“Please God, society, give us a cure for Alzheimer's” is certainly a statement that most people can get on board with, but the remark from Regeneron’s George Yancopoulos, M.D., Ph.D., landed amid a heated discussion at the Milken Institute conference in which he interrupted the moderator and described her question about paying for experimental, costly treatments as “ludicrous.”
As Bertha Coombs, a veteran healthcare reporter from CNBC, tried to ask about how society can pay for new treatments priced in the millions of dollars, Yancopoulos spoke over her as boos rose from the audience.
“You can't deliver a vaccine until you have a vaccine. You can't deliver a treatment until you have it. So these are secondary problems. I'm sorry, but think about how ludicrous your point is,” the co-founder and chief scientific officer of Regeneron said at the Future of Health Summit in Washington, D.C., Wednesday.
Yancopoulos argued that pharmaceutical innovation needs to be rewarded and treatments have to be developed before considerations are made as to how to pay for them. “Forget about paying for it,” he said as Coombs asked about how the system would handle an expensive breakthrough therapy for Alzheimer’s disease given the massive aging population.
Coombs pointed to Gilead Sciences' Sovaldi, an antiviral treatment for hepatitis C approved in 2014 that cured the disease but came with a massive price tag. She asked how future breakthrough treatments can be made available equitably.
“I’m sorry, you are so off base … so far off the problem,” Yancopoulos said, again speaking over Coombs. “The problem is we have nothing for Alzheimer's. Do you understand that?”
He continued, “Let’s pray that moment comes, and then we can worry about getting it out there.”
Yancopoulos went on to advocate for more investment into chronic lifestyle diseases and lamented that funding for the National Institutes of Health has been going backward in recent years.
Once the skirmish was over, other panel members tried to answer the question about covering the cost of expensive treatments posed by Coombs. Walmart Chief Medical Officer John Wigneswaran, M.D., admitted that “the current healthcare system is not really geared up to do that.” He pointed to the more than $2 million price tag for Novartis’ spinal muscular atrophy gene therapy Zolgensma as an example.
While Zolgensma is a one-time option, Wigneswaran said the system is set up to pay for treatments on a monthly basis rather than consider the lifetime cost of things, which makes the economics in the pharmacy benefit management space difficult.
Humana CEO Bruce Broussard said the European markets are set up better to handle those long-term costs since the government is footing the bill, which can be spread out over a long period of time. In the U.S., employer and Medicare budgets are set yearly.
“I completely agree that we need to continue to advance the clinical side, but payment innovation really allows both the treatment of it but also the financing of it,” Broussard said.
Payment models need to look at the long-term, overall cost, considering things like the societal burden or “hidden costs” of diseases like Alzheimer’s such as caregivers who can’t work or are spending money to have someone care for their loved one.
“There's inherent costs in there that will be mediated as a result of the advancement on the clinical side and those need to be taken into account in the cost of it,” Broussard said.