Xanomeline Tartrate/Trospium Chloride

With a deadline looming for President Donald Trump's most favored nation drug pricing effort, Bristol Myers Squibb says it will charge the same in the U.K. as it does in the U.S. for new schizophrenia drug Cobenfy. With a Sept. 29 deadline looming for pharmaceutical companies to adhere to President Donald Trump’s most favored nation (MFN) drug pricing system in the U.S., Bristol Myers Squibb has taken the unusual step of revealing the price it plans to charge in the U.K. for its new schizophrenia treatment Cobenfy.The New Jersey company will offer the drug "at a UK list price equal to the US list price," according to a press statement Monday. In the U.S., the drug carries a monthly list price of $1,850, according to a BMS website, which equates to $22,200 annually.BMS is submitting for approval later this year, with plans to launch Cobenfy in the U.K. in 2026, according to the statement.While analysts have characterized Trump’s MFN executive order as having more bark than bite and likely being subject to future legal challenges, the initiative is designed to match the costs of prescription drugs in the U.S. to the lowest price offered in other developed nations.In late July, Trump sent letters to 17 of the world’s largest drugmakers outlining steps they “must take” to moderate the costs of their U.S. medicines in line with international reference prices.“By making this commitment with Cobenfy, we are asking the UK to step up in recognizing the value of truly innovative therapies,” BMS Chief Commercial Officer Adam Lenkowsky said in a statement. “We agree with the Trump administration that other countries need to pay their fair share," he added.It is the first time that BMS has priced a drug in the U.K. the same as it charges in the U.S. As an example, while BMS charges $7,943 for a 240-mg dose of blockbuster cancer drug Opdivo in the U.S., the same dose is priced at 2,633 pounds sterling ($3,556) in England. In the U.K.—where pharmaceuticals are provided through the publicly funded National Health Service—prices are subject to cost/benefit scrutiny before medicines are made widely available. England's National Institute for Health and Care Excellence is notorious in the pharma industry for drawing a hard line in pricing assessments, so BMS' announcement is sure to set up a heated review process for the novel schizophrenia treatment.Crucially, while list prices are publicly known, pharma companies and U.K. officials regularly negotiate confidential discounts that enable patient access at acceptable costs to the government.BMS intends to work with U.K. regulators to make Cobenfy available, Lenkowsky said.“But we are prepared to make the difficult decision to walk away if they cannot better recognize the value our medicine brings to patients and society,” he added.The U.K. would become the first nation in Europe where Cobenfy would be approved. It is a key advancement in the treatment of schizophrenia as it offers a new mechanism of action to the dopamine receptors which currently dominate the market in the indication. The move by BMS comes as the U.K. government faces pressure from biopharma companies to reduce its heavy taxes on drugs and to provide more incentives for investment. Earlier this month, AstraZeneca paused a 200 million pound sterling ($271 million) investment in a research site the company planned near its headquarters in Cambridge.Besides AZ, several other pharma giants made headlines this month for their recent decisions to pull back from the country or pause future U.K. R&D investments.During his first term, Trump made a similar effort to reduce drug prices through a MFN structure, but it failed to survive court challenges.While the executive order was designed to force companies to reduce their prices in the U.S., it also can compel them to raise prices in other developed countries. In August, for example, shortly after receiving an MFN letter from Trump, Eli Lilly said it planned to jack up the price of blockbuster diabetes treatment Mounjaro by as much as 170% in the U.K.Then, three weeks ago, Lilly temporarily stopped taking U.K. orders for Mounjaro, citing legal protections from stockpiling by providers in anticipation of the price adjustment. 

In a company first, Bristol Myers Squibb said it plans to launch its schizophrenia drug in the UK with the same list price as in the US, as tension between drugmakers and the UK government continues to build. Cobenfy, which the FDA approved last year, has a list price of $22,500 a year in the US. The move would mark the first time a pharma company has set a drug’s UK price at its US level, following President Donald Trump’s ongoing push to bring US drug prices in line with what companies charge abroad. BMS plans to file a marketing authorization application for the drug (xanomeline and trospium chloride) with UK regulators later this year. “It’s rare for a company to disclose its UK pricing plans weeks before it intends to submit a marketing authorization application. It’s also very unusual to seek pricing parity with the US market,” independent global market access consultant Neil Grubert told Endpoints News. The announcement comes during a time of increasing industry concern in the UK over what it says is a lack of government action to improve the life science investment space. The company is still willing “to walk away” from the UK if the country’s National Health Service and National Institute for Health and Care Excellence fail to see the value of its medicine, BMS chief commercialization officer Adam Lenkowsky told Endpoints on Monday. He said BMS agrees with the Trump administration that other countries need to “pay their fair share” for drugs. The company said last week that the UK pays too little for medicines . The UK government is under pressure from biopharma companies as they call out the high payback taxes for medicines in the country, which is the portion of sales a drugmaker pays back to the NHS. The UK’s Voluntary Scheme for Branded Medicines Pricing, Access and Growth stands at nearly 23%, which is much higher compared to other countries. Drugmakers like Eli Lilly, AstraZeneca and Merck have reconsidered new builds in the UK after the government failed to strike a deal with drugmakers on medicine pricing in early September. Some smaller biotechs are now saying they are avoiding new drug launches in the UK due to the high taxes. At the same time, the White House is zeroing in on reducing drug prices in the US, spurring some drugmakers to raise their prices elsewhere. President Trump sent 17 letters to companies , including Bristol Myers, demanding that they lower prices to match those in other “most favored” nations. Last month, Lilly announced plans to raise the list price of its weight loss drug Mounjaro in the UK, to £330 ($446) from £122 ($165) for a month’s supply of the highest dose, noting it had to raise prices in other countries in order to lower them in the US. Editor’s note: This story has been updated with a quote from independent global market access consultant Neil Grubert.