After Bristol-Myers Squibb won the first immuno-oncology nod in China for its PD-1 star Opdivo in June, all parties were holding their breath for its price tag. After all, it would set a bar for other I-O therapies on their way to the key market.
And now we know. Opdivo will be priced in China at half its U.S. cost, according to local reports.
The drug will come in at retail prices of 9,260 yuan ($1,354) for the 100mg/10mL vial and 4,591 yuan ($671) for the 40mg/4mL dose, local business news organization Caixin reported, following rumors that first emerged on social media Monday. In the U.S., the larger vial costs about $2,600 to $2,800, and the smaller vial runs about $1,100, according to the drug pricing website GoodRx.
A Bristol-Myers Squibb spokeswoman wouldn’t confirm the reported price, and a media aide in China Tuesday told FiercePharma that the company is “working with the government to complete” the pricing process.
“The price of Opdivo will take the value of the medicine, affordability for Chinese patients and the high unmet medical needs into consideration,” the company said in a statement. It also promised to work with payers and third parties, through various programs, to open up Opdivo to more patients.
Caixin also reported that BMS might initiate a patient assistance program—a typical move for high-cost cancer drugs in China as well as the U.S.—which will offer patients six months of free treatment after they pay for the first five.
The Chinese price will be quite a bit lower compared with other parts of Asia, according to local reports. After a round of price cuts, the drug still costs about $2,500 in Japan. Its prices in Hong Kong and Singapore each came above $2,000 per vial.
A significant discount? Yes. But even at the much lower price, the cost is still a huge burden for Chinese patients. The drug will be given as a bimonthly injection at 3mg per one kilo of the individual patient's weight. That means someone weighing 60 kg will need to pay 18,442 yuan every two weeks.
To put that in context, in Shanghai, the per capita annual disposable income in 2017 was a little below 59,000 yuan.
Opdivo could become less pricey for patients if it's included on government-run insurance programs. However, Professor Yilong Wu, who led Opdivo’s Chinese-specific phase 3 trial that led to its approval, told The Paper (Chinese) that he doesn’t expect Opdivo will be considered for that coverage.
Compared to targeted therapies, PD-1 inhibitors cannot really pinpoint the perfect patients who benefit most, said Wu.
“Clinical trial results showed that, among five patients on Opdivo, only one really benefited from it,” he said. “It’s just that the duration of the benefit was long, which is why the drug was approved.”
Last week, China’s State Medical Insurance Administration unveiled a list of 18 cancer drugs that will be part of negotiations this year for adoption by the national medical insurance scheme. While Opdivo didn’t make that list, several other newly approved therapies did, such as AstraZeneca’s lung cancer drug Tagrisso and Takeda’s multiple myeloma treatment Ninlaro, as well as ALK-positive lung cancer therapies Zykadia by Novartis and Xalkori from Pfizer.
Based on previous talks, drugs usually need to take huge price cuts to win enlistment on the National Reimbursement Drug List and thus reach more patients. Last year, for example, the 36 drugs newly added to the roster took an average 44% discount.
As for the PD-1/PD-L1 fight in China, Merck & Co. just won Keytruda approval a month ago, and all eyes will now move to its pricing strategy. Besides, local players Jiangsu Hengrui, Innovent and Junshi Biosciences have candidates under priority review at the Chinese regulators.