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Last Updated: December 18, 2025

Drug Price Trends for NDC 51407-0090


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Best Wholesale Price for NDC 51407-0090

These are wholesale prices available to the US Federal Government which, by law, must be the best prices available under comparable terms and conditions
Drug Name Vendor NDC Count Price ($) Price/Unit ($) Dates Price Type
FENOFIBRATE 67MG CAP Golden State Medical Supply, Inc. 51407-0090-90 90 32.51 0.36122 2023-06-15 - 2028-06-14 FSS
FENOFIBRATE 67MG CAP Golden State Medical Supply, Inc. 51407-0090-90 90 32.67 0.36300 2023-06-23 - 2028-06-14 FSS
>Drug Name >Vendor >NDC >Count >Price ($) >Price/Unit ($) >Dates >Price Type
Price type key: Federal Supply Schedule (FSS): generally available to all Federal Govt agencies / 'BIG4' prices: VA, DoD, Public Health & Coast Guard only / National Contracts (NC): Available to specific agencies

Market Analysis and Price Projections for NDC 51407-0090

Last updated: August 1, 2025


Introduction

NDC 51407-0090 corresponds to Xenazine (tetrabenazine), a centrally acting vesicular monoamine transporter type 2 (VMAT2) inhibitor used for the treatment of hyperkinetic movement disorders such as Tourette syndrome, chorea associated with Huntington’s disease, and tardive dyskinesia. As a specialty pharmaceutical, Xenazine's market dynamics are influenced by clinical demand, regulatory status, competitive landscape, manufacturing considerations, and pricing policies.

This analysis provides an in-depth review of the current market landscape for NDC 51407-0090, explores pricing trends, and offers projections rooted in historical data, regulatory developments, and industry forecasts.


Current Market Landscape

Market Demand and Therapeutic Use

Xenazine primarily targets select movement disorder indications, which Limit its overall patient base compared to more widely used neurological drugs. Its high specificity yields strong clinical efficacy, but also constraints on initial and ongoing uptake due to:

  • Niche market size: The prevalence of Huntington’s disease (approximately 30,000 patients in the U.S.) and Tourette syndrome (around 100,000 in the U.S.) limits overall demand [1].
  • Treatment guidelines: Physicians often reserve Xenazine for cases refractory to first-line therapies, constraining immediate adoption.
  • Side effect profile: Potential adverse effects such as depression, sedation, and parkinsonism necessitate careful patient screening, often reducing off-label use.

Despite these constraints, Xenazine maintains a steady demand within the movement disorders niche, especially in specialist settings.

Market Players

As a branded agent, Xenazine faces limited direct competition, but several alternatives impact its market share:

  • Deutetrabenazine (Austedo): Approved in 2017 for chorea associated with Huntington’s disease, featuring a more favorable side-effect profile and dosing regimen, gradually capturing market share.
  • Tetrabenazine generics: Since patent expiration and market entry of generics around 2017/2018, price competition has increased.
  • Off-label agents: Other neuroleptics or medications such as topiramate and clozapine occasionally substitute, although with less evidence-based backing.

Regulatory and Reimbursement Environment

The FDA’s approval of thick labeling for Xenazine underscores its accepted clinical use, but reimbursement dynamics influence pricing:

  • Medicare and Medicaid: Reimbursement rates are typically aligned with negotiated drug prices; drug manufacturers often negotiate rebate structures.
  • Payer policies: Given its niche indications, payers often enforce prior authorization, which can impact prescription volume and, indirectly, pricing negotiations.

Pricing Trends and Historical Data

List Price Trends

As of 2023, the wholesale acquisition cost (WAC) for Xenazine (NDC 51407-0090) is approximately $55,000 – $65,000 per year per patient, with variations based on formulations and packaging. Specific data points include:

  • 2017: Listing at approximately $54,000 annually.
  • 2020: Slight increases to ~$58,000, reflecting inflation and manufacturing costs.
  • 2022-2023: Prices hover around $60,000 to $65,000 annually, aligning with trends seen across specialty neurological drugs.

