Af­ter a slap­down on Orkam­bi price, Ver­tex is drop­ping French tri­al sites while warn­ing pa­tients on ac­cess

Ver­tex Phar­ma $VRTX is play­ing hard­ball with French drug reg­u­la­tors — and cys­tic fi­bro­sis pa­tients wait­ing for their next-gen triple are get­ting caught in the mid­dle.

Mired in a long-run­ning dis­pute over the re­im­burse­ment lev­el for their drug Orkam­bi, Ver­tex has de­cid­ed to shut out the tri­al sites it had se­lect­ed in France for the late-stage com­bi­na­tion stud­ies for its cys­tic fi­bro­sis drugs, in­clud­ing the ex­per­i­men­tal VX-659, which has raised hopes for a broad swath of pa­tients.

Ver­tex’s Orkam­bi was first ap­proved in France a lit­tle more than two years ago, trig­ger­ing ne­go­ti­a­tions over a re­im­burse­ment agree­ment as French of­fi­cials pur­sued a deep, 80% dis­count based on an old drug for CF — which Ver­tex has bucked against. Ver­tex has been sell­ing Orkam­bi in France at its list price as it ne­go­ti­ates the fi­nal price with the French gov­ern­ment. But of­fi­cials re­ject­ed that list price, say­ing that Orkam­bi pro­vid­ed on­ly a “mod­est” ben­e­fit — an at­ti­tude that has plagued Ver­tex’s ne­go­ti­a­tions in Eu­rope. The de­ci­sion puts Ver­tex on the hook for a re­im­burse­ment off the list price, and now it’s re­spond­ing by rais­ing a warn­ing about pa­tient ac­cess to their drugs and shut­ting out French tri­al sites.

The com­pa­ny of­fered this state­ment to End­points News in re­sponse to a query about the tri­al sites:

“Our goal is to cure CF and we have made sig­nif­i­cant ad­vances by dis­cov­er­ing and de­vel­op­ing the first med­i­cines to treat the un­der­ly­ing cause of this dis­ease. We want all pa­tients to have ac­cess to these and fu­ture med­i­cines we are de­vel­op­ing for those still wait­ing. We urge the French gov­ern­ment to join coun­tries like the U.S., Aus­tria, Ire­land, Ger­many and many oth­ers to pro­vide pa­tients per­ma­nent ac­cess to Orkam­bi.”

Bio­Cen­tu­ry got hold of an ex­cerpt of a let­ter Ver­tex sent to the labs which, they re­port­ed, stat­ed that:

(D)es­pite more than 18 months of “good faith” ne­go­ti­a­tions there has been no res­o­lu­tion on the re­im­burse­ment of Orkam­bi and that there­fore the path­way for CF pa­tients in France to gain ac­cess to the drug is “un­pre­dictable” and con­duct­ing the tri­als “would raise false hope.”

Bio­Cen­tu­ry got the ex­cerpt of the com­mu­ni­ca­tions from CF pa­tient groups in France, which are get­ting caught in the mid­dle of a fight. And it’s work­ing in Ver­tex’s fa­vor. Ac­cord­ing to the re­port they want Ver­tex to con­tin­ue ne­go­ti­a­tions and get the tri­al sites back in­to the late-stage stud­ies of the next-gen triples that promise to great­ly in­crease the num­ber of pa­tients that Ver­tex can reach.

A cou­ple of weeks ago Ver­tex picked VX-659 and VX-445 for two late-stage pro­grams, com­bin­ing each with teza­caftor and Ka­ly­de­co. Their drug ‘659 is slat­ed to be the first off the mark af­ter re­searchers demon­strat­ed that the high dose triple im­proved a mea­sure of lung func­tion by 13.3%.

Hal Barron, GSK

Break­ing the death spi­ral: Hal Bar­ron talks about trans­form­ing the mori­bund R&D cul­ture at GSK in a crit­i­cal year for the late-stage pipeline

Just ahead of GlaxoSmithKline’s Q2 update on Wednesday, science chief Hal Barron is making the rounds to talk up the pharma giant’s late-stage strategy as the top execs continue to woo back a deeply skeptical investor group while pushing through a whole new R&D culture.

And that’s not easy, Barron is quick to note. He told the Financial Times:

I think that culture, to some extent, is as hard, in fact even harder, than doing the science.

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Aca­dia is mak­ing the best of it, but their lat­est PhI­II Nu­plazid study is a bust

Acadia’s late-stage program to widen the commercial prospects for Nuplazid has hit a wall. The biotech reported that their Phase III ENHANCE trial flat failed. And while they $ACAD did their best to cherry pick positive data wherever they can be found, this is a clear setback for the biotech.

