Bristol's new myeloma CAR-T needs a hefty discount to be cost-effective, watchdogs say while endorsing GSK's Blenrep

Bristol Myers Squibb is launching the pharma industry’s latest specialized cancer drug in multiple myeloma CAR-T therapy Abecma. But a cost watchdog is already pushing back.

Listed at $419,500 per dose, the one-time treatment needs a 37% to 54% discount to be cost-effective, the Institute for Clinical and Economic Review's experts found.

Meanwhile, ICER unveiled a recommended price range for Johnson & Johnson and Legend Biotech’s forthcoming CAR-T cilta-cel. The numbers are preliminary because the data now available are limited, the watchdog said. But at first look, ICER thinks the J&J launch should carry a list price between $317,000 and $475,000.

A BMS representative said via email the company takes "great care to price our medicines based on the value they deliver" plus "the scientific innovation they represent" and other factors, including R&D investment. The drug is approved for patients who've tried four prior multiple myeloma regimens.

The ICER assessment was "limited" and "disregarded these broader dynamics and their impacts on price," she added. Even within its own review criteria, the ICER analysis "used inappropriate modeling of ide-cel’s overall survival data and a misguided view of retreatment, contributing to ICER’s flawed assessment of clinical and economic value," BMS' spokeswoman said.

Meanwhile, ICER endorsed GlaxoSmithKline’s pricing on 2020 drug launch Blenrep, a first-in-class antibody-drug conjugate also approved for multiple myeloma patients who've had four prior rounds of treatment.

RELATED: ICER's blasted pharma pricing for years, but now drugmakers are 'rolling up their sleeves' to cooperate 

The watchdogs say its list price of $8,277 per vial—or $23,900 per month, on average, with dosing dependent on body weight—falls within their recommended cost-effectiveness range. ICER’s findings on the med are “relatively favorable due in part to patients discontinuing therapy because of side effects, as well as the high prices for the three-drug alternatives" that are now standard regimens, the group noted.  

ICER has been around for years and its drug reviews have often irked pharma companies who argue that drugs are costly and risky to develop, and warn that payers could use ICER reviews to clamp down on new drug access. As of 2019, though, there were signs that relations between the group and pharma were improving, an ICER official said at the time.

Over the years, the group has criticized pharma's pricing decisions on cystic fibrosis treatments, new cholesterol drugs and many others. But the group doesn't only look at price, as evidenced in its backing of Novartis' pricing on the multimillion-dollar gene therapy Zolgensma.

RELATED: Bristol Myers' Abecma launch tools? Digital CAR-T platform and provider training, for 2 

Meanwhile, for BMS’ Abecma rollout, it remains to be seen whether or how ICER's finding will affect the launch. During an interview after the approval, Krishnan Viswanadhan, BMS’ global cell therapy franchise lead, said the company was just getting underway with its payer discussions.  

In the long run, though, patient access to specialized therapies is improving as payers increasingly appreciate the value the meds offer, he said.

But analysts have said the drug’s fifth-line indication could create an opening for the forthcoming J&J competition. One multiple myeloma expert at a "leading academic center" had expected the drug to win an approval for patients after two prior treatments, RBC Capital Markets analysts wrote to clients in mid-March. The J&J drug isn’t yet FDA approved, so its exact label isn’t known, and the companies haven't yet publicly discussed pricing.