Novartis keeps surfacing in the news in not a good way regarding the ethics of drug pricing. Could their Medical Affairs and Marketing Department need to step back and think things through carefully? Of course, it is a great Swiss-based multinational biopharmaceutical company with its share of blockbusters and innovative breakthroughs—including its recently approved gene therapy called Zolgensma for spinal muscular atrophy (SMA). Priced at $2.1 million per treatment, the company articulates a value proposition, but it doesn’t sit well with most people. Why?
Well, first and foremost, a multitude of press counters that first, it isn’t necessarily certain based on the clinical trials that have been conducted, how much benefit Zolgensma confers, and whether those benefits last for the long run. For example, in one particular clinical trial, just over 50% of the babies afflicted with SMA were able to sit up on their own. But what about the other half? Second, the company reports it doesn’t have sufficient production capacity for distribution outside the U.S—Hence, the company recently announced a “lottery program” for countries where Zolgensma isn’t licensed, such as Canada, reports British Columbia’s Times Colonist. For 100 lucky children (and their parents), 100 children will access the lottery and may stand a chance of living longer. The others are out of luck.
ICER, an independent nonprofit organization, seeks to improve healthcare value by providing comprehensive clinical and cost-effectiveness analyses of treatments, tests, and procedures established by high-end boundary of $1.6 and recommended a treatment price of $900,000 based on the benchmark of $150,000 quality-adjusted life year in patients with symptomatic type 1 SMA, the most common presentation of the condition today according to Peter B. Bach, a pulmonary and critical care physician with Memorial Sloan Kettering in a recent Health Affairs opinion.
Times Colonist Lawrie McFarlane suggests, if Novartis didn’t have sufficient production capacity, why didn’t they partner to help augment and prepare for the ability to produce the gene therapy? Or could this be “a blatant attempt to pressure countries into covering the drug?” Are they merely “using a show of fake compassion to gain markets for its drug” reports McFarlane. Then there is the opaque, mystical pricing models, created in a process “shrouded in secrecy” that magically derive the $2.1 million figure. The point raised by this author in British Columbia should resonate with those brand builders seeking a positive correlate—would it not be beneficial to have more transparency and work on the way to offer greater scale and hence more reasonable price points? One metric that might get Canada’s attention: By 2017, Novartis spent just 3.9% of sales revenue on Canadian-based R&D across all drug categories the Swiss sponsor sold in the country.
The author suggests the “only workable solution” represents “an international effort to bring drug licensing under some form of a common protocol.” She implies that producing breakthrough scientific cures would probably occur before this collective and coordinated international action to control drug prices.
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