This is an open letter to the physicians, clinicians, health officials and public policy decision makers in our provincial governments who play a role in operating Canada’s blood system and, in turn, have an impact on those Canadians who depend on access to Bioverativ’s therapies.
We are Bioverativ, a company that provides critical treatments to hundreds of Canadians suffering with hemophilia. Our innovative therapies are used by approximately 40 per cent or 400 patients with hemophilia A or B, of which approximately 50 per cent are children.
We are concerned that a recent decision by Canadian Blood Services (CBS) to discontinue two of our treatments – Eloctate® and Alprolix® – is not in the best interest of Canadian hemophilia patients and is not supported by the broader community.
We are also very concerned that one of the two therapies CBS is planning to include on the national formulary has not been granted an indication for prophylaxis for those under the age of 18, while the other has not been approved for use in patients 12 years and under. Further, all patients who are currently on our therapies will now be forced to switch from a therapy that works for them to one that may or may not, not because of their doctor’s advice but because of a decision by a procurement agency.
We feel compelled to share our point of view, and urge CBS to reconsider their decision based on the following:
- The Impact on Patients Must Take Precedence: Approximately 40 per cent of Canadians who suffer with hemophilia A or B currently use our therapies. To the extent patients are doing well on a Bioverativ therapy, they should have continued access to the product, particularly as the decision by CBS is not based on any compelling reason or evidence requiring patients to switch.
- Efficacy of the Therapies: Since being made available to the Canadian hemophilia community, Eloctate and Alprolix have had a net positive impact on the healthcare system, both in terms of health outcomes and cost effectiveness. Exciting scientific data published within the last six months in the areas of immune tolerance induction therapy and long term joint health further demonstrate the potentially unique efficacy of our therapies. Additionally, CBS’ most recent published annual report shows a decrease in overall spending for clotting concentrates in the two years since Eloctate and Alprolix have been available. Further, Bioverativ has been sensitive to CBS budgetary concerns and has made price adjustments accordingly.
- Clinical Dimensions: Eloctate and Alprolix are the first in a new class of extended half-life treatments, using patented Fc Fusion technology to naturally extend circulation in the body, and manufactured in a human cell line. This unique process acts similarly to clotting factor naturally existing in the human body. We believe continued access to our products with these significant clinical attributes is in the best interest of Canadian hemophilia patients.
- The Integrity of the Process: The basis upon which this decision has been reached is not clear. It is especially confusing given that Bioverativ, conscious of CBS’ budgetary concerns, has reduced the price of our therapies by double digit percentages. But it does beg the question - is the health of hundreds of Canadian hemophilia patients being compromised to reduce costs? A November 2017 report card issued by the Canadian Hemophilia Society raises this red flag, asking, “How far will the CBS go in procuring the least expensive product even if they are not of the highest value for patients?” The report also noted that “recent tenders have taken place with no or little expert patient or physician involvement.” What impact will this ‘race to the bottom’ have on companies’ willingness to innovate? Force-switching stable patients has broader economic consequences that the Canadian healthcare system must consider when making decisions of this magnitude.
If Bioverativ were any other company, we might simply exit the market as a result of this decision by CBS and focus elsewhere. But we are not just another company. Bioverativ was created with the sole purpose of bringing new treatments to improve the health and lives of those living with hemophilia.
We are asking CBS to reconsider its decision and want to work with all parties in a constructive manner that will put the needs of patients first and maintain their access to Eloctate and Alprolix. We’re committed to doing what’s needed to ensure that Canadians with hemophilia have access to medicines that work for them.
If you share our concerns, please reach out to firstname.lastname@example.org and your respective Provincial Minister of Health and Deputy Minister of Health:
Dr. Eric Hoskins, Minister of Health and Long-Term Care
Dr. Bob Bell, Deputy Minister, Ministry of Health and Long-Term Care
Sarah Hoffman, Minister of Health
Andre Tremblay, Acting Deputy Minister of Health
Adrian Dix, Minister of Health
Stephen Brown, Deputy Minister of Health
Kelvin Goertzen, Minister of Health, Seniors and Active Living
Karen Herd, Deputy Minister of Health
Victor Boudreau, Minister of Health
Tom Maston, Deputy Minister of Health
John Haggie, Minister of Health
John Abbott, Deputy Minister of Health and Community Services
Randy Delorey, Minister of Health and Wellness
Denise Perret , Deputy Minister of Health
Prince Edward Island
Robert Henderson, Minister of Health and Wellness
Dr. Kim Critchley, Deputy Minister of Health and Wellness
Jim Reiter, Minister of Health
Max Hendricks, Deputy Minister of Health
Pauline Frost, Minister of Health and Social Services
Stephen Samis, Deputy Minister of Health
Glen Abernethy, Minister of Health and Social Services
Bruce Cooper, Deputy Minister of Health and Social Services