RE:How will Ibalizumab be used?PoorOpinion wrote: It might seem like a naive question but I'm only just realizing that once a patient 'tries' Ibalizumab (along side other drugs)then if its successful in reducing virus to an undetectable level then the prevailing wisdom around suppressing infection ( and stopping resistance developing) would mean that the patient continues to take the drug until their next virological failure ( even then Ibalizumab may still remain one of that patients effective drugs) or death or a cure. In essence each new patient becomes a potential long term user of the drug. Is this how people see it being used? So a patient that is recruited in the first year is potentially a Theratech customer for the whole 12 years of the licence agreement. Is that how people see the drug being used? At 50,000$ per year thats 600,000$, yikes!
My first question is it economically viable to go long term on such an expenive drug? I'm sure patients and doctors will want to keep access but payors must hate the idea of such long term expense.
If I think about a drug like Humira, an anti-inflammatory (anti-arthritis) drug, thst costs about 10,000$ per year in Canada. Access is highly limited. You must go thru a process of trying all the other cheaper alternatives, only if they fail and you can show particular features of disease progression do you get access to the expensive drug.
At 50-60,000$ does Ibalizumab force itself into being the drug of last choice, after you try everything else? Maybe there is still a lot of money to be made in that circumstance but it might limit the practical impact of an expanded label.
Yes, they will stay on ibalizumab until something else comes along....
I have plenty of patients in Canada on Humira. I think there have been over 400k worldwide on the drug at some point.
When you have no other portions, expensive ones tend to get approved.
bfw