According to a draft report by the Institute for Clinical and Economic Review (ICER), sickle cell disease (SCD) drugs made by Novartis, Global Blood Therapeutics (GBT), and Emmaus Medical may not be cost effective at their current prices.
In its analysis, ICER measured how many years of good health or quality-adjusted life years (QALYs) can be gained with Novartis’s Adakveo (crizanlizumab), GBT’s Oxbryta (voxelotor), and Emmaus Medical’s Endari (L-glutamine oral powder). The group also looked at incremental cost-effectiveness ratios for each agent.
Researchers determined that, in order to meet cost-effectiveness standards, the prices of all three of these medicines would need to be lowered: Adakveo, which costs an estimated $88,000 annually, should be $25,410 per year; Oxbryta would need its current yearly price of $84,000 cut down to $9,218; and Endari’s annual cost would need to drop from $24,000 to $3,859.
The QALYs for each of these three medications exceeded $1 million, while ICER’s usual cost-effectiveness threshold is $150,000.
“We look forward to gaining a better understanding of the approach ICER used to make its assessment and to helping them better understand the value of Adakveo,” Novartis said, arguing that the report did not take into account all of Adakveo’s benefits, like reduced pain crises and hospital stays.
“ICER’s review is flawed, premature, and risks adversely impacting access to new, potentially transformative therapies,” GBT said.
Costs for SCD treatments are of particular interest, as more than half of approximately 100,000 U.S. patients are covered by government health insurance.