Head-to-head for new COPD drugs?

NAPA, Calif. - Expect some major jockeying between nebulizer medication manufacturers Dey Laboratories and Sepracor as they vie for market share for new drugs. The Food and Drug Administration approved Dey's Performist Inhalation Solution in May. Last October, Marlborough, Mass.-based Sepracor got approval for Brovana. Both drugs are long-acting beta 2 agonists designed for twice daily treatments. In April, Dey filed suit against Sepracor, alleging patent infringement over the development of Brovana. "Since these drugs are competitors, they are likely to go head-to-head to create profitability for providers, or providers will not be interested," said Mickey Letson, president of Decatur, Ala.-based Letco Companies. "It will create a price battle." That could be good for the neb-med industry--if Medicare covers the drugs, said Joe Lewarski, vice president of clinical and government affairs for Inogen. "In theory, the introduction of aerosolized long-acting beta agonists should be very positive for patients and the industry, but coverage and reimbursement issues may cloud this," he said. "I think the real question is, how can providers offer the drugs without structured coverage and reimbursement?" With insiders speculating the drugs could fall in the price range of $5 to $6 per dose, the drug would be too expensive for most Medicare patients, if it doesn't get a HCPCS code. Sam Jarczynksi, president of St. Petersburg, Fla.-based Rx Stat, offers Brovana. "We've dispensed it for a few people," said Jarczynksi. "We submit claims under miscellaneous, get denied and appeal." Sepracor launched Brovana April 1; DuoNeb plans an October launch of Performist. Both have applied for separate HCPCS codes, but Medicare's recent decision to create a single code for Xopenex and albuterol under the same code means these new drugs could also wind up under a single code.