Pharmaguy's Insights Into Drug Industry News
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Pharmaguy's Insights Into Drug Industry News
Pharmaguy curates and provides insights into selected drug industry news and issues.
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Make American Medicine Great Again: #Pharma Should Offer Payers "Money Back Guarantees" as in UK

Make American Medicine Great Again: #Pharma Should Offer Payers "Money Back Guarantees" as in UK | Pharmaguy's Insights Into Drug Industry News |

Drug companies have started offering 'money back guarantees' in their treatments to make eye-wateringly expensive therapies more attractive.


This week British pharmaceutical giant GlaxoSmithKline (GSK) said it would include a warranty for its cutting-edge new gene therapy for ‘Bubble Boy syndrome’, a rare disorder which leaves suffers with such a compromised immune system that they are advised to live in a completely sterile environment.


GSK gained European approval for gene therapy Strimvelis in May but healthcare providers have been reluctant to pay for it, as it costs around £500,000 per patient, making it one of the most expensive treatments in the world.


The deal is thought to represent a new era in healthcare pricing, where drug companies will be responsible for continued success rates and allows treatments for very rare diseases, with low take-up, to come to market.


Such ‘money-back’ deals have only been made a four times in Britain in the past. The first was approved in 2002 for the treatment of multiple sclerosis with interferon beta or glatiramer where drug prices were adjusted according to outcomes.


In 2007 the NHS agreed a risk-sharing scheme with Johnson & Johnson after the National Institute for Health and Care Excellence (Nice) rejected its cancer drug Velcade.


Under the terms if a patient achieved complete or partial response, greater than 50 per cent within four cycles or treatment then the NHS would pay up. If not Johnson & Johnson agreed to pick up the entire bill.


Since then Merck Serono has reimbursed the health service for patients who failed to respond to its metastatic colorectal cancer drug Erbitux within six weeks. And GSK has a refund deal with its drug Votrient for Adcanced renal cell carcinoma.

Pharma Guy's insight:

I assume that in the U.S. scenario, patients would also get back their co-pays. Not that this would help patients who have died (like in this Opdivo case: But at lest insult would not be added to injury.

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Are Payers #Pharma Adversaries or Partners?

Payers are often seen as the adversaries that are blocking market access, rather than as customers, and as the gatekeepers to better patient outcomes. With this changed perspective in mind, pharma need to develop an understanding of the needs of national and regional payers through engagement at an early stage. Along with this, the needs of providers, guideline bodies, purchasing organisations and policy makers are also important.


These insights can be used throughout the drug development cycle by:

  • Playing a part in the landscape assessment that helps companies to decide which projects should enter the R&D pipeline
  • Supporting decisions in the clinical trial development pipeline, including choice of patients and endpoints, to ensure that the trials will produce the kind of evidence that the payers need
  • Identifying the most important claims
  • Highlighting gaps in the data sets
  • Collecting data to support the value messages
  • Helping pharma understand the nuances of different markets
  • Ascertaining where payer education might be needed
  • Learning more about willingness to pay
  • Shedding light on reimbursement issues relevant to different product types and therapy areas
  • Getting advance warning of anticipated changes in market-specific healthcare reimbursement processes

Via COUCH Medcomms
Pharma Guy's insight:

At least important pharma industry association thinks payers are adversaries and has said so: “Former Washington Pol, Now CEO of BIO, Says Insurers Discriminate Against #Pharma”;

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