Roche surprised industry watchers on Tuesday when it placed a $65,000 list price on multiple sclerosis blockbuster-to-be Ocrevus, sparking comparisons with a more expensive—and less effective, according to trial data—Merck KGaA rival. But it's a comparison the German drugmaker doesn't much care for.
On Wednesday, it hit back at those who had pointed to Ocrevus' 25% discount on its industry standard, Rebif, calling a “direct comparison” between pricing for the meds “misleading and oversimplified.”
"Ocrevus and Rebif have different modes of administration, they will typically be managed separately by payers and, therefore, the access and pricing approaches are different," a spokeswoman said in a statement.
For its part, Roche said Ocrevus was “shown to be clinically superior” to the “14-year-old standard of care” Rebif in two relapsing multiple sclerosis trials. A spokesperson pointed out that MS drug prices have grown by 400% over 12 years, with Rebif’s list price now running at about $86,000.
“We feel that the industry needs to start to reverse this trend, and believe that pricing Ocrevus 25% less than the comparator in our trials is an important first step,” a spokesperson told FiercePharma.
The way Merck sees it, Ocrevus—an infusion—"is expected to be covered under the medical benefit," and products with that designation "typically do not require the manufacturer to provide discounts to payers." Self-injectable biologics including Rebif, on the other hand, are often covered under the "pharmacy benefit," and their list prices often bake in room for manufacturer discounts "to support … access for customers and patients."
It remains to be seen, though, whether that argument will keep doctors and payers from flocking to the new Roche option—especially considering the Rebif-beating data Ocrevus posted on the way to its approval in relapsing-remitting forms of the disease. That efficacy—combined with a convenient dosing schedule—will push the drug to the No. 2 rank in 2022 sales for MS meds, according to EvaluatePharma analysts. They predict it’ll tally $4.1 billion in sales that year, trailing Biogen’s Tecfidera with $4.45 billion.
Ocrevus is also the first med approved to treat primary progressive MS, which affects 30,000 to 40,000 patients in the U.S., according to analysts with Leerink Partners. That’s where the Swiss drugmaker is likely to put the “biggest focus” with its commercial efforts, they figure. And that’s where Ocrevus “could reach very significant market penetration quite quickly,” depending on payer coverage.