardiac market in India. Globally, this drug is estimated to have a size of $4 bn.

India’s price regulator is keeping a close watch on key drugs going off patent. The Centre and the industry are working on a pricing mechanism for drugs that are going off-patent.

“While a final decision is yet to be made, the pricing mechanism is likely to set a ceiling price for drugs going off patent at 50 per cent of the innovator price. And if there is any other drug that is already under price control in combination with the patented molecule, then one may take a ceiling price which is 20 per cent lower than the prevailing ceiling price,” said an industry source.