Cost watchdogs bar Boehringer, Lilly's diabetes med Jardiance--for now

NICE's Carole Longson

Just as Eli Lilly ($LLY) and Boehringer Ingelheim's new diabetes drug Jardiance hit store shelves in the U.S., cost-effectiveness watchdogs in the U.K. were considering whether to give it their blessing. The verdict as of Thursday morning? Nay.

In new draft guidance, the National Institute for Health and Care Excellence rebuffed Jardiance (empagliflozin) as a type 2 diabetes treatment. But the agency's decision was clearly the opening thrust in a data-and-pricing duel.

NICE asked Boehringer for new analyses and comparisons with other treatments--and a revised look at cost-effectiveness. "There is good evidence which shows that empagliflozin is clinically effective, but we need more information to demonstrate that it is cost-effective when compared with other treatments the NHS already provides," said NICE's evaluation director Carole Longson in a statement.

Jardiance is one of a new class of diabetes meds known as SGLT2 inhibitors. Approved by the FDA early this month after an initial rejection, the drug won European clearance in May.

Compared with the pricey cancer drugs NICE has been rejecting lately, it's a bargain at an estimated £470.30 per year, or about $779. Compared with Johnson & Johnson's ($JNJ) new Invokana, another SGLT2 inhibitor that was approved by NICE in June, it's about par on a list-price basis, at least at the lower dose of 100mg (for the 300mg dose, Invokana runs £608.21 per year). That doesn't include any discount J&J might have negotiated with NICE, however. On a per-pack basis, AstraZeneca's ($AZN) Forxiga (dapagliflozin), which got NICE's nod last May, had a list price of £36.59--exactly the same as Jardiance's--absent discounts.

- read the NICE statement

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