Discount helps NICE flip-flop on Teva's severe asthma contender, Cinqair

There’s still no word on whether Teva has landed AstraZeneca CEO Pascal Soriot or if he is staying put, as later reports said. But in the meantime, the drugmaker got some good news Thursday on the respiratory front.

England’s cost watchdogs have changed their tune on Cinqair (reslizumab), the severe asthma contender known as Cinqaero in the U.K. After previously asking Teva to clear up some effectiveness questions in patients with multiple asthma attacks and provide more info on the full cost of treatment, the National Institute for Health and Care Excellence published draft guidance recommending the med for routine NHS use.

As usual, though, NICE’s favor comes with some conditions. Patients are only eligible to receive Cinqair if they’ve registered a blood eosinophil count of 400 cells per microliter or more, and if they’ve had three or more asthma exacerbations within the past year.

Of course, Teva also needs to provide the drug at the undisclosed discount it’s worked out with the cost-effectiveness gatekeepers. Before the price break, Cinqair’s list price sat at  £499.99 per 100-mg vial and £124.99 per 25-mg vial.

After a year of Cinqair treatment, patients should stop therapy if their asthma hasn’t come under control, meeting certain NICE criteria for an "adequate response."

"Teva is very pleased to receive this decision by NICE as we seek to expand the availability of reslizumab globally in an effort to ensure that patients living with severe, uncontrolled asthma have access to this treatment option," Sven Dethlefs, Teva SVP and head of global respiratory medicines, said in a statement.

Cinqair isn’t the first severe asthma med to experience a NICE flip-flop. GlaxoSmithKline’s Nucala, which initially bore a £840-per-dose sticker, got the same treatment after GSK served up its own confidential price cut.

And that outcome made it all the more important that Teva snag its own NICE "yes." It’s racing behind first-to-market Nucala, though Bernstein analysts don’t expect to see it make it past the $300 million mark before 2023. One reason, besides Cinqair’s latecomer status? It’s an injectable, while Nucala and candidate benralizumab from AstraZeneca are delivered subcutaneously.

Teva, meanwhile, has had a tumultuous couple of weeks thanks to conflicting reports about its CEO status. Last week, Israeli newspaper Calcalist reported that AZ’s Soriot had signed on to take the top job. Later in the week, though, Bloomberg shot down that idea with its own report that Soriot would stay.