Leading by example
Why Novartis may adopt indication-based pricing for Kymriah
A third-party cost-effectiveness analysis of CAR T therapies Kymriah tisagenlecleucel and Yescarta axicabtagene ciloleucel suggests that Novartis AG may need to price Kymriah differently for its second indication. Fortunately, the pharma is already discussing such a plan with payers.
In a draft report issued on Dec. 19, the Institute for Clinical and Economic Review (ICER) concluded that both Kymriah and Gilead Sciences Inc.’s Yescarta are priced in line with their long-term benefits in the indications for which they are approved.
Kymriah is approved to treat relapsed, refractory pediatric B cell acute lymphoblastic leukemia (ALL). It has a wholesale acquisition cost (WAC) of $475,000, including the cost of leukapheresis. Under an outcomes-based deal with CMS, the pharma is paid only for patients who are in remission one month after treatment.
Based on a complete remission rate of 63% in clinical trials and ICER’s calculation that Kymriah would provide 7.18 more quality-adjusted life years (QALYs) than clofarabine, the group concluded the CAR T product had an incremental cost per