— Report finds new therapies clinically comparable to currently available generic treatments and provides recommendation for pricing —
BOSTON, October 1, 2026 – The Institute for Clinical and Economic Review (ICER) today posted its revised Evidence Report assessing the comparative clinical effectiveness and value of baxdrostat (Baxfendy™, AstraZeneca) and lorundrostat (Mineralys Therapeutics, Inc.) for hypertension.
Downloads: Evidence Report | Voting Questions | Public Comments | Response to Public Comments
“High blood pressure is common, leads to serious complications like heart disease, strokes, and kidney failure, and is frequently undertreated,” said ICER’s Chief Medical Officer David Rind, MD, MSc. “Baxdrostat and lorundrostat are from a new class of medications intended for patients that may need more than standard first-line therapies. The hope is that they may have fewer side effects and reduce clinical events, but evidence for such benefits is currently limited.”
Key Clinical Findings
In short term trials, when added to 2-3 first-line antihypertensive medications:
- Baxdrostat and lorundrostat produced blood pressure reductions that appeared comparable to older drugs like spironolactone or eplerenone, resulting in ratings of “promising, but inconclusive” (P/I).
- Baxdrostat and lorundrostat produced blood pressure reductions that appeared comparable to amlodipine. Additionally, there is evidence of greater cardiovascular benefits with amlodipine than with some other classes of blood pressure medications — but no such evidence for these new agents, baxdrostat and lorundrostat. Therefore, ICER rated the evidence as comparable or inferior (C-) for baxdrostat and lorundrostat when each was compared to amlodipine.
When baxdrostat was compared to lorundrostat, ICER rated the evidence as “insufficient” (I); there is insufficient evidence to assess the difference in net health benefit between the two medications.
Key Cost-Effectiveness Findings
Baxdrostat is approved by the FDA for the treatment of hypertension. Lorundrostat has not yet been approved by the FDA, and the manufacturer has not yet announced a US price for the therapy, if approved. ICER calculated a health benefit price benchmark (HBPB)* for each treatment:
- Baxdrostat: between $1,400 and $2,500 per year.
- Lorundrostat: between $760 and $1,600 per year.
AstraZeneca chose a list price for baxdrostat of $10,950 per year. A 78-87% discount would be needed from the estimated price to reach ICER’s fair price range.
ICER Virtual Public Meeting
Register here to watch the live webcast of the virtual meeting. This Evidence Report will be reviewed at a virtual public meeting of the Midwest CEPAC on October 29, 2026. The Midwest CEPAC is one of ICER’s three independent evidence appraisal committees comprising medical evidence experts, practicing clinicians, methodologists, and leaders in patient engagement and advocacy.
A draft version of this report was previously open for a four-week public comment period. The updated Evidence Report and voting questions reflect changes made based on comments received from patient groups, clinicians, drug manufacturers, and other stakeholders. Detailed responses to public comments can be found here.
*ICER’s HBPB is a price range suggesting the highest US price a manufacturer should charge for a treatment, net of all rebates and discounts, based on the amount of improvement in overall health patients receive from that treatment, when a higher price would cause disproportionately greater losses in health among other patients in the health system due to rising overall costs of health care and health insurance. In short, it is the top price range at which a health system can reward innovation and better health for patients without doing more harm than good.
About ICER
The Institute for Clinical and Economic Review (ICER) is an independent, non-profit research institute that conducts evidence-based reviews of health care interventions, including prescription drugs, other treatments, and diagnostic tests. In collaboration with patients, clinical experts, and other key stakeholders, ICER analyzes the available evidence on the benefits and risks of these interventions to measure their value and suggest fair prices. ICER also regularly reports on the barriers to care for patients and recommends solutions to ensure fair access to prescription drugs. For more information about ICER, please visit www.icer.org.