Pricing & Reimbursement

Multiple payment models, including differential pricing for pooled purchases, and technology-based healthcare platforms are some of the ways to build a patient-centric ecosystem said officials from Roche, VCs and non-government bodies at a recent conference

Immuneel’s COO, Dr Arun Anand, talks to Scrip about how things are shaping for the Indian start-up’s autologous CD19 directed CAR-T cell therapy and the ‘journey to be traversed’ on the pricing front. He believes India could potentially see cell therapies being commercialized in the next 12 to 18 months.

Sanofi is the last of three big insulin makers to offer its top-selling insulin at the same out-of-pocket cost regardless of patients’ insurance coverage, but calls for other health care players to make concessions as well.

The company will lower the US list price of Levemir, NovoLog and certain other branded insulins by 65-75% and will also lower some unbranded insulin prices effective January 2024. Tresiba is not included.

Alzheimer’s product is following a different playbook than Aduhlem, reflecting better data – and hard-earned lessons. Eisai estimates that 80-90% of veterans who are eligible for Leqembi treatment based on the FDA label would also fit the VA’s criteria.

The two frontrunners look set to gain US FDA approval, but will need more robust long-term data to convince frontline physicians and payers of benefits to at-risk individuals.

Pharma business development executives and venture capital investors shared their thoughts on the Inflation Reduction Act at Biocom’s Global Life Science Partnering and Investor Conference in San Diego.

PBM contracting and payer formulary placement for branded Humira signal headwinds for biosimilar versions in the US, according to participants in an IQVIA-sponsored panel.

Biden Administration praises Lilly for latest moves to improve affordability of insulin in private market and calls for other sponsors to follow suit. Lilly’s plan is also tactical, as manufacturers of highly-rebated drugs with serial price hikes face an increased rebate liability in Medicaid next year.

The drug pricing watchdog said in its revised report that Alzheimer’s therapy Leqembi (lecanemab) meets cost-effectiveness thresholds at $8,900-$21,500, below Eisai/Biogen’s $26,500 list price.

The US FDA’s waiving of an advisory committee is another promising signal that Sarepta's Duchenne gene therapy SRP-9001 could be approved on 29 May and set it up to become a bigger earner than Novartis’s Zolgensma.

CEO Barry Greene and team spoke with Scrip about Sage and Biogen’s focus on short-term, episodic dosing, and said doctors and payers – pending zuranolone’s approval – are responding to the sales pitch.