Vertex CEO Jeffrey Leiden's move earlier this month to pressure England's prime minister Theresa May on drug prices seems to have set some wheels in motion. After negotiations seemingly broke down between health officials and the drugmaker, NHS England has made a new offer for cystic fibrosis drug Orkambi and others in the company's portfolio.
In a letter posted by Cystic Fibrosis Trust chief David Ramsden, NHS England official John Stewart wrote that during a year of direct negotiations between officials and the company, Vertex has "remained unwilling to price responsibly," even after NICE recommended against coverage. NHS just made its "final" offer that would "guarantee immediate and expanded access" for Orkambi and Kalydeco, plus Symdeco upon its approval.
The deal would also provide access to a next-generation triple therapy from Vertex. The deal would mean revenues for the company of £500 million over 5 years and £1 billion over 10 years, according to Stewart, and would be the NHS' "largest ever financial commitment" in its 70-year history.
Still, Vertex and patient advocates have concerns about the new offer. The company said it appreciates the offer and hopes it "signals a willingness to re-engage in discussions to reach our collective goal of providing access to our CF medicines for patients."
But the company says it's worried the "proposal fails to adequately reflect the value of our current and future medicines and the number of patients that will be treated with these medicines." Vertex said it stands "ready to meet to find a productive path forward." Ramsden tweeted that despite the large figures, he's "deeply concerned" the offer doesn't "truly reflect the difference the pipeline of drugs will make."
In a letter to the U.K. patient community, Vertex senior vice president and international general manager Simon Bedson wrote that the offer "does not take into account the vast time and resources invested" to develop the CF meds and claimed it could hamper the company's ability to one day find a cure.
Earlier this month, negotiations broke down after Vertex said it made the "best offer in the world" for cystic fibrosis drug pricing in the U.K., and after cost-effectiveness officials in England found the price "unsupportable." Vertex CEO Leiden wrote to May at the time that the country's decision to reject the offer devalues patient lives and threatens the entire U.K. biopharma ecosystem.
The company—which has an international HQ in London and a R&D center near Oxford—questioned its commitment in the U.K., he added. After the letter, NHS England approached Vertex with another offer.
Patient advocates blasted the standstill. Ramsden said his group is "appalled and deeply frustrated" to hear about stalled negotiations. In a related blog post, Ramsden called on the sides to make their arguments in the negotiating room instead of in public. Now, the group said in a tweet that it's "vital" the sides can get "back around the table to continue negotiations and make a deal for current and future medicines so that people with CF can start benefiting" from Orkambi.
Orkambi costs £104,000 per patient per year in the U.K. before discounts, according to documents from U.K health officials.