PHARMAC approves largest single deal

Agreements with two companies, Novartis and Biogen Idec, have been approved which will see 10 new medicines funded, and either reduced prices or widened access to eight others.

Director of Operations Sarah Fitt says the agreement with Novartis involves the highest number of new medicines funded from one agreement in PHARMAC’s 21-year history. Nine new medicines, including new treatments for dementia, the respiratory condition chronic obstructive pulmonary disease (COPD), asthma, multiple sclerosis, chronic myeloid leukaemia and a type of brain tumour, are included in the Novartis agreement.

“This is a major step forward in medicines availability,” says Sarah Fitt. “It’s a great example of PHARMAC and suppliers finding creative and innovative ways to make new medicines available to patients, and negotiating to make other medicines more cost effective.”

“While pricing and contract details will remain confidential, these new agreements are worth millions of dollars of new spending.   They will lead to better health outcomes for a wide range of people – from the very young to the very old.”

The genesis of the agreement was PHARMAC’s internal planning which identified opportunities to fund several medicines on PHARMAC’s prioritisation list, and release savings on some already funded medicines. PHARMAC put a proposal to Novartis, which the company was able to consider.

“At the same time we were looking to provide better access to new medicines for multiple sclerosis, and we were able to talk with Biogen about its multiple sclerosis product natalizumab. It’s great to be able to list these two multiple sclerosis medicines from two different companies at the same time, while also making them available to people earlier in disease.”

While contract details are confidential, Sarah Fitt says the new multiple sclerosis medicines will account for most of the projected new spending from the deals. In terms of patient numbers, the biggest products are glycopyrronium and indacaterol, which both treat COPD. PHARMAC estimates about 10,000 people will benefit from these treatments over five years.

More than 1000 people are also estimated to use the newly-funded Alzheimer’s disease treatment rivastigmine, which is a patch that sticks to the skin.

The changes, including listing of the new medicines, take effect from 1 November 2014.

Medicines funded in the decision

New medicines

• Multiple Sclerosis: Natalizumab and fingolimod - two new-generation medicines for a particular and most common type of multiple sclerosis, called relapsing-remitting multiple sclerosis. These will be funded from first diagnosis and with fewer relapses required – a major change to the availability of funded treatments for multiple sclerosis. Based on the evidence to date, these drugs appear to be more effective than current treatments for multiple sclerosis. Existing treatments will still be funded and also available earlier, but only for people in whom the new treatments are clinically inappropriate.
• Chronic obstructive pulmonary disorder: Glycopyrronium and indacaterol - two new medicines for the respiratory condition chronic obstructive pulmonary disorder (COPD). At the moment there are limited medication options for patients with COPD – this will give greater choice for doctors and, with better outcomes, could lead to fewer people needing hospital treatment.
• Alzheimer’s: Rivastigmine patches - a new funded treatment option for Alzheimer’s disease. This is the second funded treatment for Alzheimer’s disease, giving more choice for clinicians and patients where the existing funded treatment is not tolerated.
• Brain tumour: Everolimus - a newly funded drug to treat a type of brain tumour (subependymal giant cell astrocytoma) that mainly affects children. At the moment the only treatment option is surgery. This would be a less invasive treatment option.
• Severe allergic asthma: Omalizumab - a newly funded medicine for severe allergic asthma. There’s a small group of people whose allergic asthma is so severe the currently available medicines aren’t effective and patientscan  require admission to hospital. Omalizumab could help reduce the number of asthma flare-ups these patients have, which may help avoid hospital admission and help patientse manage their asthma at home.
• Cystic fibrosis: Tobramycin - A new formulation of this antibiotic, specifically developed for inhalation and used to treat the respiratory condition cystic fibrosis.
• Chronic myeloid leukaemia: Nilotinib - a newly funded treatment option for chronic myeloid leukaemia. A third treatment option, adding to the range of CML drugs that has turned this form of leukaemia into a manageable chronic condition for most patients.
• Iron overload: Deferasirox – a newly funded treatment for people who have too much iron in their bloodstream secondary to disorders like thalassaemia. The currently funded treatments aren’t suitable for everyone, so having further options is a benefit.