February 27, 2020

Allocating drugs by lottery

Novartis has held the first draw to choose four babies who will receive its one-shot treatment for the genetic disease spinal muscular atrophy, Zolgensma (onasemnogene abeparvovec), amid criticism of its lottery programme from patient groups and EU health ministers.
Priced in the United States at $2.1m (£1.6m; €1.9m), the most expensive drug course of treatment ever, Zolgensma is not yet approved elsewhere. In December the company announced a plan to give away 50 treatments in other countries over the next six months, the recipients to be chosen randomly from among applicants every two weeks.
Recipients must be under 2, the upper age limit for which the drug is approved in the US. Most of the children in the Zolgensma draw were registered by their doctors. About one child in every 8000 live births is born with spinal muscular atrophy. The most severe type, called type 1 or Werdnig-Hoffmann disease, usually causes death during early childhood if untreated.
Does this makes any sense? In my opinion is a perfect strategy (for Novartis) to create artificial  scarcity. It is a well known approach to increase willingness to access/ willingness to pay. It was described by Adam Brandenburger in a book long time ago: Coopetition.
I hope it will not succeed (at least in Europe).

David Hockney