ICER Weekly View: April 26, 2019

From the desk of David Whitrap

Business Insider recently published its list of the “Top 10 People Transforming Healthcare,” recognizing ICER’s President Steve Pearson alongside other leaders such as former FDA Commissioner Scott Gottlieb, Haven’s CEO Atul Gawande, Merck’s CEO Ken Frazier, and 23andMe’s CEO Anne Wojcicki. I encourage you to read the full announcement and (if you’re a subscriber to Business Insider) the standalone feature on ICER: “Meet the little-known Harvard spinoff that’s standing up to Big Pharma and setting its own price tags on new drugs.” Congratulations to all the honorees.

On top of that, this morning let’s look at:

  • ICER in the News: The future of gene therapy in the US, more reactions to our assessment of the SMA therapies, and a new JAMA article about valuing treatments for an aging population.
  • Pharmaceutical News: Removing a profitable cancer treatment from the market after it was proven ineffective, seeking consensus in DC over drug pricing, examining how partnerships with government and academia are speeding new treatments to market with less industry investment, separating which patient advocacy organizations truly advocate for patients and which are simply funded by industry to lobby for higher prices, and speculating on which pipeline products may ultimately generate the most revenue for their companies.

ICER in the News

Xconomy’s Alex Lash sat down with Dr. Pearson to pick his brain about how society can assess the value of, and pay for, the first two gene therapies on the market as well as the others on their way.


Xconomy: Can We Afford to Be Cured? A Conversation With ICER’s Steve Pearson

Xconomy Boston – [ Corrected, 4/23/19, 7:10 p.m. See below.] New cell and gene therapies bring the possibility of cures once hardly imaginable. But the potential cures could also cost millions of dollars, like Novartis (NYSE: NVS), the owner of the gene therapy Zolgensma, has suggested in advance of an imminent FDA approval decision.

In advance of the American Academy of Neurology’s annual meeting, Neurology Today summarized ICER’s recent assessment of treatments for spinal muscular atrophy and spoke with multiple clinical experts to gather their reactions. Dr. Gregory J. Esper, chair of the AAN Health Services Research Subcommittee, provided the concluding perspective: “Ultimately, while these drugs represent new hope for SMA patients, the realities of limited resources for global medical spending must be addressed in order to ensure unintended consequences, such as limited access to care and treatment for other patients with other diseases. My desire is that we can somehow make it all work.”

Two New Treatments for Spinal Muscular Atrophy May Be Clinically Effective, But Are They Cost-Effective? An Independent Watchdog Agency Does the Math
(Neurology Today)

Jerry Gurwitz, ICER’s Visiting Senior Fellow, partnered with Steve Pearson to author a Viewpoint article for JAMA about how the whole health system could work together to achieve higher-value care for an aging population.

Novel Therapies for an Aging Population
(Journal of the American Medical Association)

Pharmaceutical News

Yesterday, Eli Lilly announced it would withdraw its cancer drug Lartruvo from the market after a study showed that the treatment failed to prolong overall survival. Based on an earlier-stage study, the FDA granted Lartruvo accelerated approval in 2016 under the condition that Lilly would conduct additional studies to confirm the treatment’s benefit. Since that time, Latruva has pulled in approximately $500 million in revenue for the company. The latest study’s full results will be released at the annual ASCO meeting at the end of next month.

Eli Lilly to Pull Cancer Drug From Market After Failed Study

Eli Lilly plans to withdraw its cancer drug Lartruvo from the market after a study showed that it failed to prolong overall survival in a clinical trial.

After speaking with industry experts and federal government officials from both political parties, Axios’ Caitlin Owens and Jonathan Swan conclude that that a drug pricing bill has a better chance of becoming law before the 2020 election than any other controversial legislation.

There’s more optimism around a drug pricing deal than on any other issue

What they’re saying: “I think if we get a bipartisan deal on anything, it’s going to be this,” a senior administration official told Axios, characterizing the thinking at the top level of the White House.

…So this shouldn’t be THAT big of a surprise:

Some drug companies boost lobbying efforts amid scrutiny from Congress

Some drug manufacturers have significantly increased their lobbying expenditures in the face of new scrutiny from Congress, while others are tightening their wallets. AstraZeneca, Bristol-Myers Squibb, Johnson & Johnson, Eli Lilly and Genentech all increased their lobbying efforts in the first three months of this year, according to disclosure reports filed Monday, upping industry spending by hundreds of thousands of dollars.

Modern Healthcare’s editor Merrill Goozner examines how many of the newest pharmaceutical innovations rely heavily on government and academic partnerships — a synergy he suggests speeds new treatments to market with less R&D investment from industry, undermining the arguments that some companies make when justifying their drugs’ prices.

Editorial: The cost of irresponsible tech transfer

The government and academic medical centers need to rethink their technology transfer policies, which have allowed the price of specialty drugs to soar to unsustainable heights. The latest targeted therapies for cancer and genetic diseases are coming to market with price tags approaching a half-million dollars per patient.

A new survey of more than 1,500 patient advocacy organizations found that 41% of patient groups thought the pharmaceutical industry had an “excellent” or “good” reputation last year, but only 12% believed that drug makers did an excellent or good job of disclosing their pricing policies.

Pricing is taking a toll on pharma’s reputation – STAT

W hen it comes to improving its image, the best that the pharmaceutical industry can do is go sideways. Just 41% of patient groups thought the pharmaceutical industry had an “excellent” or “good” reputation last year, which is within striking distance of the 43% notched in 2017 and 38% in 2016, according to a survey by PatientView, a research firm that canvassed more than 1,500 patient groups from 78 countries between last November and this past February.

This may be why there’s an increasing number of groups that sound like patient advocacy organizations, but are actually funded exclusively by pharmaceutical companies to fight back against any efforts to lower drug prices in the US. Businessweek’s Ben Elgin investigates.

Pharma’s Secret to Lobbying for Higher Drug Prices?
(Bloomberg Businessweek)

Vantage reviewed consensus analyst estimates to create a list of the top 10 drugs currently in the pipeline that could deliver the highest revenue to their companies in five years. ICER has initiated assessments of several of these.

Splitting the difference on promising pipeline asset predictions

Lack of clarity around pricing is perhaps the most critical factor in the dispute about the eventual sales figures of Vertex’s cystic fibrosis triplet of VX-659, tezacaftor and ivacaftor. The triplet is forecast, by consensus, to become the biggest seller out of all current phase III or filed projects, with sales of $4.8bn in 2024.


Sign-up to have the Weekly View delivered to your inbox every Friday morning.