After the pan-Canadian Pharmaceutical Alliance (pCPA) ended negotiations with Novartis over the cost of Pluvicto, many Canadian prostate cancer patients are now facing uncertainty in accessing this potentially life-saving treatment. The decision follows the Canadian Agency for Drugs and Technologies in Health's recommendation that provinces cover Pluvicto treatments.
Pluvicto: A Promising Therapy
Pluvicto (lutetium Lu 177 vipivotide tetraxetan) is a targeted radioligand therapy approved for adults with prostate-specific membrane antigen (PSMA)-positive metastatic castration-resistant prostate cancer (mCRPC) who have been previously treated with androgen receptor pathway inhibition and taxane-based chemotherapy. The treatment involves intravenous injection of a compound that seeks out prostate cancer cells, attaching to them and emitting radiation to destroy the cells. According to Dr. Philip Cohen, the treatment's side effects are often less severe compared to chemotherapy, though it can sometimes target salivary glands and tear ducts, leading to dry mouth.
Cost and Coverage Concerns
Each dose of Pluvicto is priced at $27,000, with a typical course involving five doses, totaling $135,000. This cost poses a significant barrier for many patients, especially since the B.C. Cancer Agency does not offer compassionate supply of Pluvicto. Following the negotiation breakdown, patients in British Columbia will need to rely on third-party insurance or pay out-of-pocket at private facilities to access the drug.
Negotiation Impasse
The pCPA's acting CEO, Dominic Tan, stated that negotiations ended because Novartis's best offer exceeded the pCPA's assessed value of the drug. Tan emphasized the alliance's responsibility to ensure drug prices align with clinical benefits and are sustainable for the healthcare system. Despite the setback, the pCPA remains open to resuming negotiations. Similarly, Novartis has expressed disappointment and a willingness to explore all options to ensure eligible patients can access Pluvicto.
Patient Advocacy
Jim Larson, a prostate cancer patient, is advocating for the federal government to cover Pluvicto, emphasizing the urgency of the situation. Mina Bechai, CEO of Initio Medical, highlights the effectiveness of lutetium-177 treatments but notes that late intervention can limit their benefits. The consensus is that making such treatments accessible is crucial, but the high cost remains a significant obstacle.
