Vertex and English health authorities have been deadlocked in pricing negotiations for cystic fibrosis drug Orkambi for years. Now, "finally," as Vertex CEO Jeffrey Leiden put it at a Thursday hearing, the helmsman has a face to face meeting set with Britain's health secretary Matt Hancock.
Leiden and Hancock plan to meet Monday to discuss the issue, Leiden said at a hearing of the U.K. Parliament’s Health and Social Care Committee.
Such meetings aren't usual in pricing negotiations in England, but this negotiation has been far from usual. Vertex and British officials have been in a high-profile tug-of-war over Orkambi's price for years, with patient advocates protesting the delay and local media tracking every move.
Leiden said he'll bring "new ideas" to the meeting, including a proposal that the two sides agree on an Orkambi discount to give patients immediate access to the drug while their cost-effectiveness talks continue. That immediate discount could be on par with Scotland's negotiated price break, Leiden said.
As public pressure escalates and months tick by, the parliamentary committee kicked off a probe into why the sides can't reach a deal. On Thursday the panel heard from officials with NHS England, cost watchdogs at NICE, patients and advocates, and Vertex executives.
At the hearing, the two sides couldn't even agree on which group ended the most recent round of negotiations. NICE director Andrew Dillon said Vertex isn’t engaging, and Leiden said NHS “walked away” in July 2018. And obviously, they disagreed on the value of Orkambi, approved in Europe in 2015 but still not routinely available in England.
Still, Vertex executives and English health officials said Thursday that they're ready to work together now to get Orkambi to patients. At the hearing, officials asked Vertex to accept its current offer of £500 million over five years and £1 billion over 10 years for access to all its CF drugs. The two sides can negotiate another deal when Vertex's "triple combo" comes up for review.
The U.K. has the world's largest population of CF patients, so Vertex has made its best offer, Leiden said. Still, the sides aren't close on their proposed prices, officials said. Dillon said almost every other company demonstrates flexibility in pricing negotiations, calling Vertex an "outlier."
Leiden didn't favor the solution offered up Thursday. He said he hopes Hancock will endorse a deal similar to Vertex's recent contract with Scotland. On the outlier comment, Leiden said Vertex has struck Orkambi pricing deals with 17 countries, including in Ireland and Australia, whose procurement systems are similar to England's. England is the anomaly in this scenario, he said, adding that officials there are trying to secure a 90% discount compared to pricing in other European countries.
Despite the numerous disagreements, Leiden said Vertex is “eager” to work with England to adjust their cost-effectiveness reviews. If English officials agree to work with Vertex, Leiden said he’s “very optimistic” the sides can reach a deal.
After NHS England made its “largest ever” commitment last year, Vertex said the proposal "does not take into account the vast time and resources invested” to develop the drugs. An executive added that it could hamper the company's ability to one day find a cure for the disease.