OBJECTIVES

Recent high-profile product launches, notably onasemnogene abeparvovec (Zolgensma), have reignited the debate on healthcare costs in the US. The Institute for Clinical and Economic Review (ICER) is an independent research organization that determines value-based price benchmarks. This study examines recent high-profile launches to understand the interaction between ICER value-based price benchmarks and actual launch prices.

METHODS

Four recent, high-profile launches were identified: pembrolizumab (Keytruda, 2015); axicabtagene ciloleucel (Yescarta, 2017); voretigene neparvovec (Luxturna, 2018); and onasemnogene abeparvovec (2019). Cost per quality-adjusted life-year (QALY) and/or life-year gained (LYG) benchmarks were identified from their respective ICER assessments. Actual launch prices, identified from Eversana’s Pricentric® database, were compared to ICER benchmarks.

RESULTS

The intended launch price for pembrolizumab (Keytruda) of $4,381/vial was almost identical with the actual launch price ($4,316/vial), which was above the ICER-determined price of $1,719 at a $100K/QALY threshold and $2,694 at $150K/QALY.

The intended launch price for axicabtagene ciloleucel (Yescarta) was $373,000, equal to the actual launch price and falling between $100K/QALY and $150K/QALY ($340,797 and $524,015).

The price for voretigene neparvovec (Luxturna) was initially noted as $850K and the actual launch price was $425K. For age 15, this fell between $250K and $500K/QALY (US healthcare perspective) and $100K to $150K/QALY (US Modified Societal perspective). For age 3, this fell between $100K to $150K/QALY (US Healthcare perspective) and was cost-effective at $50K/QALY (US Modified Societal perspective).

Onasemnogene abeparvovec (Zolgensma) launched at $2,125,000 and was cost-effective at an updated benchmark of $150,000/LYG.

CONCLUSION

These results indicate that ICER is becoming increasingly important as a price benchmark. While the earliest launch was above the ICER benchmarks, more recent products have launched at reduced prices in line with ICER benchmarks. The most recent launch was outside the original cost effective range but was endorsed by ICER after additional information was submitted.