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 The sky-high cost of Glybera, from Dutch biotech firm UniQure
<QURE.O> and its unlisted Italian marketing partner Chiesi, shows
how single curative therapies to fix faulty genes may upend the
conventional pharmaceutical business model.
After a quarter century of experiments and several setbacks, gene
therapy is finally throwing a life-line to patients by inserting
corrective genes into malfunctioning cells - but paying for it poses
a challenge.
The new drug fights an ultra-rare genetic disease called lipoprotein
lipase deficiency (LPLD) that clogs the blood with fat. The medicine
was approved in Europe two years ago but its launch was delayed to
allow for the collection of six-year follow-up data on its benefits.
Now Chiesi has filed a pricing dossier with Germany's Federal Joint
Committee, or G-BA, which will issue an assessment of the drug’s
benefits by the end of April 2015. The company is seeking a retail
price of 53,000 euros per vial, or 43,870 euros ex-factory.
That equates to 1.11 million euros for an typical LPLD patient,
averaging 62.5 kg in clinical trials, who will need 42 injections
from 21 vials. This price will be subject to a standard 7 percent
discount under Germany's drug pricing system.
Under German rules, the launch price for a new drug is valid for the
first 12 months.
A Chiesi spokeswoman confirmed the launch price, in response to
inquiries from Reuters, prompted by information from health
insurance sources. She added that a final figure would be set after
the G-BA gives its verdict and negotiations are held with statutory
health insurance funds.
"First commercial treatments are expected in the first half 2015,"
she said.
UniQure, which will get a net royalty of between 23 and 30 percent
on sales, said EU pricing was a matter for its Italian partner,
although the Dutch firm does plan to discuss Glybera pricing during
an investor meeting in New York on Dec. 1.
BENCHMARK PRODUCT
With only 150 to 200 patients likely to be eligible for Glybera
across Europe, the impact on healthcare budgets will be small, even
at a very high price - but this case will be watched closely as a
benchmark for future gene therapies.
UniQure also has plans to seek approval for Glybera in the United
States, which it hopes to get in 2018.
Although there is already a gene therapy for cancer on the market in
China that drug has not been rolled out to other countries, making
Glybera a first for the Western world.
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Proponents of the gene-fixing technology insist it stacks up as a
cost-effective treatment, despite the high cost, since it could
permanently cure many patients. In the case of Glybera, Chiesi
said the annualized cost was no more than that charged for some
expensive enzyme replacement therapies used in other rare diseases,
taking into account the drug's proven benefits of at least six
years.
The drug consists of a harmless modified virus that carries a
corrective gene into the body's cells.
UniQure is also working on gene treatments for hemophilia and has an
early-stage project in heart failure, which would take gene therapy
beyond the rare disease space.
Assuming trials are successful, analysts expect gene medicines
treating more common conditions to cost less, since manufacturers
should be able to recoup their research and development investment
from a larger patient group.
Rivals in the gene therapy market include privately owned Spark
Therapeutics, which has an eye drug in late-stage clinical tests,
and Bluebird Bio <BLUE.O>, which is working on drugs for
neurological and blood disorders.
Bluebird Bio and UniQure both staged successful floats on the Nasdaq
market in the past 18 months, reflecting growing investor interest
in the field.
 Among major pharmaceutical companies, Bayer <BAYGn.DE> struck a gene
therapy deal with Dimension Therapeutics in June, while Novartis
<NOVN.VX> recently established a new cell and gene therapies unit,
and Sanofi <SASY.PA> has a long-standing tie-up with Oxford
BioMedica <OXB.L>.
(Writing by Ben Hirschler; editing by Philippa Fletcher)
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