Free drug pricing in the US has fewer than five years to run, thanks to mounting pressure on health care spend and resulting efficiency drives. That’s the message to pharma investors, be it from fund-managers speaking at Bloomberg Industries Healthcare event in London on Dec. 10, or from analysts such as as Citi’s Andrew Baum. It’s tempting not to believe it. After all, for now, US drug price increases are actually at a five year … Continue reading
Want Better Access? Then Take Some More Risk
Biopharma is an industry seeped in an above-average concentration of risk. Scientific, clinical and regulatory uncertainties add to more typical commercial and market-driven risks. Given that, you’d think pharma execs would be a little more willing to stick their necks out and embrace (or at least explore) change. Some are. They get that payer cost-pressures and pipeline productivity challenges are forcing new, make-or-break approaches to clinical development, payer interactions, and commercial positioning. Yet toward the … Continue reading
Drug Approvals Need Shades Of Grey
FDA’s Endocrinologic and Metabolic drugs advisory committee on Nov. 8 voted 8-4 in favor of recommending Novo’s latest insulin degludec (Tresiba) for approval. The detailed debate and deliberation underscored how unsuitably black-and-white the drug approval process is. In the end, FDA (just like the European Medicines Agency), will say either ‘yes’ or ‘no’. Yet the difference between acceptable risk and unacceptable risk among drug treatments isn’t a well-defined one. Nor is the threshold or criteria separating insufficient data from sufficient … Continue reading
Sanofi Blinks First: Zaltrap Price Cut Proves HTA Has Reached The US
Sanofi’s decision last week to cut the price of its colon cancer drug Zaltrap by up to 50% showed that the US market is no longer immune to European-style drug price pressure. Never mind that the move was partly a result of a messed-up calculation on Sanofi’s part: this was a defining moment in the evolution of America’s troubled health care system. That the price of a drug was cut at all, and voluntarily (albeit under pressure), is … Continue reading
Discounting For Access: The QALY Math Is Spreading
Last week, England & Wales’ cost-watchdog NICE approved reimbursement for two drugs for advanced melanoma, Roche’s Zelboraf and Bristol’s Yervoy. As is so often the case at NICE, both drugs had initially been rejected, and both in the end came through with confidential discounts to the list-price. But this isn’t just a story about discounting, nor is it just about the UK. Everyone knows that winning reimbursement in England & Wales boils down to math – math that culminates … Continue reading
The Value Debate: Can Personalized Drugs Support Personalized Pricing?
“Personalized health care requires a new reimbursement model,” declared Roche’s VP Global Pricing & Market Access Jens Grueger in the elegant London county hall debating chamber on Monday, at the Office of Health Economics (OHE)-sponsored gathering of payers, pharma and economists. The venue was appropriate. Debate centered around whether the move towards more personalized medicine could reasonably support more personalized pricing. Roche, with plenty of targeted medicines at stake, thinks, perhaps wishfully, that more differential, ‘value-based’ pricing is … Continue reading
Risk-Shares Pop Up Again As Payers, Pharma Circle New Payment Models
Say you’re GSK, and a head-to-head trial pitting your drug against the market leader showed non-inferiority. Say, too, that even though you assembled some trial evidence that patients preferred your drug vs. the leader, this hadn’t convinced everyone. So, with 70% of prescriptions still favoring your competitor, what to do? Blunt rebating is one option – but hardly commercially attractive. So how about taking the risk of testing your tolerability claim in the real world? … Continue reading
Patient-Based Pricing: An Answer To The Soaring Cost of Innovation?
Roche’s investor day on Sept. 5 provided heartening news for breast cancer patients. Executives outlined an array of increasingly targeted therapeutic permutations to combat the tumor, building on its leadership with Herceptin. But payers will have come away worried. The slew of new drugs, combinations and conjugates points to rapidly-multiplying per-patient costs, as (likely) premium-priced individual treatments are teamed up. Roche seems to be aware of the tension. Even as it promoted more effective versions of existing … Continue reading
The Real-World Evidence Buzz Now Matters As Payers Push For Risk-Based Pricing
Everyone’s talking about real-world evidence (RWE). But should pharma care? Is it driving coverage decisions? The answer’s getting closer to ‘yes’. (For proof of that, join a frank payer-pharma discussion on the subject at our RE Symposium November 1-2.) There’s good reason to be talking RWE: in theory, it’s the key to a more efficient, sustainable health care system. If payers and providers could track which drugs and treatment pathways lead to the best outcomes … Continue reading
Europe’s New Season HTA: German System Beds Down; NICE Grip Tightens
European HTA officers return to their offices after the summer break with more job-confidence than many other health care stakeholders. Rather like lawyers, their role will become more important as budget pressures mount amid continued European economic turmoil. Indeed, the Germans are patting themselves on the back for their new early-benefit assessment system: G-BA Chairman Josef Hecken on Sept. 3 in Berlin declared the system “transparent, legally secure and predictable” with decisions based on “clear, … Continue reading