Pfizer's Besponsa, Lilly's Taltz rack up reimbursement wins at NICE

A couple of drugmakers are celebrating this week after favorable decisions from England’s cost watchdog.

The National Institute for Health and Care Excellence (NICE) has recommended both Eli Lilly’s Taltz and Pfizer’s Besponsa—and for the latter drug, the decision marks an about-face from the cost-effectiveness gatekeeper.

For Lilly’s anti-inflammatory med, the endorsement comes in psoriatic arthritis (PsA), Taltz's newest indication. NICE backed the drug solo or with methotrexate under a couple of conditions—including that patients haven’t responded or have stopped responding to anti-TNF drugs within the first 12 weeks of treatment, and that Lilly provides Taltz with a confidential price break.

It’s a boost for Taltz, which is competing head-to-head with Novartis giant Cosentyx in both the psoriasis and psoriatic arthritis categories. And while Cosentyx had a big head start in both, Lilly thinks the positive trial data Taltz generated in PsA patients who had already been treated with anti-TNF drugs will provide its contender an edge.

"Up until now, the prescriber won’t have had a clinical trial to refer to that will give the prescriber confidence" that a therapy would perform well in the previously treated population, Pete Salzmann, Lilly VP of immunology, said in a December interview. And that population’s a large one, considering that "only about half of the patients will get a fully satisfactory response to their first-line agent."

Meanwhile, for Pfizer, new guidance recommending acute lymphoblastic leukemia drug Besponsa is also a welcome development. NICE gave the cancer-fighter the cold shoulder last August after determining it wasn’t cost effective, and Pfizer had plenty to say about that verdict.

"Today’s frustrating decision for inotuzumab ozogamicin is another example of how NICE is not appropriately assessing the value of modern cancer medicines, leaving patients without access to new treatments that could transform their lives," the company said in a statement at the time.

Now, though, NICE is in favor, and in its updated guidance it pointed to a the fact that "more people having" Besponsa "are able to go on to have a stem cell transplant when compared with people having … other treatments" for relapsed or refractory CD22- positive B-cell precursor forms of the disease. Besponsa also meets NICE’s criteria for qualifying as a life-extending end-of-life treatment, another factor that scored it points with the body.

As Lilly does, though, Pfizer has to provide Besponsa with a secret discount on the £8,048-per-vial drug if it wants to stay in NICE’s good graces, NICE said.

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