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Pricing is key for new heart drugs

Tuesday, September 02 08:45:10

Doctors looking at highly encouraging clinical trial results for new heart drugs at the world's largest cardiology meeting this week are missing one piece of data that will be critical to their success - the price.

While new treatments on show in Barcelona are certainly moving cardiovascular medicine forward after a series of setbacks in recent years, cardiologists say that cost will be key in determining how widely they are used.

"We are entering a new era of treatment and, of course, it will cost a lot of money, which is a problem," said Michel Bertrand, emeritus professor at the University of Lille and a past president of the European Society of Cardiology (ESC).

Hopes have spiked for a heart failure drug from Novartis and an innovative class of injectable anti-cholesterol agents known as PCSK9 inhibitors after the release of data at the ESC's annual meeting indicated that they can save more lives than standard therapies.

The pharmaceuticals industry, however, faces a challenge because the new drugs are designed to replace or supplement a range of older medicines that have lost patent protection and are now widely available as bargain-basement generics.

Novartis's new heart failure drug LCZ696, for example, was tested in a pivotal trial against enalapril, a generic drug in the so-called ACE inhibitor class, a month's supply of which can be bought at Wal-Mart stores for only $4.

The Swiss company has yet to say what it will charge for LCZ696, but based on the cost of recently launched drugs such as Bayer and Johnson & Johnson's anticoagulant Xarelto, analysts expect between $7 and $8 a day - or about $225 a month - with a lower price in Europe.

It would be a big price for a big population - heart failure affects about 26 million people across the United States and Europe - and analysts have forecast peak annual sales of $5 billion-plus.

Doctors, too, are keen that insurers and governments should see beyond the upfront cost to the long-term benefits.

"Unfortunately, many insurance companies focus strictly on the cost of the pill," Elliott Antman, professor of medicine at Harvard Medical School and president of the American Heart Association, told Reuters.

"But if we only look at the per-pill cost we have blinders on. We have to think about the impact on the health-delivery system overall - and if a more expensive new drug reduces symptoms to the extent that patients aren't hospitalized as much, then that has enormous economic impact."

That chimes with the message from Novartis pharmaceuticals head David Epstein, who argues that the cost of a generic "is not the way to think about this product". (Reuters)

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