This is not news if you are in say the US and Australia, but when Scrooge is in charge of the purse strings, as they are in the UK, then there has to be some behind the Scenes negotiation on price.
Ocrelizumab is cost effective for relapsing MS but how do you rate ocrelizumab for primary progressive MS. Well NICE have driven that hard bargain and Roche has obliged and so the NHS has got the green light for approval of use for PPMS. Therefore now there is an option for every one with active disease. This is excellent news and when ProfG wakes up in the US he may have something to say.
The landscape will change and now we need agents that can go on top of such drugs. Siponimod has been knocking on SPMS’s door too and in US has already been approved for SPMS and so there the whole range of MS is covered with an anti-inflammatory DMT.
This is good but it is also perhaps bad news because it makes it harder to get new agents into that space. We are kidding ourselves if we think these types of agent are the complete answer. They are not because people continue to progress albeit at a slower rate on these drugs. So to get a new drug in you may have to do your new treatments against standard of care in your trials and this could add £30,000,000-£50,000,000 to the price as you would have to buy the comparator.
So interesting times ahead.