ICER Weekly View: February 1, 2019

From the desk of David Whitrap

Good morning, everyone. I’m sure many of you are gearing up for an exciting Super Bowl, but I personally will have difficulty rooting for either 1) the team that stole a championship from my hometown or 2) the team that abandoned my hometown altogether.

So instead, I plan on Sunday to focus my energy on snacks (other than sour grapes), commercials, and the optimal betting strategy for “Super Bowl Squares.”

This week, let’s take a look at:

  • ICER in the News: CVS points to ICER’s assessment when explaining the company’s decision to cover two new treatments for migraine, anticipation builds over a potential new gene therapy for spinal muscular atrophy, and a think tank urges policymakers to pay more attention to independent value assessments.
  • Pharmaceutical News: Congressional hearings, the administration’s proposal to end the rebate model, PhRMA’s willingness to accept inflation caps, AstraZeneca’s novel approach to lower patients’ out-of-pocket costs, a peek behind the curtain at Purdue Pharma’s corporate strategy, the promising potential therapies for sickle-cell disease, and yet another setback for treating Alzheimer’s.

ICER in the News

Reporting on CVS Health’s decision to cover the new migraine treatments from Teva and Lilly, Reuters noted that ICER found the therapies’ net prices to be within traditional cost-effectiveness ranges.

Bloomberg notes that, based on our draft assessment of treatments for spinal muscular atrophy, Zolgensma may be more cost-effective than Spinraza, but still may exceed traditional cost-effectiveness thresholds if priced around $2 million. We plan to publish our revised Evidence Report on these therapies, incorporating public comments from a range of stakeholders, on February 21.

Within a series of recommended policies to control rising drug costs, the Center for American Progress discussed the positive role ICER is playing to encourage pharmaceutical companies to set prices in line with how well their treatments actually improve patients’ lives.

Comprehensive Reform to Lower Prescription Drug Prices – Center for American Progress

In recent months, the need to lower prescription drug costs has become increasingly apparent. Despite tough rhetoric from President Donald Trump, drug prices continue to soar under his administration. Last year, nearly 30 drug companies announced that price increases would take effect in January; Pfizer alone announced that it would raise the prices of 41 drugs.

Pharmaceutical News

This week, drug pricing was the subject of hearings on both sides of the Capitol. And both political parties seem motivated to do something about it, if not yet in full agreement on what that something is.

In dueling drug pricing hearings, lawmakers in both parties slam pharma

W ASHINGTON – Democrats here have, of late, been making far more noise about high prescription drug prices. But at two dueling hearings on Tuesday, the most powerful Republicans on each committee made their own mark. Rep.

And just yesterday, HHS Secretary Alex Azar proposed draft rules that, if approved, would prohibit drugmakers from paying rebates to Medicare plans unless those rebates are passed all the way through to patients. Insurers and pharmacy benefit managers were quick to point out that this rule may limit plans’ negotiating power with manufacturers.

Trump administration proposes big changes in how prescription drugs are priced

January 31 at 5:29 PM The Trump administration on Thursday proposed bringing transparency to one of the most secretive aspects of drug pricing by ending the widespread practice of rebates to middlemen – an effort to reduce what consumers pay for prescription medicine.

Meanwhile, PhRMA seems willing to cap future price hikes if the administration drops its proposal to peg Medicare drug reimbursement to an international pricing index.

PhRMA to accept inflation caps

PhRMA is prepared to accept a cap on drug price increases, biopharma executives involved in drafting the trade association’s response to the Trump administration’s drug pricing blueprint told BioCentury. The PhRMA board is considering a proposal that would commit members to limit price increases for drugs purchased by Medicare to a measure of consumer inflation.

Not waiting for government action, AstraZeneca and UPMC Health Plan have reached an outcomes-based agreement that shares cost-savings with patients.

AstraZeneca strikes ‘novel’ deal with a Medicare plan to lower patient costs – STAT

I n what is being called a novel bid to lower medicine costs, a drug maker has agreed to adjust the discounts that a Medicare Part D plan will receive for a treatment based on how patients respond – and the deal automatically lowers out-of-pocket costs for patients, as well.

And then there’s the less encouraging news that Purdue Pharma was looking to capitalize on the growing market for therapies that treat opioid use disorder at the same time the company was working to boost sales of its own controversial opioid.

OxyContin Maker Explored Expansion Into “Attractive” Anti-Addiction Market – ProPublica

Not content with billions of dollars in profits from the potent painkiller OxyContin, its maker explored expanding into an “attractive market” fueled by the drug’s popularity – treatment of opioid addiction, according to previously secret passages in a court document filed by the state of Massachusetts.

Gina Kolata at The New York Times takes a look at a half-dozen clinical trials planned or underway that suggest scientists may be on the cusp of correcting sickle-cell disease.

These Patients Had Sickle-Cell Disease. Experimental Therapies Might Have Cured Them.

Success against sickle-cell would be “the first genetic cure of a common genetic disease” and could free tens of thousands of Americans from agonizing pain. Scientists have long known what causes sickle-cell disease and its devastating effects: a single mutation in one errant gene.

Two steps forward and one step back. Countering the promising developments in sickle-cell, this week brought us yet another disappointing setback in the search for treatments for Alzheimer’s.

Xconomy: All Eyes on Biogen as Roche Alzheimer’s Drug Flunks Final Test

Xconomy National – Roche this morning added yet another failure to the ever-growing number of experimental Alzheimer’s disease drugs to crumble in late-stage human testing. The Swiss pharma and partner AC Immune (NASDAQ: ACIU) will stop two Phase 3 studies of their drug crenezumab in Alzheimer’s early after an interim analysis by a committee of investigators showed those trials were likely to fail.

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