Medicare Formularies Shift to Covering Generic Mifepristone Instead of Branded Korlym for 2025

Corcept’s (CORT) flagship product Korlym (mifepristone) has been removed from the preferred drug lists, or formularies, of nine out of 12 national prescription drug plans under Medicare Part D in 2025, a Capitol Forum investigation has found.

Korlym, which treats a type of Cushing’s disease, can cost patients $16,000 to $64,000 a month and is a cash cow for Corcept, which generated almost $500 million in net revenue in the first nine months of 2024, according to the company’s most recent quarterly filing. The company said it is “dependent on revenue from the sale of Korlym and our cash reserves to fund our commercial operations and development programs” in an annual filing for 2023.

But drugmaker Teva (TEVA) launched a long-awaited generic mifepristone product in January of last year, introducing competition into the market. That shakeup may be the reason that most of the national Medicare prescription drug plans—those available to seniors nationwide—have switched to covering generic mifepristone instead of branded Korlym.

To be sure, Corcept also began marketing its own generic in June 2024. Yet it’s not clear whether Corcept would garner the same price for that product as branded Korlym, and Corcept’s generic could still face price competition from Teva’s.

Indeed, in the risk factors in its most recent quarterly filing, the company stated, “The availability of generic Korlym could cause our revenue to decline and materially harm our results of operations and financial position, by reducing the number of tablets we sell or lowering their price. It may also cause our revenue to be materially less than the public guidance we have provided, which would likely cause the price of our common stock to decline.”

Below is a list of national Medicare Part D plans and their relevant coverage in both 2024 and 2025 for generic and branded Korlym.

Mifepristone Coverage Under the National Prescription Drug Plans

These Medicare coverage changes could impact Corcept’s bottom line. In its most recent quarterly filing, the company pointed to Medicare as a key source of revenue, albeit in the context of government-run drug price negotiations.

“If Korlym or any drug we commercialize becomes eligible for Medicare negotiation, the revenue we generate from sales of that drug may be significantly reduced,” the company said.

Corcept also wrote, “If government or private payers cease to provide adequate and timely coverage, pricing and reimbursement for Korlym, physicians may not prescribe the medication and patients may not purchase it, even if it is prescribed, or the price we receive may be reduced, which would reduce our revenue.”

Though Corcept doesn’t specifically report Medicare profits, its drug is certainly costly to the government. The Medicare program spent over $187 million for Korlym in 2022, the most recent year of data available. In its calendar year 2022, Corcept reported $401.9 million of revenue.

The exclusion of branded Korlym from insurance formularies could threaten Corcept’s plan to maintain its dominant market share even in the face of generic competition.

Corcept and Teva didn’t respond to requests for comment.