This calculator estimates the number of commercially insured individuals who may use Exondys 51 (eteplirsen), the annual drug cost to treat these individuals, and the annual per member per month cost for Exondys 51. Exondys 51 is administered via intravenous infusion and drug costs are expected to impact primarily the medical benefit.
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Number of members to be treated
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Annual Cost of New Drug Therapy(ies)
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Total new drug cost per member per month (PMPM) Pharmacy + Medical benefits
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DISCLAIMER: These numbers are estimates only and provided as-is, without warranty. Actual results may vary based on a number of factors. Last updated February 2017.

*Per member per month (PMPM) cost for treating the diagnosed members with Exondys 51 (eteplirsen), for 12 months. Assuming members are adherent to therapy for 12 months. Assumptions are based on Prime Therapeutics book of business commercially insured distributions of individuals with primary field Duchenne muscular dystrophy (DMD) diagnosis code and assumes 13% of those members are eligible for treatment with Exondys 51 and and no coverage restrictions are utilized (unmanaged forecast). The managed forecast assumes 13% of members are eligible and 25% of those will seek out and be granted medical exception for coverage of Exondys 51. Exondys 51 is administered via intravenous infusion and drug costs are expected to impact primarily the medical benefit. No inflationary drug costs are included.

**Wholesale acquisition cost (WAC) is estimated because Exondys 51 (eteplirsen) uses weight based dosing. Exondys 51 is dosed 30mg/kg per weekly infusion. Average weight of trial participants (Ann Neurol 2016 79: 257–271. doi:10.1002/ana.24555) was 30kg so 900mg per dose. A 900mg dose would require one 10mL 500mg vial and four 2mL 100mg vials. WAC is $8,000 for 10mL vial and $6,400 for four 2mL vials. Total per infusion = $14,400, infused weekly x 52 weeks = $748,800 annual estimated WAC.

For more information on these estimates, and solutions Prime can deploy to help you best manage these costs, please contact your Prime representative. If Prime is not your pharmacy benefit manager, please email us at info@primetherapeutics.com