two new treatments appear at more than 300,000 euros

Novartis and Gilead are charging hospitals a high price for gene therapy, pending a negotiated rate. A hundred people could be treated this year.

With new gene therapies, a sting can be worth gold. Thus, the injection of Yescarta or Kimriah will cost 350,000 or 320,000 euros in France, to treat patients with cancer of the lymphatic system. These prices charged to hospitals will be fully covered by Social Security for patients.

These tariffs were set unilaterally by the manufacturers and unveiled on Tuesday by the Ministry of Health. They are comparable to the US tariffs of $ 373,000 and $ 475,000, respectively, for the commercial launch of these products across the Atlantic in 2017.

Yescarta and Kimriah, however, will not endanger the balance of health insurance accounts. First, these innovative therapies based on the technique of "CAR-T" cells still concern very few people. They treat some acute lymphoblastic leukemias, and are only provided in a few medical institutions in France. The treatment is tricky: cells are taken from a person already very weakened by the disease; they are sent back to an American laboratory, where they are genetically modified; then they are reinjected to the sampled person. Only two or three patients have been treated since 2018, and a few dozen more could be cared for in 2019.

A price called to fall

Nothing to do with the arrival of Gilead's Sovaldi hepatitis C treatment in 2014, which had endangered Social Security accounts, with a potential target of more than 150,000 patients and a very high initial price ( 56,000 euros the cure). There is one thing in common between these therapies, however: they do not just win a few months or years of life, but seek healing.

Moreover, this unit price of 320,000 or 350,000 euros should not be misleading. It is only an "indemnity" fixed by the laboratory within the framework of a temporary authorization of use, pending the negotiation of a definitive price with the economic committee of the health products, attached to the government. The latter will focus on lowering the bill - even if the producer shows a high level of demand.

The Economic Evaluation and Public Health Commission of the High Authority of Health is expected to decide in late January on the cost / benefit ratio of Yescarta and Kimriah, which will open the tariff negotiation. Laboratories will have to pay the difference between the amounts collected and the final price. In addition, their earnings are framed by law. During the phase of temporary authorization of use, they are not entitled to cash more than 30 million euros of income in twelve months on this therapy. If they exceed this ceiling, the cost of treatment will be reduced to 10,000 euros per patient per year.

Solveig Godeluck