With NICE backing, Novartis' Entresto sees more European love


Cost-effectiveness gatekeepers in England backed Novartis’ new heart failure drug Entresto, giving the drug more fuel for growth in Europe. The recommendation does come with restrictions, however, which will limit the number of eligible patients.

National Institute for Health and Care Excellence said Entresto should be routinely covered in England and Wales for patients who are already taking older treatments known as angiotensin receptor-blockers, and whose symptoms meet certain criteria.

The NICE decision opens Entresto up to a sizable population of patients, which would add to its penetration in Europe. Last week, on a conference call with analysts, company executives said the drug is growing more quickly in Europe than in the U.S., where payers have been slow to strike reimbursement deals and have erected barriers to its use.


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The company didn’t break out its first-quarter Entresto sales by market, but in its earnings release, Novartis said, “Early experience in Europe has also been encouraging, with better early access and a more rapid uptake.”

Novartis reported $17 million in global sales for Entresto in Q1, much less than analysts were looking for, as sales in the U.S. continued to ramp up slowly.

Earlier this year, Novartis pharma chief David Epstein highlighted the quick uptake in Europe. During its first week on the market in Germany, doctors put 1,000 patients on the drug, while in the U.S., it took six months to get 11,000 scripts. Uptake in Switzerland, Novartis' home country, was 5 times that in the U.S., Epstein said at the time.

Novartis CEO Joe Jimenez said during the earnings call that government payers in Europe are quicker to see the value in Entresto, because they cover both drugs and hospital treatment. One of Entresto’s key selling points is that it can reduce hospitalizations among heart failure patients by 20%.

“The savings that Entresto could provide across the system is being recognized,” Jimenez said during the call.

Meanwhile, Novartis’ efforts to strike pay-for-performance deals on the drug in the U.S.--where insurers get higher rebates if Entresto doesn’t perform as anticipated--have yielded fewer such arrangements than Novartis might have hoped. Cigna and Aetna did jump on that bandwagon recently, with programs on the drug at each insurer.

Jimenez says that he’s still bullish on Entresto’s long-term prospects. Novartis sees peak sales of $5 billion even after the drug’s slow start. The company expects $200 million this year.

- see the NICE recommendation

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