Zurich : The spotlight on finding a cancer cure has spurred improvements in systems to collect and analyze oncology data, but efforts to track patients with other diseases lag behind, Roche pricing head Jens Grueger said.
Consequently, new data-driven flexible pricing schemes the Swiss drug maker and others in the industry are pushing to replace today’s “pay-per-pill” approach are well advanced in cancer treatment but will take longer for conditions like multiple sclerosis (MS), Grueger said.
Such schemes foresee drug pricing based on measurable benefits for a patient or health care systems, an approach seen as becoming more important as aging populations and chronic disease put the squeeze on health care systems.
Roche has introduced flexible pricing for cancer drugs in about a dozen European countries, including Italy, Belgium, Hungary, Switzerland and Austria. For instance, it already prices drugs like Avastin differently in some markets depending on the cancer being targeted.
On the flipside, if Roche’s investigational MS drug Ocrevus wins U.S. regulators’ approval possibly as early as next month pricing it flexibly for patients with different forms of the highly variable neurological disease is not in the cards.
“At this point in time, we don’t see a way that it would practically work,” Grueger said in an interview. “The data are not available, but it would be very much in line with our pricing philosophy.”
Novartis Chief Executive Joe Jimenez has struck value-based pricing deals with insurers on its heart failure drug Entresto.
But Jimenez has also called out inadequate data collection as a barrier to new pricing models.
“Building the framework needed to support value-based pricing, and the infrastructure of data and systems required to achieve them, is a priority for us,” said Jimenez, whose company is also working on a new drug for MS.
MS researchers have raised the issue of improved data too.
“To truly personalize treatment of MS, major breakthroughs in the areas of bioinformatics and biological computation systems will be required to make sense of this large and complex mix of information types,” researchers from the University Hospital Carl Gustav Carus in Dresden wrote earlier this year.
DRUG PRICE DEBATE
Amid escalating concern over drug prices, Roche and Novartis have invested millions to collect and analyze patient data, to help make the case their new medicines should still command a premium.
Roche this year led a $175 million investment into U.S. cancer data company Flatiron Health, while Novartis has expanded post-approval research into its $4,500-per-year heart failure medicine Entresto, to convince doctors and insurers of its merits versus older, cheaper medicines.
Experts say insurers and governments will intensify demands that pharmaceuticals makers justify their asking price for drugs by demonstrating they can generate savings for health care systems while improving patients’ quality of life.
“The industry will need to capture this data to prove their medicines work in the real world,” said Hilary Thomas, chief medical adviser at KPMG.
Drug costs have been the center of heated political debate, too, with Democratic presidential candidate Hillary Clinton promising to halt big price hikes if elected, and the U.S. state of California weighing in on a price-limits measure the industry is fighting tooth and nail.
Against this backdrop, drug makers say arming themselves with more data about their medicines will help them support prices.
“If you cannot demonstrate an additional benefit for patients, you should not charge a premium,” Grueger said. “The bar that has been set for demonstrating this evidence has been rising.”
He expects Flatiron’s algorithms to buttress Roche’s arguments during talks with payers as new combinations of expensive, often-personalized therapies hit the market.
“It gives us better insights into the potential for our products,” Grueger said. “But it also creates flexibility in how we can create value contracts in the future.”