In the great national debate over drug prices, a new treatment for spinal muscular atrophy illustrates the complex balance between the good news — saving children from a horrible disease — and the bad news — stratospheric prices. WBUR
"We're betting $2 million, within a small amount of that range," predicts Michael Sherman, chief medical officer of the health insurer Harvard Pilgrim Health Care.under way about drug prices, Zolgensma is sure to be a hot topic. But not a simple one: It illustrates the complex balance between the good news — saving children from a horrible disease — and the bad news — stratospheric prices.
But Michael Sherman from Harvard Pilgrim Health Care takes issue with calculating a one-time drug's value based on the number of years it saves:"If you go to the hospital and have your appendix out as a child, or they save your life through some other mechanism, we don't pay the hospital $10 million for saving a child's life. That's absurd. So it may not be the right model for a one-time innovative treatment.
"It isn't about saying no. It's about how do we say yes? But it's also about coming up with fair pricing," he says. "Now that we have the specter of a new drug coming to market which is going to be seven figures, and several others that we expect to hit the market over the next 12 to 24 months, I think that's enough of a call to action that we're going to see more attention," he says.
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