Gruß vom
Advamillionär
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www.forbes.com/sites/brucejapsen/2016/10/...drug/#60ed8a507b8d
Despite recent U.S. Food and Drug Administration approval, health insurer Anthem said it won’t cover the expensive biotech drug eteplirsen for Duchenne muscular dystrophy, saying the prescription is “investigational and not medically necessary.”
The news is a blow to eteplirsen’s maker, Sarepta Therapeutics, and patients who suffer the disease because Anthem is the nation’s second-largest health insurer, operating Blue Cross and Blue Shield plans in 14 states. Other insurers could follow suit, particularly given the drug costs $300,000 a year. Anthem is poised to become the nation’s largest insurer should its merger with Cigna be approved next year.
“In summary, the clinical benefit of treatment for DMD with eteplirsen, including improved motor function, has not been demonstrated,” Anthem policy, posted Thursday on its web site, said. “Establishment of a clinical benefit is warranted in on-going clinical trials.”
Grund: keine nachgewiesene Wirksamkeit. Eine umstrittene FDA Zulassung ist eben nicht alles...Sollten da wirklich andere Versicherer folgen (können? müssen die eigentlich zahlen mit der Zulassung? scheinbar nicht...), hat Sarepta ein grosses Problem...Da stünde dann PTC am Ende mit den Erstattungen in Europa und anderen Ländern doch besser da...
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