Giving patients access to Novartis' $475,000 breakthrough leukemia therapy — an extremely expensive but highly effective treatment — is going to take novel collaboration, Express Scripts CMO Steve Miller, MD, wrote in a blog post on the company's website.
The price of the cancer drug, Kymriah, is "dramatically higher" than other specialty drugs like it on the market and the healthcare system isn't set up to pay for it, Dr. Miller wrote.
Kymriah, a CAR-T cell leukemia therapy, uses patients' genetically modified immune cells to fight the disease. The drug is administered to patients just once, resulting in a high price tag as Novartis has a single opportunity per patient to redeem its investment, according to Bloomberg.
"The healthcare system isn't set up for this type of economic model," wrote Dr. Miller. "We need a new payment model."
Paying for these types of therapies will require collaboration among payers, pharmaceutical companies and policy makers, he added.