The FDA’s approval this week of Novartis’ novel cancer treatment is making a well-deserved splash as the first ever CAR-T therapy approved for use in the United States. CAR-T is a revolutionary gene therapy that works by harvesting a patient’s white blood cells and reprogramming them to target tumors. The drug, Kymriah, which has been approved to treat children and young adults with acute lymphoblastic leukemia, has a remarkable effect: 83% of patients were cancer free after three months of treatment in clinical trials.
It could, however, prove a costly cure. Novartis (NVS)announced Kymriah’s list price for a one-time treatment as $475,000, and England’s National Institute for Health and Care Excellence says CAR-T therapies could cost up to $681,000. Novartis says they will partner with the government to develop an outcomes-based pricing agreement for the drug, but questions remain on how best to deliver value to patients.
One of the major obstacles to successful value-based pricing models is patients skipping their medicines, called “non-adherence.” Studies show that 20 to 30% of prescriptions are never filled, and that half of medicines for chronic diseases are not taken as prescribed. Non-adherence leads to an estimated 125,000 deaths and 10% of U.S. hospitalizations every year, in addition to costing our health care system hundreds of billions of dollars annually.
Yes, we need to ensure that patients can afford their medicines. But we also need to make sure that they’re taking them as prescribed. Those may seem to be two different problems, but they’re really two sides of the same coin.
We pay for medicines by the pill, but it’s health outcomes — better, longer lives — that we really care about. A health care system that pays for each part of care individually has little sense of how it all fits together. Instead, everyone defends their own turf and profit margins.
Patients deserve better.
Read more: https://www.investors.com/politics/commentary/making-americas-health-care-system-smarter-and-cheaper-with-digital-tech/