Ex-FDA/CMS chief: Delivery efficiencies could balance drug costs
This article was originally published in Scrip
There have been few forums held in Washington in the past year about the biopharmaceutical industry that haven’t had at least one discussion focused on high drug prices, with Gilead Sciences $1,000-per-pill hepatitis C virus (HCV) drug Sovaldi (sofosbuvir) generally at the center of the debate.
And last week's two-day FDA-CMS Summit, hosted by Scrip's parent company Informa, was no exception.
But Dr John McHutchison, executive vice president of clinical research at Gilead, insisted all of the attention Sovaldi's $84,000 per treatment course price has been getting is simply "a distraction," and argued the focus should be on the long-term benefits the drug brings in reducing the overall costs to the US healthcare system through preventing the expensive care of dealing with advanced liver disease, such as hospitalizations and liver transplants.
With more "curative" treatments like Sovaldi expected to come to the marketplace for HCV and other diseases, Dr Mark McClellan, director of the Healthcare Innovation and Value Initiative at the Washington-based think tank the Brookings Institution, and the former head for both the FDA and the Centers for Medicare & Medicaid Services during the George W Bush administration, contended conversations about drug costs should be on the table.
But, he said, hopefully those discussions, which he expects to increasingly become more complex, will have constructive outcomes.
While the $84,000 price tag "is probably worth it," Dr McClellan pointed out the reality that multiplying that figure by "millions of patients" in the US with HCV "turns out to be a very big number" (scripintelligence.com, 24 March 2014, 25 March 2014).
Sovaldi is now the number one and fastest-growing item in state budgets, he noted.
"If you are a state Medicaid director, somebody looking at policies and at the federal budget, you're going to be making cost-effectiveness decisions not just within healthcare but within healthcare versus other national priorities," Dr McClellan said. "As a result in the growth in Medicaid, there is no question that state spending on other very important priorities, including public health priorities, like early childhood education, have been squeezed out."
The big question, he said, is how to find ways to balance the costly innovations, like breakthrough treatments, with other innovations, like delivery of care, aimed at bringing costs downs.
"I think it definitely can be done," Dr McClellan said. But, he lamented, "We're just not very good at doing it yet."
While the focus should rightly be on the value of medical innovation, Dr McClellan insisted "there's a lot more that, especially, the larger, successful companies that have a lot of products on the market could do to facilitate more efficiencies in use of drugs and supporting some of the reforms in delivery that could make healthcare much more sustainable."
He urged biopharmas to partner with healthcare groups that are focused on innovations to bring down costs.
"The more we can make healthcare work innovatively and efficiently, the better off we will be," Dr McClellan said.
This article may also be read at US Capitol Capsule http://www.scripintelligence.com/capitolcapsule/