Swiss pharmaceutical giant Novartis has launched an unprecedented financing scheme for its cholesterol-lowering drug inclisiran (Sybrava) in India, marking the first time a major pharmaceutical company has introduced installment payments for high-cost medications in the country. The initiative aims to address accessibility barriers created by the drug's substantial cost of ₹1.2 lakh per injection.
Innovative Payment Structure Addresses Cost Barriers
The company has partnered with Indian payment technology firm Pine Labs to offer zero-interest equated monthly installments (EMIs) for the twice-yearly injectable treatment. Each installment is priced between ₹15,000-16,000, significantly reducing the immediate financial burden on patients requiring this advanced cholesterol therapy.
"We have recently launched a zero-interest EMI scheme with Pine Labs so that this treatment can be accessible to more patients," said Amitabh Dube, country president and managing director of Novartis India, in an exclusive interview.
The treatment protocol involves a loading dose followed by a second injection after 90 days, then subsequent doses every 180 days in a rolling cycle. Additionally, Novartis has implemented a one-on-one promotional scheme where patients receive the second injection free upon purchasing the first dose through the EMI plan.
Market Expansion Through Strategic Partnerships
To broaden inclisiran's reach across India's diverse healthcare landscape, Novartis has established marketing partnerships with three prominent Indian pharmaceutical companies. Mankind Pharma markets the drug under the brand name Crenzlo, Lupin has launched it as Tilpazan, and JB Pharma sells it under the Izirize brand.
According to PharmaTrac data, inclisiran generated combined sales of ₹7.7 crore among all three partners in the year following April 2024. More than 3,000 patients are currently receiving the treatment across India.
Atish Majumdar, senior president of sales and marketing at Mankind Pharma, indicated that the company is evaluating additional patient assistance programs to further enhance affordability for eligible patients in India.
Clinical Positioning and Expert Perspectives
Inclisiran represents a novel approach to cholesterol management, functioning as a small interfering RNA (siRNA) therapy that targets PCSK9 protein production. The drug is not intended as a replacement for statins, the standard first-line cholesterol medications, but serves as an additional treatment option for patients who are statin-intolerant or require further cholesterol reduction beyond what statins can achieve.
The medical community remains divided regarding the drug's optimal utilization. Dr. Nihar Mehta, associate director of the Department of Structural Heart Diseases at Jaslok Hospital & Research Centre, expressed enthusiasm about the therapy's potential impact.
"It is a very important drug that has come into the market. It has the potential to be a very big game changer for blockages," Dr. Mehta stated.
However, other cardiologists advocate for more selective prescribing practices. Dr. Ganesh Kumar AV, director of cardiology at LH Hiranandani Hospital Powai in Mumbai, emphasized the importance of appropriate patient selection.
"The medicine is good but it is being overused. With the right usage there are not many patients who need it. My usage of inclisiran has not been much over the last one year; maybe less than 10 out of the about 2,000 patients with coronary artery diseases I treated," Dr. Kumar explained.
Global Pricing Context and Market Access
The Indian pricing strategy reflects Novartis's efforts to balance accessibility with commercial viability in emerging markets. While inclisiran costs ₹1.2 lakh per injection in India, the same drug, marketed as Leqvio in the United States, is priced at $3,373.4 per dose (approximately ₹2.9 lakh), highlighting the significant price differential between markets.
This financing initiative represents a broader trend in pharmaceutical access strategies, where companies are exploring innovative payment models to overcome traditional barriers to expensive specialty medications. The success of this approach in India could potentially influence similar programs in other emerging markets where high drug costs limit patient access to advanced therapies.
