The Financial Forces Behind the Discontinuation
According to an official letter to healthcare providers, Indivior discontinued Perseris's sales and marketing based on market dynamics rather than safety or efficacy issues. A confluence of market pressures, including increased payor management and intense competition, rendered the product financially unviable for the company. CEO Mark Crossley specifically cited provisions within the federal Inflation Reduction Act (IRA), which were anticipated to lead to intensified category management, affecting both price and volume.
Despite achieving a 50% increase in sales in 2023, reaching $42 million, the drug's performance was not enough to justify continued marketing efforts under the new market conditions. Indivior concluded that there was "no financially viable means to move forward with Perseris in 2025". This decision resulted in the company cutting approximately 130 jobs to align with its revised business strategy.
Alternatives to Perseris
For patients currently on Perseris, healthcare providers will facilitate a transition to alternative treatments. As Perseris is a long-acting injectable (LAI) form of risperidone, several other LAIs are available for treating schizophrenia, in addition to various oral antipsychotics. Patients should discuss all options with their doctor to determine the most suitable alternative for their specific needs.
Common Alternatives to Perseris:
- Other Risperidone Formulations: Risperdal Consta and Rykindo are other long-acting injectable formulations of risperidone, though with different injection schedules and administration methods.
- Other Atypical Long-Acting Injectables: Alternatives with different active ingredients include Invega Sustenna (paliperidone), Abilify Maintena (aripiprazole), and Aristada (aripiprazole lauroxil).
- Oral Antipsychotics: Patients may also consider switching to oral formulations of risperidone or other oral atypical antipsychotics like olanzapine (Zyprexa) or quetiapine (Seroquel).
Comparison of Key LAI Alternatives
| Drug (Brand Name) | Active Ingredient | Administration Frequency | Key Features/Notes |
|---|---|---|---|
| Perseris (discontinued) | risperidone | once-monthly (subcutaneous) | First subcutaneous once-monthly risperidone. |
| Risperdal Consta | risperidone | every 2 weeks (intramuscular) | The original long-acting injectable risperidone. |
| Invega Sustenna | paliperidone (metabolite of risperidone) | once-monthly (intramuscular) | A once-monthly LAI that is a metabolite of risperidone. |
| Abilify Maintena | aripiprazole | once-monthly (intramuscular) | Another once-monthly LAI option. |
| Aristada | aripiprazole lauroxil | once every 4 to 8 weeks (intramuscular) | A longer-acting aripiprazole option. |
A Summary of the Market Decision
Indivior's decision to discontinue the sales and marketing of Perseris stemmed from a multi-pronged business analysis in mid-2024. The key factors driving this move can be summarized as follows:
- Market Competitiveness: The market for long-acting injectable antipsychotics is highly competitive, with established alternatives like Risperdal Consta and Invega Sustenna, as well as newer options.
- Payor Landscape Changes: The Inflation Reduction Act (IRA) created a new environment for pharmaceutical pricing and reimbursement, leading to more aggressive payor management.
- Financial Viability Assessment: The company's internal analysis determined that continuing promotion for Perseris was no longer financially sound, despite growing sales figures.
- Corporate Restructuring: The withdrawal was accompanied by a corporate restructuring, including a reduction of approximately 130 jobs to adjust to the new business reality.
What This Means for Current Perseris Patients Indivior has committed to supplying Perseris for at least a year following the announcement to minimize any potential disruption to patient treatment. Patients should immediately contact their healthcare providers to discuss their treatment plan and transition to an alternative medication. The company has also established a medical information team to assist with inquiries during this transition. The switch to a new medication should be supervised by a professional to ensure continuity of care and avoid potential withdrawal symptoms.
Conclusion In conclusion, the discontinuation of Perseris is a result of strategic business decisions made by Indivior based on evolving market dynamics and financial viability concerns, particularly influenced by recent legislation. It is crucial to remember that this withdrawal is unrelated to any safety or efficacy problems with the medication itself. For patients and healthcare providers, the focus now shifts to managing a smooth and effective transition to a suitable alternative long-acting injectable or oral antipsychotic. For further information and support, patients can reach out to their healthcare provider or consult the resources provided by Indivior regarding the transition.