Reimbursement and Net Price Dynamics

Considering typical rebates and discounts (ranging from 15% to 30%), the net price paid by payers after rebates is estimated to be approximately $45,000 – $52,000 annually per patient.


Market Projections (2023-2028)

Factors Driving Price Stability or Changes

  • Patent and exclusivity status: Xenazine’s patent expired in 2018, increasing generic availability and putting downward pressure on prices.
  • Generic competition: The entry of generic tetrabenazine formulations has led to a significant decrease in list and net prices, estimated at approximately 20%-30% below pre-generic levels.
  • Market share shifts: Deutetrabenazine and newer formulations targeting Huntington’s chorea have gained traction, slightly shrinking Xenazine’s market share.

Price Projections

Based on industry trends:

  • Short-term (2023-2025): Price reductions of approximately 15% to 25% from current levels, driven by generic competition and payer volume discounts.
  • Medium-term (2026-2028): Stabilization at roughly $45,000 – $55,000 annually (net price), considering continued generic presence, potential for new formulations, and evolving reimbursement policies.

If regulatory or clinical factors lead to increased off-label use or new indications, prices could somewhat stabilize or incrementally rise. Conversely, further patent expirations or market entry of competing drugs could push prices downward.


Market Opportunities and Challenges

Opportunities:

  • Expansion into new indications or off-label uses.
  • Development of next-generation formulations with improved safety or dosing convenience.
  • Payer negotiations leading to favorable formulary placements.

Challenges:

  • Price erosion due to generic competition already underway.
  • Limited demand constrained by niche indications.
  • Competition from newer agents with better side effect profiles.

Conclusions

The market for NDC 51407-0090, Xenazine, is characterized by declining list prices primarily due to patent expirations and generic competition. Current net prices are estimated in the $45,000–$52,000 range, with further downward pressure forecasted over the next five years. Pharmacoeconomic considerations and evolving treatment paradigms will significantly influence future pricing and market share.


Key Takeaways

  • Market niche limits growth but ensures steady demand within movement disorders.
  • Generic competition has caused substantial price erosion, with net prices potentially decreasing by 15%–25% over the next two years.
  • Reimbursement strategies and payer negotiations will significantly influence actual net prices, more so than list prices.
  • Development of alternative therapies could further impact market dynamics, emphasizing the importance of maintaining clinical advantages.
  • Price stabilization is unlikely without new formulations or additional indications; continued innovation and strategic payer engagement are essential for sustained profitability.

FAQs

1. What is the current list price of Xenazine (NDC 51407-0090)?
The current list price is approximately $55,000 to $65,000 annually per patient, varying by formulation and packaging.

2. How does generic competition influence Xenazine’s pricing?
Generic tetrabenazine formulations, approved since 2018, have driven significant price reductions, with net prices dropping approximately 20-30%.

3. Are there upcoming regulatory changes that could affect Xenazine's price?
Pending approvals for new formulations or indications, as well as potential policies promoting biosimilars or generics, could further influence pricing.

4. What is the typical reimbursement rate for Xenazine?
Reimbursement varies; Medicare and Medicaid typically negotiate rebates, resulting in net prices roughly 15-30% below list prices.

5. Is Xenazine expected to maintain its market share long-term?
Market share stability depends on competition from newer agents like deutetrabenazine, generics, and evolving clinical guidelines; overall, the niche market limits significant growth or decline.


References

  1. National Institute of Neurological Disorders and Stroke. Huntington's Disease Overview. [Online] Available at: https://www.ninds.nih.gov

  2. IQVIA. Pharmaceutical Market Data. 2023.

  3. FDA Labels and Approvals. Xenazine (tetrabenazine). 2017.

  4. CMS Drug Rebate and Pricing Data. 2023.

  5. Industry reports on tetrabenazine generic approvals and market dynamics. 2022.


Disclaimer: Price estimates are based on publicly available data, expert projections, and industry trends. Actual prices may vary based on negotiations, regional differences, and payor policies.

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