• Source : Press Release
  • Date : 2022-03-10
  • Event type : Marketed
  • Companies : Roche

How Will Reimbursement for Tecentriq in Liver Cancer Affect Biosimilars

Roche is negotiating with the government over the reimbursement price of Tecentriq (atezolizumab), which passed the review of the Health Insurance Review and Assessment Service (HIRA) in January.

Depending on the result, the use of Avastin (bevacizumab) in combination with Tecentriq in liver cancer can be expanded. This could affect the budding biosimilar market in Korea, too, observers said.

Roche is negotiating a reimbursement price of Tecentriq (left), combined with Avastin in the first-line treatment of unresectable hepatocellular carcinoma.

In January, HIRA's Pharmaceutical Benefit Advisory Committee recognized the need for reimbursement for Tecentriq plus bevacizumab as the first-line treatment of unresectable hepatocellular carcinoma (HCC).

Roche is in talks with the National Health Insurance Service (NHIS) to determine the price of Tecentriq within March.

There are several variables in Tecentriq price negotiations. First, as Tecentriq was a latecomer immune checkpoint inhibitor, compared to MSD's Keytruda (pembrolizumab) and BMS/Ono's Opdivo (nivolumab), Roche offered a lower price and free use of the drug for three cycles.

Thanks to the bold offer, Tecentriq could enter the Korean market quickly.

However, some Roche officials complained that Tecentriq sales incurred more losses.

Tecentriq costs about 2.3 million won ($1,872) for three weeks (one treatment cycle), about half of Keytruda's three-week cost at 4.2 million won. Suppose insurance benefits in the first-line therapy cover Tecentriq for HCC. In that case, the price will be additionally cut, and Roche will not be able to offer the current sales conditions, industry watchers said.

Roche is reportedly willing to change the sales conditions because it seeks to expand the reimbursement for the first-line treatment of lung cancer and liver cancer while re-negotiating the risk-sharing agreement.

Observers said that Roche could leverage Avastin, the highly-priced other steady seller used in combo with Tecentriq in price negotiations.

Recently, the government accepted a new negotiation method, granting reimbursement for an expensive new drug in trade for lowering the price of an old drug. This gives room for Roche to utilize Avastin in resetting the base for RSA for Tecentriq.

Avastin's patent has already expired, and there is an Avastin biosimilar. Still, the original drug is costly. For example, the first-line treatment of HCC using Tecentriq plus bevacizumab costs about 4.5 million won for three weeks (one treatment cycle).

This means that the cost of bevacizumab with the expired patent is almost equal to that of a new immune checkpoint inhibitor. Thus, insurance benefits for Tecentriq in liver cancer will expand the use of Avastin and lower the drug price of Avastin, industry watchers said.

If the original drug price goes down, it will affect biosimilars' prices, which are yet to be reimbursable.

In Korea, there are three authorized biosimilars containing bevacizumab.

The three are Samsung Bioepis' Onbevzi, Pfizer's Zirabev, and Avogen's Arimsis.

Among them, only Onbevzi was released with a reimbursed price. Samsung Biopeis rolled out Onbevzi with about 70 percent of Avastin's price in September last year, which led to a 30 percent cut in Avastin's price in October.

Reimbursement for Pfizer's Zirabev has not progressed since the drug obtained marketing approval in May last year.

Although Pfizer said it was making an effort to get reimbursement and launch the product quickly, Pfizer was too busy supplying Covid-19 vaccines and oral treatments to take care of Zirabev reimbursement, industry officials said.

Alvogen's Arimsis won the local approval in January.