Last updated: February 16, 2026
What is NDC 42291-0289?
NDC 42291-0289 refers to a specific pharmaceutical product listed in the National Drug Code directory. This code identifies Aprepitant Injection, used to prevent chemotherapy-induced nausea and vomiting. It is marketed by Wyeth (now part of Pfizer) as Emend IV.
Market Overview
Market Size and Demand
The global antiemetic market was valued at approximately USD 1.2 billion in 2022, with expectations to reach USD 1.6 billion by 2030, growing at a CAGR of around 4% (MarketsandMarkets). Aprepitant, as a key drug within this sector, targets chemotherapy patients.
Key demand drivers include:
- Increasing prevalence of cancer globally
- Expanded adoption of intravenous formulations in hospital settings
- Rising awareness of chemotherapy side effects
Competitive Landscape
Major competitors include:
- Ondansetron (Zofran)
- Dolasetron
- Granisetron
- Other NK1 receptor antagonists
Pfizer's Emend IV holds a competitive niche due to its efficacy profile, especially in patients with contraindications to oral medications or those requiring fast-acting IV formulations.
Regulatory Status
- FDA Approval: Approved in 2008.
- CDER Oversight: Classified as an injectable drug with a REMS program due to potential infusion reactions.
- Pediatric and Adult Indications: Approved for prophylaxis of nausea and vomiting caused by emetogenic chemotherapy.
Pricing Landscape
Current Pricing
- Initial list price for a single 150 mg vial averages USD 200 - 260.
- Reimbursement varies, often with negotiated discounts and insurer coverage.
- The drug's hospital and infusion center average selling prices (ASPs) are generally higher due to handling and administration costs.
Pricing Trends
- Patent exclusivity ended in 2018, leading to potential price competition from generics.
- Generic versions have been introduced; however, as of 2023, branded Emend IV maintains a price premium owing to brand recognition and formulation stability.
Price Projections (2023-2028)
| Year |
Estimated Average Price Per Vial (USD) |
Notes |
| 2023 |
200 - 260 |
Market containment due to generic entry |
| 2024 |
180 - 240 |
Competitive pressures intensify, slight decline |
| 2025 |
170 - 220 |
Increased generic market share |
| 2026 |
160 - 210 |
Shift towards low-cost generics persists |
| 2027 |
150 - 200 |
Price stabilization, market saturation |
| 2028 |
140 - 180 |
Potential further discounts, increased biosimilar competition |
Note: These are projected averages based on current trends, patent expirations, market dynamics, and economic factors. Actual pricing varies across geographies and healthcare settings (e.g., hospital vs. ambulatory infusion).
Market Entry Considerations
- Generic Competition: Entry of approved generics is expected to exert downward pressure on prices.
- Formulation Differentiation: Any novel formulation (e.g., longer stability, easier administration) could command premium pricing.
- Reimbursement Policies: Changes in Medicare/Medicaid coverage or insurance reimbursement policies influence net prices.
Regulatory and Market Risks
- Delays in generic approval or market entry.
- Shifts in preferred antiemetic therapies.
- Pricing pressures from payers and formulary decisions.
Key Takeaways
- NDC 42291-0289 (Aprepitant IV) is a targeted treatment with a significant but declining premium market presence.
- The market is marked by increasing generic competition since patent expiry in 2018.
- Price declines are projected over a five-year horizon, with unit prices decreasing approximately 25-35% from 2023 levels.
- The product remains a critical option for hospital settings, particularly where IV administration is necessary.
- Future price trends depend on regulatory approvals, formulation innovations, and market share among competitors.
Frequently Asked Questions
Q1: When did patent expiry occur for Emend IV?
A1: The patent expired in 2018, allowing generics to enter the market.
Q2: How do generic prices compare to the branded product?
A2: Generics typically sell at 40-60% of branded prices, depending on manufacturing and marketing costs.
Q3: Are there upcoming regulatory changes that could impact pricing?
A3: No recent regulatory changes are anticipated imminently; however, policy adjustments affecting reimbursement could influence net pricing.
Q4: What factors most significantly influence future price declines?
A4: Generic market penetration, biosimilar developments, and payer negotiations primarily influence future prices.
Q5: How does the market size for Aprepitant injection vary geographically?
A5: The U.S. accounts for approximately 60-70% of demand, driven by high cancer treatment rates; emerging markets show growing demand but at lower prices.
Sources
- MarketsandMarkets, "Antiemetics Market," 2022.
- FDA, "Emend Injection - Review and Approval Documents," 2008.
- IQVIA, "United States Hospital Market Data," 2022.
- GoodRx, "Drug Price Listings," 2023.
- Pfizer corporate filings and investor presentations, 2022.
Note: This analysis is based on publicly available data as of early 2023 and market trends are subject to change.
