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Msg  34755 of 34984  at  1/14/2020 9:51:34 AM  by


Endpoints article on Inclisiran

 I have been saying this for a while, but I still think Inclisiran may be a big deal. I also  hope to be using it as soon as it's approved, but that's another story.
January 14, 2020 08:21 AM EST
Natalie Grover

Still to be ap­proved in­clisir­an gets red car­pet treat­ment by UK's NHS in deal with No­var­tis

It may not have yet se­cured ap­proval, nor re­viewed by UK’s price-ef­fec­tive­ness watch­dog NICE — but the cho­les­terol ther­a­py in­clisir­an at the heart of last year’s No­var­tis $9.7 bil­lion buy­out of the Med­i­cines Com­pa­ny will be made wide­ly avail­able to pa­tients at risk of heart dis­ease in the Na­tion­al Health Ser­vice (NHS), the UK agency said on Mon­day.

NHS Eng­land will agree to a pop­u­la­tion-lev­el com­mer­cial arrange­ment with No­var­tis to make it wide­ly avail­able to pa­tients as soon as 2021 — in ad­di­tion, the bian­nu­al shot will al­so be test­ed in UK pa­tients as part of a large-scale NHS clin­i­cal tri­al ex­pect­ed to start lat­er this year.

“Ear­ly re­sults from clin­i­cal tri­als sug­gest that if in­clisir­an is giv­en to 300,000 pa­tients an­nu­al­ly, it could help pre­vent 55,000 heart at­tacks and strokes, and has the po­ten­tial of sav­ing 30,000 lives in the next 10 years,” the NHS said, high­light­ing that re­cent tri­als have shown in­clisir­an can halve bad cho­les­terol in two weeks.


De­spite the wide adop­tion of statins, such as Pfiz­er’s $PFE near­ly $13 bil­lion-at-peak Lip­i­tor, hy­per­c­ho­les­terolemia and as­so­ci­at­ed car­dio­vas­cu­lar dis­ease is a lead­ing glob­al killer, rep­re­sent­ing fer­tile ground for fresh, po­tent ther­a­pies to reap lu­cra­tive re­turns. In the UK, heart dis­ease is the sec­ond biggest cause of death.

The cho­les­terol-low­er­ing Repatha from Am­gen, and ri­val Pralu­ent from Re­gen­eron and Sanofi, were ap­proved in the Unit­ed States in 2015 in post-statin pa­tients amidst much fan­fare — their mak­ers flush with block­buster ex­pec­ta­tions. In­stead, they faced in­sur­er push­back for their high stick­er prices ($14,000) that led to low­er-than-ex­pect­ed adop­tion. Lat­er, tri­als demon­strat­ed the PC­SK9 in­hibitors al­so sig­nif­i­cant­ly cut car­dio­vas­cu­lar risk — da­ta that are now re­flect­ed on their la­bels — as well as safe use in re­nal­ly-im­paired pa­tients, but their man­u­fac­tur­ers end­ed up cut­ting their prices by 60%, in a bid to boost tepid sales.

Un­like Repatha and Pralu­ent — which work by in­hibit­ing the PC­SK9 pro­tein and there­by di­min­ish­ing LDL-C or “bad” cho­les­terol — in­clisir­an is a siR­NA ther­a­py de­signed to curb the pro­duc­tion of the PC­SK9 pro­tein at its source in the liv­er to oust LDL-C from the blood­stream. The Med­i­cines Co part­nered with RNAi pi­o­neer Al­ny­lam to de­vel­op the drug.

Now, an­a­lysts ex­pect the twice-year­ly (more con­ve­nient, and like­ly cheap­er if ap­proved) in­clisir­an to take a chunk out of once-month­ly PC­SK9 mon­o­clon­al an­ti­body sales and reap the block­buster re­turns that the an­ti­bod­ies were orig­i­nal­ly pro­ject­ed to rake in. A Eu­ro­pean mar­ket­ing ap­pli­ca­tion for in­clisir­an is ex­pect­ed to be sub­mit­ted this year.


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