by Judy Packer-Tursman
The first targeted therapy to treat pain crises in people with
sickle cell disease presents a "welcome" new option that payers
likely will embrace, a PBM head tells AIS Health. While the drug’s manufacturer
cites "positive" early discussions with payers on it, some experts
note the lifetime treatment — via a monthly intravenous infusion — is costly:
around $100,000 annually.
On Nov. 15, the FDA approved Novartis' Adakveo
(crizanlizumab-tmca), a treatment to fight the underlying cause and reduce the
frequency of vaso-occlusive crisis, described as a common and painful
complication of sickle cell disease. It is approved for patients ages 16 and
older with the genetic blood disorder.
Hydroxyurea, a drug approved by the FDA in 1998, is now generic,
costs about $1,000 a year, and is approved for children, the New York Times
reported on Dec. 7. The two newcomers are Adakveo and Global Blood
Therapeutics' Oxbryta (voxelotor), a daily pill granted accelerated approval by
the FDA 10 days after Adakveo's approval. This led one expert to tell the news
outlet that insurers likely will want to begin with hydroxyurea as the
front-line therapy.
Yet Mesfin Tegenu, R.Ph., president of PerformRx, LLC, says that
"options for patients with sickle cell disease have been very limited up
to this point, so the approval of Adakveo is a welcome addition in the
treatment of this debilitating disease."
Eric Althoff, a Novartis spokesperson, says the company
anticipates that health plans will see a value proposition with Adakveo.
"Early discussions with payers are positive," Althoff says. "In
fact, a number of payers have already added Adakveo to medical policy including
state Medicaid [programs]." Florida and Alabama's Medicaid programs have
agreed to cover Adakveo, Reuters reported on Dec. 20.
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