Lifesaving $700,000 medicine referred to special committee
The B.C. government will refer a drug that costs more than $700,000 a year to a special committee for exceptional coverage, and potentially pay the bill on a patient-by-patient basis, says the health minister.
Adrian Dix said Monday that the committee will be allowed to authorize coverage of the drug Soliris in certain cases, despite what he called an “outrageous” cost by the drug manufacturer. Soliris can treat atypical hemolytic uremic syndrome, a rare autoimmune disorder. But it is also one of the most expensive drugs in the world.
“These are very, very significant costs and very extraordinary circumstances,” Dix told reporters at the legislature. “That’s why we’ve decided to stick to the evidence here. These issues will be taken on a case-by-case basis.”
The province’s lack of coverage for Soliris became news after 23-year-old Shantee Anaquod began fundraising for the drug to save her life because the government would not fund it.
On Monday, Anaquod’s mother Jennifer said she’d yet to hear directly from the government, but was hopeful at the minister’s announcement. “It gives me some hope to hang on to,” she said. “It’s still up in the air. I don’t want to be too hopeful, but I am hopeful.”
However, Anaquod’s condition continues to worsen and the timeline of the review needs to be quick, said Jennifer.
“I’m worried about how long it will take,” she said.
Soliris is covered in Alberta, Saskatchewan, Ontario and Quebec, but British Columbia’s Drug Benefit Council and Common Drug Review did not recommend coverage due to insufficient clinic evidence and high costs.
Dix had promised to review B.C.’s research, following media reports about Anaquod’s case. He said his ministry consulted with other provinces and physicians, before deciding the drug could be approved on a limited basis, depending on the patient and circumstances, if it was deemed necessary by an existing review board that already handles exceptional drug coverage in the province.
“The decisions are going to be made ultimately by doctors,” he said. “This is a very expensive drug and it has significant implications.”
Dix said B.C.’s Pharmacare system has run a deficit the previous three years, and adding additional SEE VIDEO WITH THIS STORY AT VANCOUVERSUN.COM
costs cannot be done lightly. A patient on Soliris for five years would bill $3.5 million in drug costs to Pharmacare. Health ministry officials said two to four new patients a year are expected to meet the criteria for coverage under the exceptional drug review panel. Coverage would be reviewed every six months, he said.
A federal drug pricing watchdog in September found Soliris’ manufacturer, Alexion Pharmaceuticals, was charging excessive costs and ordered it to repay Ottawa for some overcharges.
“With a price of more than $700,000 a year per patient the ministry is strongly objecting to the excessive pricing Alexion, the pharmaceutical company, has set for Soliris,” said Dix, arguing it is charging Canada 21 per cent more than other countries. “I note that Alexion has reported cumulative Soliris references from 2010 to the third quarter of 2017 of $14.2 billion.”
Alexion is appealing the federal review board decision, and B.C. will apply to be an intervener in the hearing panel, said Dix.