Boehringer calls for pharma reimbursement reform in Germany

Boehringer Ingelheim has called for changes to Germany's drug reimbursement system AMNOG following its failed attempt to agree a price for its diabetes treatment Trajenta in the country.

The drug has been launched in several countries, including the US, but is still not available in Boehringer's home nation as the German healthcare system said it would not fund the drug after it was deemed not to provide enough value for money in comparison to current generic treatments.

Speaking at its annual conference the pharma company's chair Professor Andreas Barner disputed the validity of these claims though, saying Trajenta, a DDP-4 inhibitor co-developed with Lilly, was the first drug of its kind to be ruled upon.

This, Barner said, meant there was no justification for using generic sulfonylurea drugs as a comparator therapy in the AMNOG process because this wouldn't cater for the additional benefits new drugs might offer.

In Trajenta's case these include it being a potentially safer option for patients with kidney problems because of the way it's excreted, via bile and the gut rather than through urine.

He said: “We would consider it right to take a holistic perspective when evaluating the role in the spectrum therapy, as is the case in the UK.

“We urge politicians to recognise that a correction is urgently required.”

Prof Barner's thoughts were backed up by Boehringer's head of pharma marketing and sales, Engelbert Tjeenk Willink, who spoke to PMLiVE about the talks Boehringer is having with Germany's drug pricing watchdog the Federal Joint Committee (G-BA).

“Discussions are still ongoing – the process is new. On both sides of the fence, parties are trying to figure out what is the best way to do this. So far it has proven to be very difficult, but also society cannot afford not to reward innovation at all.

“It's somehow hard to imagine our home country is the only place we can not launch Trajenta.”

Willink also said Germany could learn from other cost-effectiveness systems, such as the UK's National Institute for Health and Clinical Excellence (NICE), saying it was a “good system in that it is a science driven approach”.

He said: “On the basis of science, they try to judge what kind of value you add and as a research driven industry, and that is an approach that we have to support.”

This echoed a previous statement made during the conference from Boehringer's head of finance and animal health Hubertus von Baumbach, who said that in current health policy debates “you gain the impression that innovative medicines are simply seen as a cost factor”.

Boehringer's annual results

The company's annual conference also saw its annual results unveiled. These showed a 5 per cent rise in yearly revenues, which rose to €13.17bn and were buoyed by the launch of Trajenta and bloodthinner Pradaxa in several countries.

Boehringer was particularly pleased with Pradaxa's performance, which von Baumbach described as “one of the most successful product launches” in recent industry history.

The oral anticoagulant drug made net sales of €629m during 2011, helping to combat the loss of patent exclusivity for restless legs syndrome treatment Sifrol, which saw sales decrease by 30 per cent.

Pipeline confidence

Speaking at the conference Prof Barner said he was confident the company's pipeline would helping increase Boehringer's growth over the next few years, and noted that the company had increased its R&D investment by 3 per cent to €2.5bn during 2011.

Products in development include further diabetes treatments as part of Boehringer's alliance with Lilly, as well as therapies for hepatitis C, cancer, asthma, COPD and idiopathic pulmonary fibrosis.

However, Barner dismissed the notion that Boehringer might form a similar partnership in in any other therapy area, noting: “We do not want to go for another large alliance because the degrees of freedom you are losing with an alliance are quite significant.”

China is also a continued focus for Boehringer after its €70m investment to expand its facility in Shanghai in December, 2011.

Von Baumbach said: “We intend to invest well over €100m in China in the next five years and want to more than quadruple our current business that exceeds €240m.”

For 2012, Boehringer said it expects to increase growth and have a high single-digit increase in net sales.

• Learn more about Germany's AMNOG system of drug reimbursement in our webinar.