However, patients who cannot get insurance coverage will be able to access AspyreRx at a significant self-pay discount.
Better Therapeutics says it has decided on a price point for its newly authorized type 2 diabetes digital therapeutic, but the company said it also plans to temporarily offer a lower price for patients unable to get the product covered by insurance.
Better Therapeutics’ AspyreRx will sell for a list price of $750 for a 90-day prescription, company officials said during a conference call this week. They believe the price point allows them to make a strong case for the value of the product, since they said uncontrolled HbA1c can significantly increase the healthcare costs of patients.
The pricing news comes one month after the company gained authorization from the Food and Drug Administration to market AspyreRx (formerly known as BT-001), a program that leverages cognitive behavioral therapy to help patients with type 2 diabetes lower their HbA1c. In a clinical trial involving 668 participants, half of participants achieved a mean A1c reduction of 1.3% after six months of usage. The company said most patients also achieved other benefits from the therapy, including reduced blood pressure and weight.
Chief executive Frank Karbe said FDA authorization has helped the company get meetings with key decision-makers at major payer organizations to discuss coverage.
“The commercial potential for AspyreRx is significant,” he said during the conference call. “We continue to get very encouraging feedback from providers, payers, and patients, and we are exploring multiple business development and royalty options to get our product to as many patients as possible as quickly as possible.”
One advantage the company believes it has is that AspyreRx is not intended to be used on a permanent basis. Diana Gomez-Thinnes, MBA, the company’s chief commercial officer, said they anticipate most patients will get at least one refill, meaning they would be on the therapy for 6 months.
“At $1,500 per patient for a six-month treatment experience, we believe it is well priced when considering the costs associated with chronic medication,” she said. “We are confident we provide a compelling value proposition to payers, offering cost-predictability for a defined period of time, unlike other treatments.”
Yet, Karbe conceded that it “will take some time” before the company can achieve broad coverage by payers. That’s why the company said it will temporarily offer AspyreRx at a significant discount to patients who are unable to get the therapy covered by their insurance.
Karbe said the final cash-pay price is not yet set, but he cited market research showing that providers felt a cost of $25-50 was a reasonable price for patients for a diabetes product. The market research found payers were willing to pay around $40-55 per month.
“So it is going to be somewhere in that vicinity,” Karbe said.
He hopes the low self-pay price will spark significant payer and provider adoption, which in turn will lead to increased payer coverage.
“As coverage broadens, we expect an increasing number of scripts to switch from cash pay to covered scripts, which in turn will drive our revenue,” Karbe said.
In the meantime, the company said it is also working to generate more evidence to support the case for coverage of AspyreRx. As of July 31, the company had achieved about 90% of its target enrollment for a real-world evidence program designed to show how well the product works outside of a trial setting. The company said it expects to complete enrollment in the program by the end of the third quarter of this year, and to release its first data set sometime during the fourth quarter of this year.