How dare you, Novartis?
Basel, 28 February 2020
« Dear Chairman and members of the Board of Directors,
Ladies and Gentlemen,
My name is Patrick Durisch, I am the pharma specialist of Public Eye, an independent Swiss advocacy NGO (formerly known as Berne Declaration).
I will start by paraphrasing youth climate activist Greta Thunberg:
How dare you?
How dare you, Novartis, impose an insane price of over 2 million dollars for a single injection of Zolgensma – the result of a pure financial speculation over the acquisition of a biotech that had largely benefitted from public and charities funding, and not of your own investments in research and development?
How dare you say that this price is a good bargain in the long run, while nobody knows today how long the benefits of Zolgensma may really last? It has been tested on very few children over a short time span, with reported data manipulation, and without even doing a head-to-head comparative study with the existing treatment.
How dare you launch a Zolgensma global lottery, a sort of Russian roulette playing with children’s lives and parent’s distress, and resembling more a marketing stunt than charity to increase pressure on regulatory authorities? As European health ministers of Beneluxa stated: “If one equals the fate of a patient to a lottery ballot, human dignity and moral values get out of sight”. Your aspiration to (I quote) “hold to the highest ethical standards and be a trusted leader in changing the practice of medicine” seems just an empty slogan.
Zolgensma is only the latest example of skyrocketing prices that threaten the financial sustainability of our health systems, even in wealthy countries. Take Kymriah, your CAR-T cell therapy against leukemia that also hit the headlines. First, because of its price tag of 370,000 Swiss francs for a single injection – totally unjustifiable as the technology stems from public efforts and as we don’t know what Novartis has really invested in it. Second, because of the untransparent reimbursement scheme, subject to secret agreements between Novartis and health insurers, with the real covered price being kept confidential. Finally, because of its unmerited patents, as witnessed by your recent decision to drop the European Kymriah patent following our and Doctors of the World’s opposition for lack of novelty. The revocation of this patent and your unilateral withdrawal of another application are a confirmation that such patents are abusive. We call on Novartis to spontaneously drop all remaining Kymriah patents.
Finally, our latest study on post-trial access to medicines tested in some low- and middle-income countries showed that you are still not complying with your ethical obligations in this field. If most of your products were found to be registered locally, a notable improvement compared to past studies, your pricing policy makes many of them totally unaffordable. An average Mexican worker earning the official minimum wage would have to work over 20 years to pay for just one year of treatment with Cosentyx or Gilenya, even if Mexico has contributed to their development. Dr Reinhardt, six years ago at this same tribune, you agreed that post-trial access to tested medicines in resource-poor countries is essential and that you would act upon it. You need to walk the talk now.
Innovation and affordable access can coexist, assuming you end up your irresponsible pricing policy and accept to be totally transparent on your real R&D investments. A fair price is one that takes into account the public contribution to innovation – but while taxpayers are largely footing the bill for drug research, you are reaping all the gains and focus on short-term shareholder value. Another proof that the current incentive system, revolving around patents and monopoly prices, fails to deliver optimal, affordable treatments and must be reformed.
With an annual core net income of more than 12 billion US$ (over 25% profit margin), we trust
you have the necessary leeway to apply affordable prices without compromising on your R&D efforts, and still make a reasonable profit.
Instead, Novartis has been embroiled in a series of marketing scandals such as in Greece and in the USA in recent years, despite the priority set by the new CEO to restore the company’s reputation and integrity. This has to change urgently.
Thank you for your attention.»