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Re: Zadie420 post# 799262

Saturday, 11/22/2025 6:57:22 AM

Saturday, November 22, 2025 6:57:22 AM

Post# of 824203
Exactly. I was reading about Amvuttra NICE approval for a second indication

England's National Institute for Health and Care Excellence (NICE) has cleared Alnylam’s blockbuster Amvuttra for use by the National Health Service (NHS) as a treatment for wild-type or hereditary transthyretin amyloid cardiomyopathy (ATTR-CM).

The endorsement comes two years after the U.K. agency endorsed Amvuttra as a treatment for polyneuropathy of hereditary transthyretin-mediated amyloidosis (hATTR-PN).
https://www.fiercepharma.com/pharma/fierce-pharma-regulatory-tracker-second-half-2025?utm_medium=email&utm_source=nl&utm_campaign=LS-NL-FiercePharma&oly_enc_id=4891B5384067C3X

And here's Gemini's AI overview

The National Institute for Health and Care Excellence (NICE) has recommended Amvuttra (vutrisiran) for use within the National Health Service (NHS) at a confidential discounted price. The official list price for the drug in the UK is approximately £96,000 per pre-filled syringe, with an estimated annual list cost of just over £383,000 per patient [or $501,768].
NICE Guidance and Pricing Details
Confidential Discount: The actual price paid by the NHS is subject to a confidential commercial arrangement and is not publicly disclosed. NHS organizations can access details via the Commercial Access and Pricing (CAP) Portal.
List Price: Before the confidential discount, the list price in the UK is £95,862.36 per 0.5 ml injection. At the recommended dosage of one injection every three months, this results in an annual cost of £383,449.44 per patient.
Recommendation: NICE has recommended Amvuttra as an option for patients with hereditary transthyretin-related amyloidosis (hATTR) with polyneuropathy (PN). The recommendation was made through a cost-comparison process, where it was found to be a cost-effective option compared to alternative treatments like Onpattro.
Availability: Because the drug was recommended through the cost-comparison process, NHS England and commissioning groups have agreed to provide funding to make the treatment available within the NHS.
US Pricing Comparison
For context, the list price in the United States is significantly higher, around $477,000 per year. The price varies in the US based on insurance coverage and patient assistance programs like Alnylam Assist.

Say, the confidential discount gets a 22% discount to £300,000. That's still a lot of money. What this says to me is that pricing is about drug effectiveness and the cost to make it. And thinking out loud, what would stop NICE from pricing DCVax-L accordingly considering the cost to make it w the manual method especially knowing that that price will be nicely reduced after Eden implementation. And in the Amvuttra example, it has competition w a Pfizer drug, DCVax-L would not have any real competition. Here's an article that describes a little bit of the NICE thinking that went into it:
https://pharmaphorum.com/news/alnylams-attr-cardiomyopathy-drug-backed-nhs-use

NICE's guidance document recommends that the NHS "use the least expensive option of the suitable treatments," including Amvuttra and Vyndaqel, after discussing the advantages and disadvantages of the available treatments with the person living with the condition.

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