Novartis cuts price of Cosentyx after PVA negotiations

with the National Health Insurance Service

Was applied ‘Type B’ of Price-Volume Agreement Scheme after being applied ‘Type A’ in 2021…affected by the company’s release of a new product

Cosentyx UnoReady Pen

The price of Novartis’s Cosentyx(secukinumab) is set to be reduced due to its increased use.

 

This is because the National Health Insurance Service recently reached an agreement during Price-Volume Agreement negotiations with the company for Cosentyx.

 

According to industry sources on the 6th, the insurance price ceiling of Cosentyx was adjusted for the second time under the PVA system after 2021.

 

The affected products are the Cosentyx SensoReady Pen and Cosentyx UnoReady Pen.

 

Cosentyx was listed for reimbursement in Korea in August 2017.

 

Currently reimbursed indications include ▲chronic severe plaque psoriasis, ▲active and progressive psoriatic arthritis, and ▲severe active ankylosing spondylitis.

 

According to the market research institution IQVIA, Cosentyx SensorReady Pen has seen an increase in sales every year since its reimbursement.

 

In 2019, sales reached KRW 12.3 billion, then KRW 19.9 billion in 2020, KRW 25.1 billion in 2021, KRW 30.3 billion in 2022, and KRW 31.7 billion in 2023.

 

In addition, Cosentyx UnoReady Pen, a high-dose product that was launched last year, generated sales of KRW 4.5 billion.

 

Due to such high demand, the insurance price ceiling of Cosentyx had been adjusted in 2021 under the PVA system.

 

At the time, the price of Cosentyx Sensoready Pen dropped by 7.3% from KRW 682,938 to KRW 630,084.

 

At the time, 'Type A’ of the PVA negotiations was applied.

 

Type A negotiations are applied to listed new drugs whose claims in the same product category have increased by more than 30% from the expected claims amount.

 

In 2020, the drug had already well exceeded the expected claims amount.

 

Three years have passed, and this year, ‘Type B’ PVA negotiations were applied.

 

Type B negotiations are applied when the claims for the same product group, whose insurance price ceiling had been adjusted by Type A negotiations, or four years passed after the date of initial listing or the date the price ceiling was adjusted through negotiations, have increased by 60% or more than the previous year's claims, or by 10% or more but the increase is more than KRW 5 billion.

 

Since Cosentyx had its price ceiling adjusted through Type A negotiations, it is possible that the additional negotiation for price adjustments was ordered because its claims increased by more than 60% or more than KRW 5 billion over the previous year's claims.

 

Given that Cosentyx Sensoready’s sales grew 5% YoY in 2023 by KRW 1.4 billion (IQVIA), the introduction of Cosentyx UnoReady Pen, which falls in the same product group, may have triggered the PVA negotiation.

 

Combined, the increase in sales amounted to more than KRW 5 billion compared to the previous year.

 

Upon the agreement, the final price of Cosentyx is expected to be announced after deliberation by the Ministry of Health and Welfare’s Health Insurance Policy Review Committee.