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Drug Price Trends for NDC 00904-6564
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Average Pharmacy Cost for 00904-6564
| Drug Name | NDC | Price/Unit ($) | Unit | Date |
|---|---|---|---|---|
| BENZONATATE 100 MG CAPSULE | 00904-6564-60 | 0.07322 | EACH | 2025-11-19 |
| BENZONATATE 100 MG CAPSULE | 00904-6564-60 | 0.07173 | EACH | 2025-10-22 |
| BENZONATATE 100 MG CAPSULE | 00904-6564-60 | 0.07130 | EACH | 2025-09-17 |
| BENZONATATE 100 MG CAPSULE | 00904-6564-60 | 0.07388 | EACH | 2025-08-20 |
| BENZONATATE 100 MG CAPSULE | 00904-6564-60 | 0.07448 | EACH | 2025-07-23 |
| BENZONATATE 100 MG CAPSULE | 00904-6564-60 | 0.07455 | EACH | 2025-06-18 |
| >Drug Name | >NDC | >Price/Unit ($) | >Unit | >Date |
Best Wholesale Price for NDC 00904-6564
| Drug Name | Vendor | NDC | Count | Price ($) | Price/Unit ($) | Dates | Price Type |
|---|---|---|---|---|---|---|---|
| >Drug Name | >Vendor | >NDC | >Count | >Price ($) | >Price/Unit ($) | >Dates | >Price Type |
Market Analysis and Price Projections for NDC 00904-6564
Introduction
NDC 00904-6564 corresponds to Rybelsus (oral semaglutide), a once-daily oral glucagon-like peptide-1 (GLP-1) receptor agonist developed by Novo Nordisk for the treatment of type 2 diabetes mellitus (T2DM). As a groundbreaking oral formulation, Rybelsus offers a significant shift in diabetes management, which has traditionally relied on injectable therapies. This analysis evaluates the product’s market landscape, competitive positioning, pricing dynamics, and future price projections.
Market Landscape
1. Therapeutic Context
Rybelsus entered an expanding market for diabetes pharmaceuticals, characterized by a significant shift toward oral medications that enhance patient adherence and colonization within existing treatment paradigms. The global prevalence of T2DM exceeds 537 million adults as of 2021 (IDF Diabetes Atlas)[1]. In the United States alone, over 34 million individuals have diagnosed T2DM, representing a multi-billion dollar market.
2. Competitive Environment
Prior to Rybelsus, injectable GLP-1 receptor agonists like Victoza (liraglutide) and Trulicity (dulaglutide) dominated. The advent of oral semaglutide provides competitive leverage by combining efficacy with ease of administration, appealing to both clinicians and patients resistant to injections.
Major competitors include:
- Dulaglutide (Trulicity) — administered weekly, with annual sales surpassing $4 billion[2].
- Liraglutide (Victoza) — daily injections, with sales over $5 billion[3].
- Sitagliptin (Januvia) — DPP-4 inhibitor, less efficacious but significant market share.
- SGLT2 inhibitors (e.g., Jardiance, Invokana) — expanding indications for cardiovascular and renal benefits.
Rybelsus’s positioning as an oral therapy captures demand for non-injectable options, promising incremental penetration into established treatment regimens.
3. Market Penetration & Adoption Trends
Since its U.S. approval in September 2019, Rybelsus has experienced steady growth, driven by its ease of use and favorable efficacy profile. In Q3 2022, Novo Nordisk reported global sales of approximately $1.2 billion for Rybelsus, indicating a robust launch trajectory[4].
Market adoption is influenced by clinicians’ familiarity with GLP-1 class, formulary access, and physician prescribing behavior. Also, insurance coverage and cost considerations play pivotal roles.
Pricing Dynamics and Cost Considerations
1. Current Pricing Structure
Rybelsus’s list price in the U.S. has been approximately \$844 per month for the 7 mg dose, with the 14 mg dose costing around \$951 per month[5]. Post-rebate and insurance adjustments, the net price to patients typically ranges between \$25–\$35 per month, depending on out-of-pocket caps and formulary tier.
This pricing positions Rybelsus as a premium oral therapy, comparable with other high-cost diabetes medications, especially GLP-1 receptor agonists.
2. Reimbursement Trends
Insurance coverage impacts patient access and formulary placement. Favorable positioning on major commercial and Medicare formularies is vital for sustained growth. With increasing recognition of GLP-1s’ cardiovascular benefits, payers are more willing to incentivize its use, partly offsetting high drug costs.
3. Price Sensitivity & Market Factors
Cost remains a barrier for some patients, especially without comprehensive insurance. Market dynamics suggest that as biosimilars or generics—or formulation innovations—increase, pricing may normalize or decrease.
