Zolgensma Outcomes Based Agreement
Nolan: We used value-based price frameworks to reward Zolgensma with about 50% less than several established repositories, including the current cost of chronic SMA therapies for 10 years. The current cost of 10 years of chronic therapy, which is given over the patient`s life, can often exceed $4 million in just the first ten years of a small child`s life. In addition, this therapy no longer works when treatment is discontinued. Many insurers are currently paying for chronic ADM therapy and would therefore achieve cost savings with Zolgensma over time. Italy has long been at the forefront of managed access, thanks in large part to its network of online registries. It is interesting to note, however, that the use of „results payment“ has declined sharply in recent times, as has the savings that the health sector derives from these agreements. Instead, Italy has increasingly focused on appropriate prescription agreements and spending limits. „We are at the forefront of an exciting period in the health field, where we can see great progress in the medical management of potentially curative gene therapies. While there are many issues that we need to consider as a health care system, our work does not change to ensure that these life-saving drugs are affordable and available to patients who need them,“ said Steve Miller, Cigna Corporation Clinic Director. „We look forward to continuing the work we started with AveXis to find unique solutions such as staggered payments and results-based agreements for these life-changing genetic therapies.“ Basel, May 24, 2019 – Novartis AveXis today announced innovative access programs for zolgen® (Onasemnogen abeparvovec-xioi) for the treatment of pediatric patients under 2 years of age with spinal muscular atrophy (AMS) with bi-allerl mutations in the motor neuron survival 1 (SMN1) gen. AveXis works closely with payers to provide full-time options for up to 5 years and results-based agreements for up to 5 years and to offer a patient program to support accessibility and accessibility. To cover innovative therapy, Novartis offers payers results-based agreements, which only spread the total cost over five years if the drug continues to work.
The payers welcomed the new models. In July 2019, about 40% of business life and four Medicaid plans implemented strategies. According to CEO Vas Narasimhan, coverage rates rose rapidly through October to 90% of commercial life and 30% of Medicaid patients. In addition, almost all online patients received final authorization after Novartis was subjected to certain appeal procedures, he said. With the introduction of the „Day One“ patient access program for Zolgensma, a new high-level gene therapy for spinal muscular atrophy distributed by AveXis (a subsidiary of Novartis), the manager`s entry has taken a fascinating new turn in Europe. The company is reported to have met with more than 100 interest groups across Europe to ensure that the programme – which offers retroactive discounts, staggered payments, results-based discounts and a global product register – is compatible with pay payers` pricing and reimbursement frameworks and can be tailored to different markets. This strategy is particularly interesting when viewed in the context of high-level commissioning in the context of the current COVID 19 pandemic, which is causing significant delays in HTA negotiations and prices and refunds.Share