ICER Update 05.20.19

Hello, everyone, and welcome to this edition of Excelsior Solutions’ ICER Update. Here is this week’s ICER recap:

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 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.”

The link to the full interview with Dr. Pearson can be found here:

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

Also, a Reuters piece discusses possible discounts for Zolgensma (before we even have a confirmed final launch price!) and describes some of the conditions that may accompany those discounts to market.

The link to that piece can be found here:

Novartis pitches discounts on pricey gene therapy for deadly muscle disorder (Reuters)

EXCELSIOR ACTION POINT: Much of the discussion surrounding the impending launch of Zolgensma to this point has focused on its cost, which is understandable. The first of the two linked pieces brings in some the ethical and basic family considerations that gene therapies, potential cures, and one-time treatments will necessarily cause to enter into the discussion of future drug/treatment coverage and financing determinations. The second piece gives a glimpse into some of the possible conditions that Novartis, the manufacturer of Zolgensma, may impose in consideration for receiving Zolgensma discounts. I highly recommend both pieces to you.

If you would like to discuss these ICER activities, or any other aspects of your Pharmacy Benefit Plan, simply reach out to your Excelsior Solutions account team and we will be happy to quickly set up a call.

Until next time!

Bob Kordella, RPh, MBA

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