Following the FDA’s approval of Roche’s multiple sclerosis (MS) treatment ocrelizumab (Ocrevus), the company surprised industry observers when it placed a $65,000 list price on the new drug, leading to comparisons with its MS drug competitor, and more expensive rival, Merck’s interferon beta-1a (Rebif), which has a list price of $86,000. The annual price announced for ocrelizumab represents a 20% discount to the average price of other MS medications, Roche noted, stating that the industry needs to start to reverse the trend of rising MS drug prices, which have grown by 400% over 12 years, according to the National MS Society.
A Roche spokesperson noted that ocrelizumab was shown to be clinically superior to interferon beta-1a in phase 3 studies that compared patient responses to the 2 drugs. Ocrelizumab reduced the annualized MS relapse rate by 50% compared with interferon beta-1a, over a 2-year period.
Merck rejected any direct comparison between pricing for the 2 medications, calling it misleading and oversimplified to do so, because both drugs have different modes of administration and are typically managed separately by payers. Therefore, the access and pricing approaches are different. According to Merck, ocrelizumab is an infusion medication and is “expected to be covered under the medical benefit, and won’t typically require the manufacturer to provide discounts to payers.” Self-injection biologics such as interferon beta-1a, however, are often covered under the pharmacy benefit, Merck asserts, and their list prices often “bake in” room for manufacturer discounts to support access for patients.
It isn’t yet apparent if this distinction will prevent prescribers and patients from moving to the new drug, especially with the clinical data showing superiority of ocrelizumab for relapsing-remitting forms of MS. Experts have predicted ocrelizumab will be a potential blockbuster, with $4.1 billion in sales by 2022. Further, it is the first MS drug approved to treat primary progressive MS, potentially helping the drug achieve significant market adoption.