While a Panadol vs. Paracetemol comparison is good, it's different in a few ways.
Patients will need a prescription to access a GLP-1 agonist for IIH so it's not attainable over the counter. The prescribers will be a mix of highly specialised ophthalmologists and neurologists. Once a diagnosis of IIH is made, they'll follow the international guidelines(that Sinclair wrote) and use the drug listed for the indication e.g. Presendn. Insurance in the UK and US cover over 90% of the population, so very few patients won't be covered.
The question then becomes around the premium that can be charged on drug innovation. Payors will have to assess Presendin again the cost metrics of this, rather than the generic GLP-1 agonist, given the patent and orphan drug protections. This article summarises the drug pricing landscape nicely. For the US, Invex gets to decide on the price. For the UK and Aus, it's a 'Health Technology Assessment' to assess the burden to the health system.
The company has already given us some numbers to work off:
- 40% of patients have repeat hospital admissions, with average stays of 2.7 days
- Significant impact on quality of life and rapidly rising healthcare costs e.g. £462M in UK by 2030 (5x increase on 2017)
Putting it together, a drug that stops repeated hospital admissions, saves vision in a young person and increases quality of life through increase participation in the workforce, is going to attract a large reimbursement. They're going to easily attract $1500/month if not several multiples of this IMO.
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