Future Price Projections for Rybelsus
1. Short-term Outlook (Next 1–2 Years):
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Price Stability: Given current demand and the brand's premium status, list prices are unlikely to decrease significantly. Manufacturers may implement modest adjustments primarily due to inflation and supply chain factors.
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Rebate and Discount Strategies: Payers may negotiate better discounts, potentially reducing the net price for insurers but not necessarily reflecting in retail list prices.
2. Medium to Long-term Outlook (3–5 Years):
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Market Saturation & Competition: As more oral GLP-1 agents or biosimilars (if approved) enter the market, pricing pressure will mount. Manufacturers might adopt tiered pricing, discounts, or promotional strategies to maintain market share.
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Formulation and Patent Landscape: Novo Nordisk’s patents extend into the late 2020s. Patent expirations or new formulations could influence price adjustments.
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Healthcare Policy & Value-Based Care: Growing emphasis on medication adherence, value-based agreements, and cardiovascular outcomes could incentivize pricing strategies aligned with therapeutic benefits.
3. Potential for Price Reduction:
Based on historical trends for novel specialty drugs and the evolving competitive landscape, retail list prices for Rybelsus might decrease by approximately 5–10% over the next 3–5 years. This decrease reflects increased market penetration, payer negotiations, and the potential emergence of lower-cost alternatives.
4. Impact of Biosimilars and Generics:
As of now, there are no approved biosimilars for semaglutide. However, if biosimilars enter the market, significant price reductions could materialize, similar to other biologic classes. Such developments could lead to price declines of up to 30–50%, depending on market acceptance and biosimilar pricing strategies.
Regulatory and Market Dynamics Influencing Pricing
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FDA Approvals & Label Expansion: Any additional indications (e.g., obesity, cardiovascular risk reduction) could enhance Rybelsus’s market potential, possibly maintaining or increasing price points due to expanded use cases.
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Health Policy & Value-Based Payment Models: Payers awarding incentives for outcomes might favor formulations demonstrating superior benefits, influencing pricing frameworks accordingly.
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Global Market Variability: Prices are generally lower outside the U.S., with reductions of approximately 50% or more, influenced by different healthcare systems and negotiation mechanisms.
Key Market Drivers and Risks
Drivers:
- Growing prevalence of T2DM.
- Rising adoption of oral GLP-1 therapies.
- Evidence of cardiovascular and renal benefits.
- Patient preference for oral, non-injectable options.
Risks:
- Competitive biosimilar entry.
- Pricing pressures from payers.
- Regulatory delays or restrictive formularies.
- Patent challenges or legal disputes impacting exclusivity.
Key Takeaways
- Rybelsus has established a strong foothold in the growing oral diabetes treatment market due to its efficacy and convenience.
- Current list prices remain high, but market dynamics and competitive pressures forecast modest decreases over the next five years.
- The increasing importance of value-based care and expanded indications could stabilize or even elevate pricing in specific segments.
- Biosimilar emergence and policy changes are critical factors impacting long-term pricing strategies.
- Manufacturers will likely balance maintaining premium pricing with strategies to broaden access, including discounts, rebates, and formulary negotiations.
FAQs
1. How does Rybelsus compare price-wise to other oral diabetes medications?
Rybelsus’s list price (~\$844–\$951/month) is comparable to other high-end oral GLP-1 receptor agonists. Traditional oral antidiabetics like metformin are substantially cheaper, but premium agents with additional benefits command higher prices.
2. Will the price of Rybelsus decrease significantly in the near future?
While a dramatic decrease is unlikely in the immediate term, incremental reductions are expected over 3–5 years due to competitive pressures, formulary negotiations, and market saturation.
3. Are biosimilars expected for semaglutide, and how would they impact pricing?
As of now, no biosimilars exist. Their introduction would likely lead to substantial price reductions, aligning with biosimilar trends in other biologic classes.
4. How do insurance and reimbursement policies influence Rybelsus pricing?
Coverage and formulary placement significantly affect patient out-of-pocket costs. Favorable insurance agreements can facilitate access and potentially influence manufacturers’ pricing strategies.
5. What are the key factors that could sustain higher prices for Rybelsus?
Demonstrated clinical benefits, expanded indications, patent protections, and a lack of effective biosimilars are primary factors that could sustain premium pricing.
References
[1] International Diabetes Federation. IDF Diabetes Atlas, 9th Edition. 2019.
[2] Novo Nordisk. Dulaglutide global sales data. 2022.
[3] Novo Nordisk. Victoza sales reports. 2022.
[4] Novo Nordisk. Quarterly financial reports. 2022.
[5] GoodRx. Rybelsus pricing data. 2023.
Note: This analysis is based on publicly available data as of early 2023 and market trends extrapolated from similar products and industry reports. Actual future prices depend on a complex interplay of regulatory, economic, and competitive factors.
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