Cost-effectiveness watchdogs skewer Novartis' MS drug Mayzent and J&J's depression spray Spravato

The Institute for Clinical and Economic Review (ICER) had a busy day Thursday, issuing final cost assessments on two highly anticipated neurology drugs: Spravato, the inhalable depression treatment from Johnson & Johnson’s Janssen, and Novartis’ Mayzent to treat secondary progressive multiple sclerosis (SPMS). The bottom line? Neither treatment is cost effective, ICER said. The agency weighed in first on Mayzent, which was approved by the FDA in March and priced at $88,500 per year. When ICER applied its usual analysis method to the drug—cost per life years gained—it determined that Mayzent exceeds its maximum threshold of $150,000. In fact, the drug would cost $1.57 million per life year gained, the final report said (PDF). The Novartis product “contributes substantial costs without providing a meaningful extension of life relative to best supportive care,” ICER said in a summary of its assessment (PDF). A spokesperson for Novartis told FiercePharma that the company provided feedback and recommendations to ICER during the review process but that those "are not fully reflected in the final report." He noted that ICER established cost effectiveness by comparing it to no treatment, when in fact most SPMS patients are treated with some form of therapy. The spokesperson added that the phase 3 trial for Mayzent "demonstrated a significant effect in delaying disability progression in a representative SPMS population."