NOC Watch – Mozobil, Resotran
Mozobil™ (plerixafor injection)
Mozobil™ is a new drug that has been approved for use in conjunction with another agent, granulocyte-colony stimulating factor (G-CSF), for patients with certain blood cancers (i.e. non-Hodgkin’s lymphoma or multiple myeloma). The combination allows their own blood-derived stem cells to be collected before treatment with chemotherapy or radiation, and then returned after high dose chemotherapy or radiation is given, thereby allowing the production of new normal blood cells to replace those destroyed during these therapies.
Mozobil™ is given as a subcutaneous injection (under the skin) approximately 11 hours before each stem cell collection, up to a total of 4 days. Based on pricing in the US, a single vial of Mozobil™ is expected to cost around $7,500, running a 4-day treatment cost of $30,000 for an adult patient.
Patients will most likely receive Mozobil™ treatment at a hospital or transplant centre. Therefore, it remains to be determined whether plan sponsors will feel that coverage of this product falls under the responsibility of the public health care system, or whether they will feel that private-sector coverage for Mozobil™ is warranted given its role as an adjunctive treatment for these blood cancers. Plan sponsors may wish to re-visit their plan contract wording to ensure their plan provisions accurately reflect their intended coverage for Mozobil™ and other hospital use products and/or ensure they are equipped with a well-structured Prior Authorization program for specialty products like Mozobil™.
Resotran™ (prucalopride succinate)
Resotran™ is a drug used to help normalize bowel movements in women with chronic constipation in whom standard laxatives have not provided satisfactory relief. While it just received approval to be marketed in Canada, this drug has been approved for use in Europe since 2009 under the name Resolor®.
Resotran™ is taken orally, once daily, and is expected to provide improvement in patient satisfaction and quality of life. While pricing for Resotran™ in Canada is not available at the time of writing, a one-month supply is expected to cost around $100 CAD based on pricing in the UK.
From the plan sponsor’s perspective, it’s important to note that the National Institute for Health and Clinical Excellence (NICE) in the UK suggests that prucalopride should only be considered in women who have tried at least two different kinds of laxatives for at least six months with no relief and in whom further invasive treatment is being considered. Plans may therefore wish to consider covering Resotran™ within a step-therapy or prior authorization program to ensure that such criteria have been satisfied before coverage begins.