In 2015, our annual Pharmaceutical Strategy Conference (PSA) hosted four pharmaceutical experts during our panel discussing market access and new payment methods for breakthrough medicines.
Our panelists included:
- Garrett Ingram, VP, Head of US Market Access, Sanofi
- Sam Rasty, PhD, VP & Head of New Products, Rare Diseases Business Unit, Shire Pharmaceuticals in Lexington, Mass.
- Rod Cavin, Managing Director, Health Strategies Group. The company provides market access, insight and the market access research in the US and the U5 for pharmaceutical and device companies.
- Roger Longman, Chief Executive Officer, Real Endpoints. The company does objective drug valuation and pipeline products mostly for payers and pharmaceutical companies.
Moderated by Casey McDonald, Senior Editor of Pharmaceutical Executive
Sam Rasty began the conversation with his views on gene and cell therapies and how they are relative to breakthrough medicines, their value to different stakeholders and emerging digital technologies.
He first poses the question, what are some of these model payment mechanisms, etc.? Here was his response:
There’s the notion of gene therapy as being a single new approach but in reality, different gene therapeutics from a product development perspective I guess, have different product profiles. You’ve got non-viral, vector mediated delivery for gene therapy and viral. Within the viral component you’ve got multiple different viral vectors from a technical perspective that can be used for delivery. Integrating versus non-integrating vectors, different constructs and genetic components in terms of the promoter DNA sequence and regulatory mechanisms within all these vectors, etc.
So within just gene therapy itself as a field, I think, what we’re seeing is an evolution of multitudes of different types of products coming out with the ability potentially to express long term a therapeutic protein which then begs the question how do we commercialize these types of products. What is the reimbursement model? As an industry, we have yet to get to that point to see a product that truly expresses a therapeutic benefit in a one and done manner in as such how do you price and ask for reimbursement of such therapies. So I think we’re at the cusp of seeing that and at the cusp of seeing industry players coming up with novel models such as pay for performance, risk sharing models, annuity based models where you’re reimbursed over a number of years, but we don’t have the evidence yet of long term clinical benefit from any of these types of vectors which I think payers will demand before they agree to any of these mechanisms. But one thing for me that’s clear and perhaps others could add to this is the notion of having to or being required to deliver clinical benefit and being required to show performance before any of these types of products can garner really high levels or reimbursement at the types of prices that are being proposed over a million dollars, etc.
So it’s going to be challenging going forward, but it will certainly keep for a number of interesting conversations