NICE's Soliris request – a watershed for ultra-orphan drugs or more of the same?
Published in FirstWord 6 March 2014 by Shrinivas Rao Mukku and Simon King
Forbes' healthcare editor Matthew Herper noted back in January that when "Alexion's performance stops beating like clockwork, we'll know that pricing pressure has come to medicine."
Herper was referencing more specifically the performance of Alexion Pharmaceuticals' ultra-orphan therapy Soliris, which is indicated for the treatment of paroxysmal nocturnal haemoglobinuria (PNH) and atypical haemolytic uremic syndrome (aHUS), and accounts for all of the company's revenue ($1.6 billion in 2013).
Highlighting the particularities of the ultra-orphan drug model, Soliris is regularly cited for its status as being the world's most expensive pharmaceutical product, costing around $400,000 per patient per year in the US market.
That price has yet to be challenged in the US, but in Europe the ultra-orphan model appears to be under increased pressure. Does a decision by the UK's National Institute for Health and Care Excellence to ask Alexion to explain the price of Soliris suggest that this trend may be intensifying?
Pharma Payer Partnerships - Rhetoric or Reality?
“Progress is impossible without change, and those who cannot change their minds cannot change anything” George Bernard Shaw
Successful Pharma Payer Partnerships require a change in the mindset of participants from their current comfort zones - payers from a fixed focus on purely budgetary matters and pharma from providing medicines on a volume based, benefits selling basis. A consideration of the complete patient treatment journey will require fresh thinking from both stakeholders. External factors, such as a realization by Pharma that the era of the blockbuster is over, an increased patient empowerment fuelled by the Internet and the current austerity measures sweeping Western Europe, are accelerating the need for mutually beneficial partnerships.
Recently in the United Kingdom the Health and Social Care Bill 1 provided a framework to promote joint working between the NHS and the pharmaceutical industry. Its aim is to improve the innovation and delivery of healthcare through improved collaboration between the NHS and Industry.
Navigating and mitigating Payer uncertainty around innovative oncology products
We have conducted many payer research projects supporting the commercialization of oncology products. During our research, payers frequently express their frustration at the apparent disconnect between a manufacturer’s pricing and market access value proposition and the clinical and economic evidence to support the manufacturer’s position.
Unfortunately our industry’s reliance on traditional qualitative payer interviews and advisory boards has left many gaps in the identification of value as defined by the payer and the “value proposition” as communicated by the manufacturer.
Price and Revenue Optimisation modeling
With the increased emphasis on value-based pricing, Access Partnership has been working with a number of big pharma partners recently to deliver price models that maximise their product’s revenue potential.
Our approach utilises 3 critical pricing elements: pricing strategy, the value of the product to both buyer and seller, tactics that manage all elements impacting profitability.
Transformation of services and care pathway re-design – creating a sustainable future for healthcare
One of the major issues for global pharma currently is the global anxiety around the sustainability of healthcare. There is a broad consensus that transformation rather than transaction is key to creating a financially stable health economy.
Unfortunately, the evidence indicates that certain markets have had limited success to date. In the UK for example, 47% of PCT clusters in 2011-12 reinvested less than a quarter of their cash releasing savings in transforming services. The proportion of cash-releasing savings reinvested in transforming services varied and there is no evidence of a shift in staff from the acute to the community sector