• Source : Press Release
  • Date : 2022-03-30
  • Event type : Marketed
  • Companies : Roche

Roche, Government Miss Deadline for Tecentriq Reimbursement Talks

Roche Korea and the government failed to reach an agreement over the reimbursement rate of Tecentriq (atezolizumab) for the treatment of hepatocellular carcinoma (HCC) within the negotiation deadline.

Roche Korea said it was actively talking with the government to win health insurance benefits, but Korean liver cancer patients will have to wait for another month.

Roche's immunotherapy Tecentriq (left) and anti-angiogenic therapy Avastin.

The plan for Tecentriq reimbursement for HCC passed the Health Insurance Review and Assessment Service's (HIRA) Drug Reimbursement Evaluation Committee in January.

Roche Korea began the price negotiation for Tecentriq with the National Health Insurance Service (NHIS) in the same month. As a drug pricing negotiation period is set for 60 days, the two sides had to complete the talks by the end of this month.

However, the government and Roche Korea could not narrow their different positions. The government said it had to additionally lower the price of Roche's Avastin (bevacizumab), used in combination with Tecentriq, due to increased uses of Tecentriq, while Roche was against the idea.

Roche decided to release Tecentriq in the Korean market as quickly as possible, offering a lower price and accepting the government's proposal of free use of Tecentriq for three cycles.

Industry watchers said that Roche's move was a latecomer's strategy after witnessing the delay in reimbursement expansion of MSD's Keytruda (pembrolizumab).

However, as Tecentriq use increased and some Roche officials complained that Tecentriq sales incurred more losses, Roche said it would revise unfavorable conditions to renew the risk-sharing agreement (RSA) and the price negotiation for Tecentriq.

As Tecentriq's following indication may become a postoperative adjuvant therapy for early non-small cell lung cancer (NSCLC), Roche has to prepare for increased Tecentriq use in a large number of lung cancer patients. Roche aims to win approval for an expanded indication for early NSCLC within the year.

As the use of Tecentriq is expected to grow, the government's spending on health insurance will increase, too. Under such a scenario, the government cannot maintain the price of Tecentriq. Thus, the adjustment of Avastin price will be the focal point of the price negotiation for Tecentriq, observers said.

By lowering the price of expensive Avastin with its patent expired and other biosimilars available in the local market, Roche could defend a price cut of Tecentriq, and the government could save health insurance spending with a reduced price of Avastin because the drug is used in many types of cancer.

If the original drug Avastin's price goes down, it will also affect the prices of future biosimilars, which can further save the health insurance budget for the government.

Liver cancer patients, who hailed Tecentriq's passing of the drug reimbursement evaluation committee's review in January, are frustrated by the tug of war between the government and Roche.

Related patient groups pointed out that although the nation has many liver cancer patients, the number of those who can be treated with the Tecentriq and Avastin combo is much smaller, so the impact on health insurance finance may not be as significant as the government's calculations.

In other words, Roche may not need to adjust the price of the two drugs that are more widely used in other cancer types to win reimbursement for Tecentriq in liver cancer.

The guidelines for systemic chemotherapy for advanced HCC recommend using Tecentriq and Avastin combo as the first-line treatment. Yet, considering that upper gastrointestinal bleeding is common and fatal in cirrhosis patients, only about one-third of HCC patients are estimated to be able to receive the combo therapy.

Some critics said that while the government overestimated liver cancer treatment's impact on health insurance finance and Roche underestimated the importance of the indication of liver cancer, patients were taking the damage.