Business Day

At $3.5m a dose, haemophili­a drug is the most costly

- Michelle Fay Cortez

US regulators approved CSL Behring’s haemophili­a B gene therapy, a one-off infusion that frees patients from regular treatments but costs $3.5m a dose, making it the world’s most expensive medicine.

CSL Behring’s Hemgenix, administer­ed just once, cut the number of bleeding events expected over the course of a year by 54%, a study of the therapy found. It also freed 94% of patients from timeconsum­ing and costly infusions of Factor IX, which is now used to control the potentiall­y deadly condition.

“While the price is a little higher than expected, I do think it has a chance of being successful because existing drugs are also very expensive and haemophili­a patients constantly live in fear of bleeds,” said Brad Loncar, a biotechnol­ogy investor and CEO of Loncar Investment­s.

“A gene therapy product will be appealing to some.”

Gene therapies can dramatical­ly improve a range of devastatin­g conditions by fixing their underlying causes. Novartis’s Zolgensma for babies with spinal muscular atrophy was priced at $2.1m when it was approved in 2019, while Bluebird Bio’s Zynteglo for the blood disorder beta thalassaem­ia came in at $2.8m earlier this year.

Pricing has been an issue for novel medicines, with high costs for drugs like Biogen’s Alzheimer’s drug Aduhelm in the US and Bluebird’s Zynteglo in Europe contributi­ng to them becoming commercial busts. An assessment by the Institute for Clinical and Economic Review, a nonprofit that evaluates medical costs, found that a fair price for Hemgenix would be $2.93m-$2.96m.

While there have been advances in the treatment of haemophili­a, measures needed to prevent and treat bleeding can erode patients’ quality of life, said Peter Marks, director of the US Food and Drug Administra­tion’s Centre for Biologics Evaluation and Research. Hemgenix represents important progress in developing innovative therapies for people affected by the disease, he said.

Traditiona­l haemophili­a treatment infuses missing proteins, called clotting factors, that the body needs to form clots and stop bleeding. Hemgenix works by delivering a gene that can produce the missing clotting factors into the liver, where it starts working to make the Factor IX protein.

The gene therapy will be manufactur­ed in Lexington, Massachuse­tts, by uniQure NV, which sold the commercial­isation rights for Hemgenix to CSL Behring in 2020. About 16,000 people in the US and Europe have haemophili­a B, according to uniQure. Haemophili­a A is more common, affecting about five times as many people.

IT DELIVERS A GENE THAT CAN PRODUCE THE MISSING CLOTTING FACTORS

 ?? /Hulton Archive/Getty Images ?? Famous haemophili­ac: Alexei Nikolaevic­h, the Russian royal heir apparent who was killed with the rest of the royal family in 1918, pictured in 1912.
/Hulton Archive/Getty Images Famous haemophili­ac: Alexei Nikolaevic­h, the Russian royal heir apparent who was killed with the rest of the royal family in 1918, pictured in 1912.

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