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BioCryst Achieves Reimbursement for ORLADEYO Across all Major European Countries

Key Takeaway: BioCryst Pharmaceuticals announced that ORLADEYO (berotralstat) has obtained reimbursement approval in the Netherlands, facilitating access across all major European countries for patients aged 12 and older with hereditary angioedema (HAE). This approval follows the European Commission's marketing authorization from April 2021 and signifies a significant advancement for the treatment of HAE, which is the first oral, once-daily preventive therapy available. The drug is commercially available in over 30 countries. However, there are safety concerns regarding QT prolongation at higher doses and insufficient data on pediatric and pregnancy use.

Market Sentiment Analysis

POSITIVE FACTORS

  • BioCryst secures reimbursement approval for ORLADEYO in the Netherlands.
  • The approval allows HAE patients in major European countries to access a first-line oral therapy.
  • The drug is now commercially available in over 30 countries, indicating strong acceptance.
  • This event is seen as a victory for the HAE community and improves treatment options.

CONCERNS & RISKS

  • Safety and effectiveness of ORLADEYO for acute HAE attacks have not been established.
  • Potential for QT prolongation at higher dosages raises safety concerns.
  • Limited data exists on use during pregnancy and for pediatric patients under 12.

Full Press Release Details

RESEARCH TRIANGLE PARK, N.C., June 06, 2025 (GLOBE NEWSWIRE) -- BioCryst Pharmaceuticals, Inc. (Nasdaq: BCRX) today announced that, following a positive recommendation from the Zorginstituut Nederland, ORLADEYO® (berotralstat) has been approved for the routine prevention of hereditary angioedema (HAE) attacks in patients aged 12 years and older. This reimbursement approval in the Netherlands marks national reimbursement for ORLADEYO across all major European countries, providing HAE patients with access to the first oral, once-daily preventive therapy.
“From day one, our mission has been to bring ORLADEYO to as many people living with hereditary angioedema as possible. Securing reimbursement in the Netherlands is a proud moment for our team as it means that patients and physicians across all major European countries now have access to a modern, oral prophylactic option to help prevent HAE attacks. This is a great day for the HAE community and for the future of treatment,” said Abid Karim, general manager of Europe at BioCryst.
This decision in the Netherlands follows the European Commission marketing authorization of ORLADEYO in April 2021. To date, ORLADEYO is commercially available in more than 30 countries.
About ORLADEYO® (berotralstat)
ORLADEYO® (berotralstat) is the first and only oral therapy designed specifically to prevent attacks of hereditary angioedema (HAE) in adult and pediatric patients 12 years and older. One capsule of ORLADEYO per day works to prevent HAE attacks by decreasing the activity of plasma kallikrein.
U.S. Indication and Important Safety Information
ORLADEYO® (berotralstat) is a plasma kallikrein inhibitor indicated for prophylaxis to prevent attacks of hereditary angioedema (HAE) in adults and pediatric patients 12 years and older.
The safety and effectiveness of ORLADEYO for the treatment of acute HAE attacks have not been established. ORLADEYO should not be used for the treatment of acute HAE attacks. Additional doses or dosages of ORLADEYO higher than 150 mg once daily are not recommended due to the potential for QT prolongation.
IMPORTANT SAFETY INFORMATION
An increase in QT prolongation was observed at dosages higher than the recommended 150 mg once-daily dosage and was concentration dependent.
The most common adverse reactions (≥10% and higher than placebo) in patients receiving ORLADEYO were abdominal pain, vomiting, diarrhea, back pain, and gastroesophageal reflux disease.
A reduced dosage of 110 mg taken orally once daily with food is recommended in patients with moderate or severe hepatic impairment (Child-Pugh B or C).
Berotralstat is a substrate of P-glycoprotein (P-gp) and breast cancer resistance protein. P-gp inducers (eg, rifampin, St. John’s wort) may decrease berotralstat plasma concentration, leading to reduced efficacy of ORLADEYO. The use of P-gp inducers is not recommended with ORLADEYO.
ORLADEYO at a dose of 150 mg is a moderate inhibitor of CYP2D6 and CYP3A4. For concomitant medications with a narrow therapeutic index that are predominantly metabolized by CYP2D6 or CYP3A4, appropriate monitoring and dose titration is recommended. ORLADEYO at a dose of 300 mg is a P-gp inhibitor. Appropriate monitoring and dose titration is recommended for P-gp substrates (eg, digoxin) when coadministering with ORLADEYO.
The safety and effectiveness of ORLADEYO in pediatric patients <12 years of age have not been established.
There are insufficient data available to inform drug-related risks with ORLADEYO use in pregnancy. There are no data on the presence of berotralstat in human milk, its effects on the breastfed infant, or its effects on milk production.
To report SUSPECTED ADVERSE REACTIONS, contact BioCryst Pharmaceuticals, Inc. at 1-833-633-2279 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Please see full Prescribing Information.
About BioCryst Pharmaceuticals
Forward-Looking Statements
This press release contains forward-looking statements, including statements regarding BioCryst’s plans and expectations for ORLADEYO. These statements involve known and unknown risks, uncertainties and other factors which may cause actual results, performance or achievements to be materially different from any future results, performance or achievements expressed or implied by the forward-looking statements. These statements reflect our current views with respect to future events and are based on assumptions and are subject to risks and uncertainties. Given these uncertainties, you should not place undue reliance on these forward-looking statements. Some of the factors that could affect the forward-looking statements contained herein include: BioCryst’s ability to successfully implement or maintain its commercialization plans for ORLADEYO; risks related to government actions, including that decisions and other actions, including as they relate to pricing, may not be taken when expected or at all, or that the outcomes of such decisions and other actions may not be in line with BioCryst’s current expectations; the commercial viability of ORLADEYO, including its ability to achieve sustained market acceptance; the FDA, the Zorginstituut Nederland, or other applicable regulatory agency may require additional studies beyond the studies planned for products and product candidates, may not provide regulatory clearances which may result in delay of planned clinical trials, may impose certain restrictions, warnings, or other requirements on products and product candidates, may impose a clinical hold with respect to product candidates, or may withhold, delay, or withdraw market approval for products and product candidates; BioCryst’s ability to successfully manage its growth and compete effectively; and risks related to the international expansion of BioCryst’s business. Please refer to the documents BioCryst files periodically with the Securities and Exchange Commission, specifically BioCryst’s most recent Annual Report on Form 10-K, Quarterly Reports on Form 10-Q, and Current Reports on Form 8-K, which identify important factors that could cause the actual results to differ materially from those contained in BioCryst’s forward-looking statements.

Frequently Asked Questions

What is ORLADEYO® approved for?

ORLADEYO® (berotralstat) is approved for preventing hereditary angioedema (HAE) attacks.

Who can use ORLADEYO®?

ORLADEYO® is for patients aged 12 years and older.

How does ORLADEYO® work?

It prevents HAE attacks by decreasing plasma kallikrein activity.

What are common side effects of ORLADEYO®?

Common side effects include abdominal pain, vomiting, and diarrhea.

Is ORLADEYO® safe for pregnant patients?

Safety data on ORLADEYO® use during pregnancy is insufficient.

Last updated: Jun 6, 2025