Replies to post #678305 on NorthWest Biotherapeutics Inc (NWBO)

[georgebailey]

Senti that was a question of mine. Once Eden’s approved Nice re prices the reimbursement ?

[ATLnsider]

sentiment_stocks, I do wholeheartedly agree that once Flaskworks devices are approved to be implemented into the DCVax-L manufacturing process, that will significantly decrease the cost to manufacture DCVax-L and it will also decrease the cost of DCVax-L for patients.

However, as you know, when Advent, Charles River Laboratories (CRL), or any other CDMO working with NWBio to manufacture DCVax-L, all the patients’ dosages (up to 8 to 10 years of doses) are made upfront in 1 batch process. NWBio will be required by their CDMO to pay for all the doses made for each patient regardless.

I believe that the reasons that NWBio allowed patients to pay for doses in installments in the Specials Program are:

(1) DCVax-L is not covered by the NHS national insurance in the UK, because it has not been approved by the MHRA yet. As a result, patients are having to fund-raise to pay for DCVax-L out-of-pocket. The funds that they are raising are coming in incrementally over time, and NWBio wants these patients to be able to start their treatment on DCVax-L ASAP.

(2) NWBio and Advent wanted as many patients in the UK as possible to be treated in the UK to help with the Flaskworks comparability studies. By allowing these patients to pay for DCVax-L in installments, that was a win-win for the patients, NWBio, Flaskworks and Advent.

However, one fallacy (lie) that shorts and other NWBio detractors like to promote is that DCVax-L will cost too much for regulators to approve, and for patients to afford.

The truth is, even at a total cost of $250,000 for up to 8 to 10 years of DCVax-L doses. DCVax-L would be 1 of the least expensive (cheapest) Advanced Therapy Medical Products (ATMPs) on the market in the UK, US, EU, Canada and the rest of the world (ROW).

If you assume a patient will use all of their DCVax-L doses over 8 years, the average annual cost would be $31,250. If you assume a patient will use all of their DCVax-L doses over 10 years, the average annual cost would be $25,000 per year.

The regulators will look at the average annual cost of DCVax-L compared to other ATMPs. Even if you assume the malignant brain tumor patients will only use their DCVax-L doses for up to 3 years, instead of 8 to 10 years, the average annual cost of DCVax-L for $250,000, over 3 years would only be $83,333 per year.

Compare that to the cost of the other approved ATMPs in the UK and the EU in the table below, and you will see that even at a total cost of $250,000, DCVax-L is 1 of the least expensive (cheapest) ATMPs:

https://www.valueinhealthjournal.com/action/showFullTableHTML?isHtml=true&tableId=tbl6&pii=S1098-3015%2823%2900005-0

[dennisdave]

I don’t anticipate the cost of DCVax-L, after approval, to be £250k… more like £150k. And once Flaskworks is implemented, the price lessen by even more.

The price for DCVAXL is not dictated by the production cost of DCVAXL its determined by what reimbursement companies and governments are prepared to pay for DCVAXL. Part of that negotiation is the total investment cost of the medical trial and the production cost.

[biosectinvestor]

I mostly agree with you. I don't agree on this. I think DCVax-L at 250,000 and even higher, is competitive with the early approvals of drugs like Keytruda that while generally very useful, had terrible side-effects and were for many, many more patients.

It's not that I want them to charge more than they should, but my research says 250,000 actually makes DCVax-L, per patient, given few side-effects, dispensable in a community setting and a longer term treatment that extends life, more affordable, overall, than drugs costing the same or more. So I think people puzzling over the pricing at this stage and the cost and how it's got to be so much less, are really just anticipating things that are not yet issues for approval and really inventing issues to explain away shadows that are invented for lack of other things to talk about.

And yeah, shorts exploit all of the fear mongering. But DCVax-L, even at that price, once covered, is very reasonable overall. And in the longer run, the company will likely figure out better ways to finance it for patients and distribute the cost over time, without trying to become a cancer charity. They actually do have to cover the costs of development to this point and further development. Things don't end on approval of DCVax-L for glioblastoma. All of that comes with more sophisticated operations and financial capabilities and with resources behind them. I do hope that they are planning and have more of a plan than they have revealed so far, though I do also recognize that large drug companies want something like mRNA vaccines rather than cellular treatments because they have never, ever liked the idea of cellular treatments. So they are, it appears, going to have to be dragged kicking and screaming into this era of cellular vaccines and treatments. They could have been far more helpful, and really, I suspect that to some large degree, they have enjoyed the tribulations and difficulties and hope to exploit them. But I hope the company has made some progress on that front.