ICER Weekly View: March 1, 2019

From the desk of David Whitrap

Hello everyone. This week, a self-proclaimed “fixer” testified in front of the House Oversight Committee. And the day before that, the Senate Finance Committee held a separate hearing to identify some fixes of its own for our country’s drug pricing dysfunction. Time will tell which of these sessions will end up having a bigger impact.

This morning, let’s take a look at:

  • ICER in the News: Our new Evidence Report on treatments for spinal muscular atrophy, and the launch of a new drug assessment.
  • Pharmaceutical News: Did I mention seven pharma execs testified on Capitol Hill?

ICER in the News

Last Friday, ICER published our Evidence Report assessing the comparative clinical effectiveness and value of nusinersen (Spinraza®, Biogen) and onasemnogene abeparvovec (Zolgensma®, Novartis/AveXis) for the treatment of spinal muscular atrophy (SMA). Both treatments provide substantial health benefits, and payers will cover them. However, the current pricing of Spinraza would require a significant discount to meet traditional cost-effectiveness ranges. And for the gene therapy Zolgensma, which does not yet have an actual price, ICER established a value-based price range of between $310,000-$900,000 using our standard methodology and as high as $1.5 million using an alternative measure of health gain. Next week, an independent appraisal committee will be reviewing these findings — as well as the many contextual issues and broader benefits for patients and families — when they vote on the clinical and economic value of these treatments.

ICER’s Assessment Finds Spinraza and Zolgensma Provide Substantial Health Benefits for People with Spinal Muscular Atrophy

Our announcement was covered by several media outlets, including Reuters, STAT News, and Bloomberg.

Novartis gene therapy would be cost effective up to $900,000: U.S….

(Reuters) – An experimental gene therapy for spinal muscular atrophy (SMA) developed by Novartis AG would be worth up to $900,000, according to an independent U.S. nonprofit organization that reviews the value of drugs and medical treatments.

Two drugs for spinal muscular atrophy should be priced how low?- STAT

T wo medicines designed to treat spinal muscular atrophy, a rare and often fatal genetic disease affecting muscle strength and movement, would have to carry much lower price tags than the manufacturers prefer in order to be considered cost effective, according to an updated analysis.

Novartis Gene Therapy Could Be Cost-Effective Up to $1.5 Million (Bloomberg)

BioCentury took a deeper look into how and why our report features multiple ways to calculate the treatments’ ability to lengthen life.

ICER’s life year calculation gives Novartis wider pricing ballpark for SMA therapy

Based on the number of years of life it adds, spinal muscular atrophy therapy Zolgensma onasemnogene abeparvovec (AVXS-101) would be cost effective if priced under $1.5 million per year, according to an evidence report released Friday from the Institute for Clinical and Economic Review (ICER).

And following the publication of our SMA Evidence Report, we announced we’re launching a new assessment into icosapent ethyl (Vascepa®, Amarin Pharma) and rivaroxaban (Xarelto®, Janssen Pharmaceuticals). Open Input is now being accepted through March 12.

ICER to Publish Upcoming Assessment on Additive Cardiovascular Disease Therapies

Pharmaceutical News

The other top news item of the week clearly was the Senate Finance Committee’s drug pricing hearing, which featured leaders from AbbVie, AstraZeneca, Bristol-Myers Squibb, Johnson & Johnson, Merck, Pfizer and Sanofi. The executives predictably expressed support for some legislation aimed at curbing drug prices, but they hedged that support, and many of the proposals they back don’t target drug makers.

Pharma Execs Dig In For A Fight Against Outraged Senators

Senators got their first opportunity Tuesday to prod drugmakers about the wallet-emptying prices they charge for prescription drugs. Almost in unison, the executives expressed support for eliminating rebates that flow to industry middlemen instead of patients; for increasing transparency about how they set prices; for shifting to a more value-based pricing system, in which outcomes are rewarded.

Drug Makers Try to Justify Prescription Prices to Senators at Hearing

WASHINGTON – Pharmaceutical executives, testifying before Congress, could not readily explain on Tuesday why the prices for many brand-name prescription drugs were much higher in the United States than in other developed countries.

Who shined and who sank: How 7 executives fared in defending pharma

Pharma executives struggled at times to push back against lawmakers’ arguments, but many of them also had moments in which they made a favorable impression.

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