Delay to generic tafamidis keeps affordability in focus

Pfizer's agreements to delay generic competition for Vyndamax until mid-2031 have renewed questions about the cost of treating ATTR-CM.

Tafamidis carried a list price of about $268,000 a year when the Institute for Clinical and Economic Review assessed it in 2024, well above the $13,600 to $39,000 range ICER judged cost-effective. BridgeBio's Attruby launched at about $244,000 a year, TCTMD reported.

Branded competition from Attruby and Amvuttra gives payers alternatives, but neither product is a generic copy of tafamidis that pharmacies can substitute automatically. Analysts say generic entry is typically the strongest driver of price reductions for an established medicine. The Congressional Research Service has examined how patents and exclusivities affect drug prices.

Pfizer said the settlements changed its revenue outlook, with sales now expected to stay relatively stable through mid-2031 rather than falling from 2029.

A recent review of the ATTR-CM market argued that new treatment options matter little if patients and payers cannot afford them.