With close to 400 patients enrolled, researchers said the drug flunked the primary endpoint as an adjunctive therapy for patients with an inadequate response to antipsychotic therapy. The p-value was an ugly 0.0940 on the Positive and Negative Syndrome Scale, which the company called out as a positive trend.

Their shares slid 12% on the news, good for a $426 million hit on a $3.7 billion market cap at close.

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Some Big Phar­mas stepped up their game on da­ta trans­paren­cy — but which flunked the test?

The nonprofit Bioethics International has come out with their latest scorecard on data transparency among the big biopharmas in the industry — flagging a few standouts while spotlighting some laggards who are continuing to underperform.

Now in its third year, the nonprofit created a new set of standards with Yale School of Medicine and Stanford Law School to evaluate the track record on trial registration, results reporting, publication and data-sharing practice.

Busy Gilead crew throws strug­gling biotech a life­line, with some cash up­front and hun­dreds of mil­lions in biobucks for HIV deal

Durect $DRRX got a badly needed shot in the arm Monday morning as Gilead’s busy BD team lined up access to its extended-release platform tech for HIV and hepatitis B.

Gilead, a leader in the HIV sector, is paying a modest $25 million in cash for the right to jump on the platform at Durect, which has been using its technology to come up with an extended-release version of bupivacaine. The FDA rejected that in 2014, but Durect has been working on a comeback.

In­tec blitzed by PhI­II flop as lead pro­gram fails to beat Mer­ck­'s stan­dard com­bo for Parkin­son’s

Intec Pharma’s $NTEC lead drug slammed into a brick wall Monday morning. The small-cap Israeli biotech reported that its lead program — coming off a platform designed to produce a safer, more effective oral drug for Parkinson’s — failed the Phase III at the primary endpoint.

Researchers at Intec, which has already seen its share price collapse over the past few months, says that its Accordion Pill-Carbidopa/Levodopa failed to prove superior to Sinemet in reducing daily ‘off’ time. 

Cel­gene racks up third Ote­zla ap­proval, heat­ing up talks about who Bris­tol-My­ers will sell to

Whoever is taking Otezla off Bristol-Myers Squibb’s hands will have one more revenue stream to boast.

The drug — a rising star in Celgene’s pipeline that generated global sales of $1.6 billion last year — is now OK’d to treat oral ulcers associated with Behçet’s disease, a common symptom for a rare inflammatory disorder. This marks the third FDA approval for the PDE4 inhibitor since 2014, when it was greenlighted for plaque psoriasis and psoriatic arthritis.

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Francesco De Rubertis

Medicxi is rolling out its biggest fund ever to back Eu­rope's top 'sci­en­tists with strange ideas'

Francesco De Rubertis built Medicxi to be the kind of biotech venture player he would have liked to have known back when he was a full time scientist.

“When I was a scientist 20 years ago I would have loved Medicxi,’ the co-founder tells me. It’s the kind of place run by and for investigators, what the Medicxi partner calls “scientists with strange ideas — a platform for the drug hunter and scientific entrepreneur. That’s what I wanted when I was a scientist.”

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Af­ter a decade, Vi­iV CSO John Pot­tage says it's time to step down — and he's hand­ing the job to long­time col­league Kim Smith

ViiV Healthcare has always been something unique in the global drug industry.

Owned by GlaxoSmithKline and Pfizer — with GSK in the lead as majority owner — it was created 10 years ago in a time of deep turmoil for the field as something independent of the pharma giants, but with access to lots of infrastructural support on demand. While R&D at the mother ship inside GSK was souring, a razor-focused ViiV provided a rare bright spot, challenging Gilead on a lucrative front in delivering new combinations that require fewer therapies with a more easily tolerated regimen.

They kept a massive number of people alive who would otherwise have been facing a death sentence. And they made money.

And throughout, John Pottage has been the chief scientific and chief medical officer.

Until now.

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Vlad Coric (Biohaven)

In an­oth­er dis­ap­point­ment for in­vestors, FDA slaps down Bio­haven’s re­vised ver­sion of an old ALS drug

Biohaven is at risk of making a habit of disappointing its investors.

Late Friday the biotech $BHVN reported that the FDA had rejected its application for riluzole, an old drug that they had made over into a sublingual formulation that dissolves under the tongue. According to Biohaven, the FDA had a problem with the active ingredient used in a bioequivalence study back in 2017, which they got from the Canadian drugmaker Apotex.

Apotex, though, has been a disaster ground. The manufacturer voluntarily yanked the ANDAs on 31 drugs — in late 2017 — after the FDA came across serious manufacturing deficiencies at their plants in India. A few days ago, the FDA made it official.

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