Novartis' Kisqali aims for convenience edge with new Femara combo packs

Novartis has already undercut Pfizer’s Ibrance on price with its newcomer breast cancer med Kisqali. Now it’s looking for a convenience edge, too.

The Swiss drugmaker snagged an FDA approval this week for Kisqali Femara Co-Pack, a combination package pairing two of its breast-cancer fighters. With the pack, patients receive a 28-day cycle of the two meds with just one prescription and one copay, Novartis noted. Plus, it’s available at all three Kisqali dosage strengths—at the same cost as Kisqali alone.

Now, U.S. doctors “have the flexibility to prescribe Kisqali two different ways,” Novartis pointed out in a statement. They can either use the co-pack, if prescribing Kisqali alongside Femara, or they can write separate scripts for Kisqali and any aromatase inhibitor.

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Novartis is hoping that flexibility will draw docs to its CDK4/6 med, which rolled out in mid-March. After all, it’s going up against Ibrance, a med that’s been on the scene for more than two years and built up a major following. It's been prescribed more than 360,000 times, with more than 61,000 of those scripts coming in the first quarter alone, Pfizer Innovative Health President Albert Bourla recently told investors on a conference call.

Before Kisqali’s rollout, some industry watchers handed the convenience trophy to Ibrance, thanks to recommendations from regulators that patients receive ECG monitoring before starting treatment with the Novartis med and repeat it at day 14 of the first cycle and the beginning of the second cycle. Novartis execs, though, have called the monitoring “relatively routine,” sloughing off the idea that it’ll put doctors off.

And on top of the combo pack, the Basel-based company has three available dosage strengths, which ups its flexibility game, Novartis says. Doctors “can dose-reduce mid-cycle, and they don’t have to write a new prescription and everything that goes along with that,” Novartis EVP of U.S. oncology Bill Hinshaw said in a recent interview.

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While Pfizer has said it’s not worried about Novartis’ pricing play—the New York giant has successfully “managed … price competition in the past, and we will do it in the future,” Bourla said on the call—it’s working to enhance options for physicians surrounding its med, too.

In April, it grabbed an FDA go-ahead to use Ibrance alongside any aromatase inhibitor rather than just Femara, a tweak that Pfizer Oncology Chief Development Officer Mace Rothenberg said “really makes it easier" for physicians to put their prescribing practices in line with the label.

“For physicians who are used to using anastrazole, this actually makes it easy to add Ibrance to that rather than having to use it with an aromatase inhibitor that they’re less familiar with,” Rothenberg said in an interview at the time. “We’re trying to remove as many barriers to prescribing Ibrance appropriately as possible.”