ICER Weekly View: May 17, 2019

From the desk of David Whitrap

Good morning everyone. If you’re trying to avoid internet spoilers for either Game of Thrones or Jeopardy!, you’ve come to the right place. (Although as I say this, it strikes me that James Holzhauer might actually be the most deserving of the iron throne.)

Instead, let’s dive into this week’s news on drug pricing…

  • ICER in the News: Speculation about potentially the most expensive treatment ever, and media coverage of our Evidence Review for treatment-resistant depression.
  • Pharmaceutical News: An update on drug price proposals inside the beltway, why generics and biosimilars don’t always bring prices down, a preview of NASH treatments and digital therapies targeting depression and MS, and the latest lesson why ethically questionable behavior should be kept off social media.

ICER in the News

As we step one week closer to a potential FDA approval of the gene therapy Zolgensma for spinal muscular atrophy, the media focuses on the significant benefits this treatment offers patients living with the devastating disease, and whether or not the health care system can afford a treatment that may be priced well above $1 million. WBUR (Boston’s NPR affiliate) quotes ICER’s President Dr. Steve Pearson:

“This has been anticipated to be the most expensive treatment ever launched in the United States and perhaps in the world — for several reasons: One is because it is creating tremendously improved outcomes. It’s taking an always-fatal condition, and it could be a true cure. So you try to capture all that value in a one-time price. It’s different than trying to figure out the price for something that you would take every day for the rest of your life, where you could spread out that cost. We need to wrap up all that value and reward it. And that’s why the price, if you will, is going to be the highest sticker price that the U.S. or medicine anywhere in the world has seen.”

$2 Million Drug? Treatment For Rare Genetic Disease Is Expected To Break Price Record

Novartis pitches discounts on pricey gene therapy for deadly muscle disorder

Several media outlets reported on the Evidence Report we issued last week on the value of Janssen’s Spravato (esketamine) for treatment-resistant depression. Our Chief Medical Officer Dr. David Rind provides his perspective:

“Major depression is a severe and common condition, and new therapies are needed for the many people who are resistant to existing treatments. Esketamine shows some benefits for such patients and provides an FDA-approved treatment for TRD that may be covered by payers; however, it is concerning to have an overpriced therapy where there is such need for treatment. Additionally, the similarity of ketamine to esketamine raises issues for all stakeholders about how to consider off-label prescription and coverage of a treatment that has not been as well studied but is being increasingly used for TRD.”

J&J’s new esketamine drug for depression, Spravato,
not worth the money or the risk, watchdog says

(The Philadelphia Inquirer)

ICER chastises J&J for overpricing depression drug esketamine
‘where there is such need for treatment’

(EndPoints News)

Cost watchdogs scold J&J for ‘overpricing’ its new ketamine-like antidepressant

Pharmaceutical News

Yesterday, House lawmakers passed a suite of health care bills that paired fixes to the Affordable Care Act with proposals for lowering prescription drug prices.

House Passes Legislation Aiming
to Shore Up Health Law and Lower Drug Costs

(The New York Times)

Meanwhile, after having proposed more competitive negotiation within the Medicare “protected classes,” the Trump Administration received pushback from drug makers and is now retreating from this component of its blueprint to lower drug prices.

Trump administration backs off a proposal
to let Medicare plans exclude certain drugs

(STAT News)

While we’re at it, The Atlantic’s Jim Hamblin reviews how the administration has turned public anger at the pharmaceutical industry into real action – but has also left some meaningful opportunities on the table.

Has Trump Actually Done Anything About Drug Prices?
(The Atlantic)

Attorneys general from more than 40 states are alleging the nation’s largest generic drug manufacturers conspired to artificially inflate and manipulate prices for more than 100 different generic drugs, including treatments for diabetes, cancer, arthritis and other medical conditions.

States bring price fixing suit against generic drug makers
(The Associated Press)

And if anyone was holding out hope that a lower-cost version of Humira might soon become available, AbbVie just settled patent litigation with Boehringer Ingelheim that will delay a US biosimilar until 2023.

AbbVie settles key patent litigation over Humira,
preserving ‘monopoly prices’ in the U.S.

(STAT News)

Joining other big pharmaceutical companies in expanding beyond pills and injections into a new frontier of tech-based treatments, Sanofi is now studying a potential digital therapy for patients with depression and multiple sclerosis.

Sanofi Joins Drugmakers’ Bid to Treat Patients With Software

According to BioPharma Dive, the earliest drugs for nonalcoholic steatohepatitis (NASH) are likely to come with limited efficacy, price tags of $10,000 or more, and payer apprehension.

On the path to patients, NASH drugs may hit a payer roadblock
(BioPharma Dive)

And finally this week, Katie Thomas at the New York Times reports on the ethical concerns raised by a lavish “advisory board meeting” for the pharmaceutical company Evolus. They might’ve gotten away with it, if not for Instagram.

A Rival to Botox Invites Doctors to Party in Cancun,
With Fireworks, Confetti and Social Media Posts

(The New York Times)


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