Restricted reimbursement and 28% price cut on Novartis' migraine drug Aimovig in Germany, template for CRPG inhibitors

Country : Germany

Keywords :
BERLIN, 20 Dec (APM) - Novartis has agreed with payers on a restricted reimbursement on one patient group and a 28% price cut on its migraine drug Aimovig (erenumab) in Germany, an agreement that will serve as a template for the two other CRPG inhibitors under review, APM has learned.
German umbrella payer group GKV-Spitzenverband (GKV-SV) on Thursday published a note saying a reimbursement price has been found for Aimovig, including a restriction of coverage to patients for which an added benefit was proven.
This subgroup are patients who do not respond to, are not suitable for or do not tolerate metoprolol, propranolol, flunarizine, topiramate or amitriptyline, valproate or Allergan's Botox (botulinum toxin).
It is based on the considerable added benefit rating on this subgroup - "no added benefit" in two other subgroups- published by Germany's higher health technology assessment (HTA) body in May (APMHE 62862)
Aimovig, approved in the EU for prophylaxis of migraine in adults who have at least four migraine days per month, was launched in Germany in November 2018 (APMHE 60333).
G-BA's rating formed the basis of pricing and reimbursement negotiations between Novartis and GKV-SV. These pricing negotiations which started in May were prolonged over the usual six months time.
Aimovig's new reimbursed price is €495,73 for one pen (70 mg or 140 mg) and €1.465,10 for three pens (70 mg or 140 mg), Novartis Germany told APM in a Friday emailed statement.
The new price will be published in the pharmacists' database Lauer-Taxe on 1 January 2020 but will apply retroactively to 1 November, that is 12 months after the German launch, Novartis said.
This new price is 28% lower that Aimovig's launch price in November 2018, according to APM's calculations.
As part of pricing negotiations, Aimovig was also given a "special requirement status" ('Praxisbesonderheit') for the prescription in the subgroup with considerable added benefit.
This means that doctors prescribing it will not be audited by health insurers for their prescriptions and cannot be sanctioned for them.
Before this agreement and since May, several German payers have already limited their coverage to this patient group, APM reported earlier (APMHE 65006).

Template for Emgality and Ajovy

It is very likely that this agreement on a restricted reimbursement would be used as a template for negotiations on the two other CRPG inhibitors marketed in Germany, an industrial source told APM on Friday.
Lilly's Emgality (galcanezumab) and Teva's Ajovy (fremanezumab), launched in Germany after Aimovig, in April (APMHE 62421) and May (APMHE 62983) respectively, have been priced identically and have received the same rating by G-BA (APMHE 64416) (APMHE 65042).
Price negotiations between the pharma company and GKV-SV are ongoing separately, until April 2020 for Emgality and May 2020 for Ajovy.



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