Press review

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French press says high price of Novartis' Zolgensma raises questions over pharma pricing strategies

PARIS, 28 June (APM) - A child's life is worth $2 million according to Novartis, as that is the U.S the price the pharma has set for its spinal muscular atrophy (SMA) drug Zolgensma (onasemnogene abeparvovec), reported La Croix on Tuesday (p.13-15).
While the drug can have an extraordinary impact, extending lives of infants with type 1 SMA who are usually dead before their third birthday and meaning some of them can sit up and walk unaided, its equally extraordinary price is raising questions about pharma pricing strategies.
Avexis, which developed the drug before being bought by Novartis, defended the drug's price, saying it provides major therapeutic benefit for a limited number of patients and its development and production costs are high.
The debate over Zolgensma leads to a more general discussion of how prices are agreed with pharma companies in different countries, the paper continued.
Non-governmental organisations (NGOs) are fighting for more transparency, saying that even though some pharma companies and countries announce a drug's public reimbursement price, discounts are often negotiated behind closed doors. This means countries do not know how much their neighbours are actually paying for a drug to the benefit of pharma companies.

Slow, steady progress of gene therapies

Gene therapies are making slow but steady progress, Le Figaro reports on Friday (p.10).
Since the first clinical trial involving gene therapies for severe combined immunodeficiency (SCID) took place 30 years ago, the technology has been widened to target not just diseases arising from genetic mutations but cancers as well.
In total, about a dozen gene therapies are now available, including the CAR-T therapies Novartis' Kymriah (tisagenlecleucel) and Gilead's Yescarta (axicabtagene ciloleucel).
However, the paper pointed out that at the moment, gene therapies are only available for a handful of rare diseases and there is another issue with these innovative treatments: cost.

AbbVie to buy Allergan

AbbVie is buyingAllergan to get hold of its star product, Botox, to make up the sales it is losing as biosimilars of its own star product Humira (adalimumab) start to arrive on the market, reported Les Echos on Wednesday (p.15) (APMHE 63456).
Humira is the world's best-selling drug and AbbVie has used a very defensive strategy to protect these sales from competition as long as possible, especially in the U.S.
However, this has merely given the pharma time to develop new products and acquire Allergan, the economic daily continued.
The sales generated by Botox should make up for the sales lost to Humira biosimilars, but Botox is also facing competition from generics, so this will not solve the long-term problem of renewing AbbVie's portfolio, the paper added.
Le Figaro also reported on the topic on Wednesday (p.23).

BMS to sell Otezla to secure Celgene takeover

Bristol-Myers Squibb will have to sell Celgene's psoriasis drug Otezla (apremalist) for its takover of the pharma to get approval from the U.S. Food and Drug Administration, Les Echos reported in a brief on Tuesday (p.15) (APMHE 63441).
BMS announced in January that it was buying Celgene for $74 billion, the largest ever takeover deal in the pharmaceutical industry and which should be completed in 2020.

France's health insurance plans to save €2 billion in 2020

France's health insurance published a report on Thursday detailing how it will save €2 billion in 2020, reports Les Echos on Friday (p.2).
This year, the health insurance has decided to highlight the savings it could make on drugs and medical devices, stating that it aims to make savings of €887 million on healthcare products, not including price cuts and agreement-based discounts given by pharma companies.
The savings will be made through various measures, including cutting down on waste and unused products, and encouraging the prescription in hospitals and in the community of biosimilars, the paper continued.
Le Figaro also reports on the topic on Friday (p.19).

Hope for haemophilia

New haemophilia treatments are promising a better life for patients, as they require fewer and more spaced-out injections, reported Le Figaro on Monday (p.10).
Haemophilia is well covered for the 6,000 patients with the condition in France. However, despite constantly being told that they can now lead a normal life, that is far from the case for patients as these treatments require frequent intravenous (IV) injections and do not cure haemophilia.
New gene therapies are looking to correct this, by introducing into certain cells, via a non-pathogenic virus, the correct version of the gene mutation that causes this particular blood disorder.
Another type of gene therapy - monoclonal antibodies - are already being used in some haemophilia patients and are set to be given to more in 2019-2020. Although these drugs do not cure haemophilia, they are administered less frequently (only once a week or once every fortnight) and can be administered via simple injection rather than requiring an IV.

France behind in adopting generics

Despite the efforts of France's authorities to promote them, generics are having a hard time taking off in the country compared to its European neighbours, reported Le Figaro on Tuesday (p.1, 20-21).
Generics have a market share of just 37% in France, well behind Germany and the UK where they have market shares of over 80%, even though generics are on average 30% cheaper than their brand name counterparts and saved the health insurance €7 billion between 2010-2014.
Pharma company lobbying is said to be behind this massive difference, the paper continued. Pharma companies promote their own drugs, while encouraging the idea that generics are not as good and made in China, causing patients to think that not as expensive means not as good.
Due to patient pressure, doctors tend to specifically mention on their prescription that the brand name drug must be given and cannot be substituted by the pharmacist for a generic.
The French authorities are trying to increase generic prescriptions through two measures from the 2019 social security funding law (LFSS) set to come into effect in January 2020. The first one will see doctors having to justify why the brand name drug must be given instead of the generic and the second one will see patients insisting on the brand name drug instead of the generic having to pay the price difference between the two.

Cannabis therapeutic trials to start in France

A committee of experts from France's drugs' regulator was set to approve conditions under which cannabis therapeutic trials can start in France on Wednesday, reported Les Echos the same day (p.12-13).
This means cannabis will be prescribed to patients from 2020 for two years, but under very strict conditions. These include the doctor having to be willing to prescribe it, that the cannabis taken can only be inhaled or swallowed, not smoked and being available for certain diseases only, including epilepsy and multiple sclerosis.
France is behind in approving cannabis, which is already legal in some way in 50 countries. The economic daily said the global market is set to be worth $32 billion by 2022.
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