Ann: Expanded Heart Protection Discovery for Zantrene, page-171

Hi @hotcongo

Yes, there is something nasty which is often referred as evergreening. But perhaps all is not as bad as you think. Let's look at this hypothetical scenario:

1) Amgen currently sells Carfilzomib for 300K per treatment (before patent expiry). Amgen makes a 15% gross profit, or 45K per treatment
2) In 2025, patent expires and RAC agrees to licence Zantrene combo to Amgen. Amgen now sells Zan+Carfilzomib combo for 320K per treatment. Amgen makes a 15% gross profit, or 48K. Of which, only 3K attributable to Carfilzomib, and 45K from Zantrene (keep in mind, Amgen paid big $$$ for Zantrene).

The alternative is that if a combo did not become SoC, then any competitor would have sold a generic version of Carfilzomib for just 20K with a 15% gross profit, which is 3K. In fact, insurers are unlikely to accept paying more than before for the Carfilzomib side of the combo.What Amgen really gains from this combo, besides added revenue from Zantrene, is that it maintains its leading market share for Carfilzomib.

Other competitors are free to bid for a Zantrene combo! And I am sure patients who can't afford the combo can always by the generic.