Celgene discount offer spurs NICE to a turnabout on psoriasis pill Otezla

Celgene’s Otezla won over England’s cost-effectiveness watchdogs--thanks to a discount. After negotiations with the U.S.-based biotech, National Institute for Health and Care Excellence now backs Otezla for use in patients with severe psoriasis.

Otezla is one in a new generation of anti-inflammatory drugs, and Celgene has high hopes of capitalizing on the fact that it’s a pill, rather than an injectable like others in its field.

After rejecting the drug last year, NICE backed Otezla (apremilast) to treat psoriasis patients who haven’t responded to or can’t tolerate other therapies such as methotrexate, provided they suffer severe symptoms. The recommendation depends on a confidential cost-saving deal with the agency.

Otezla’s quoted price, according to the agency, is £500 for a 28-day pack, and the negotiated terms involve a “simple discount” to that list price.

NICE rebuffed Otezla as a psoriatic arthritis treatment soon after its psoriasis rejection, and the agency hasn’t yet issued a final ruling for that use. Last year, the drug ran into trouble with Germany’s tough cost-effectiveness agency, which demanded more data to prove that the drug is worth its cost.

Otezla is expected to break the blockbuster barrier by 2018, with $1.3 billion in sales by then, analysts figure. Celgene has said it thinks the pill can do even better than that, with peak sales of up to $2 billion. To hit that goal, the drugmaker is working on other indications for Otezla, including rheumatoid arthritis, a major anti-inflammatory market that could fuel big growth for the pill.

But Otezla faces a raft of competitors, from old standbys such as AbbVie’s Humira and Amgen’s Enbrel, to newcomers from Novartis (the fast-launching Cosentyx) and Eli Lilly (the brand-new Taltz). To set itself apart from the pack, Otezla has been running TV and print ads, beginning with a blitz of its “Show More of You” campaign last summer.

- see the NICE documents

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