Citing unreasonable price, PHARMAC declines eculizumab funding proposal

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Chief Executive Steffan Crausaz says the price being asked by Alexion is $670,000 per patient per year, making it one of the most expensive drugs PHARMAC has ever assessed.

“It’s one of the most expensive medicines we’ve evaluated; but it’s not the most effective and that’s the core of the problem,” says Steffan Crausaz.

“The price Alexion is offering is higher than is charged overseas, and higher than the cost charged by competitors for similar drugs for other rare conditions, one of which we have just funded for another rare blood disorder.”

“We would like nothing better than to make eculizumab available for New Zealanders with PNH. If Alexion wants to make the price more reasonable, our door is open to them.”

Steffan Crausaz says PHARMAC does not think it is reasonable for New Zealand to be asked to pay more than the price charged in the UK or Canada, even with a discount.

PHARMAC also sees similar products priced much more reasonably. An example is eltrombopag, a new medicine that treats another rare blood disorder, which costs $36,000 per patient per year. Eltrombopag will be one of the most expensive per-patient medicines funded by PHARMAC, yet is about a 20th of the price of eculizumab on a per-patient basis.

Steffan Crausaz says eculizumab could benefit up to 20 people in New Zealand, at a cost of approximately $10 million per year. If funding was committed to the drug, it would mean potentially tens of thousands of New Zealanders missing out on new medicines and this would be unfair.

“Eculizumab has benefits for patients, and for that reason we would love to be able to fund it. But the reality is the price being asked by Alexion puts funding far out of our reach. We also need to bear in mind the needs of other patients, and how funding eculizumab at this price would curb our ability to fund other medicines.”

The decision doesn’t mean the door is forever closed to eculizumab funding.

“We are hoping to get around the negotiating table with Alexion, that they can come to us with a reasonable price, just as other companies do, and we can get on with making this drug available for New Zealanders with PNH.”

Notification of eculizumab funding decision

Consultation about the proposal to decline a funding application for eculizumab

Cost-utility analysis of eculizumab for PNH (TAR 209) [PDF, 807 KB]

PTAC and Haematology Subcommittee minutes concerning eculizumab [PDF, 109 KB]

Summary of feedback [PDF, 395 KB]

Board decision paper [PDF, 339 KB]