Roche's hep A treatment gets nod but with black box warning

Roche needs its pipeline to pick up quick successes, with its big earners are looking at precipitous patent cliffs, and, as the FDA approves its hepatitis A medicine, it looks like it may be delivering.

The hep A treatment will be known as Hemlibra and has been approved to treat patients who have developed inhibitors to factor VIII replacements therapies. The approval came earlier than expected, with a decision expected at any point up until 23 February, which should help the treatment hits its predicted peak sales of $1.6 billion by 2022.

This has been calculated off the back of strong Phase 3 data on reduced bleeding events and, crucially, the fact that the drug can administered just once a week.

This latter factor is significant when rival treatments need to be delivered three times, providing carers and those afflicted by hep A greater time without needing a further dose of treatment.

Well aware of its advantage in this area, Roche quoted a mother of a child with Hep A in its press release: "With Hemlibra, he now has an injection once a week that he has proudly learned to administer himself to help prevent bleeds. Not only has he had fewer bleeds compared to his prior treatment, he has more time to be a kid and we have more quality time as a family because of the new treatment schedule."

Rivals, in the form of Shire and Novo Nordisk, expect that Roche’s product will be able to cut a significant swathe through their products’ sales.

The only major drawback for Roche is a black box warning that will warn users of medicine of the serious adverse events that occurred during clinical trials of the product. Patients were found to develop thrombosis that can arise when patients are undergoing therapy.

Previously, Roche had attempted to explain away these events by blaming Shire’s bypassing agent, a claim that the latter company did not appreciate.

How far this warning on the label deters sales remains to be seen; Roche has pitched its price at $482,000 per patient, which places it between the $393,000 and $537,000 that Shire charges for Advate and Adynovate, respectively.

With the former being non-inhibitor and the latter the inhibitor market, Roche’s approval for its inhibitor treatment places it at a significant discount on the Shire’s competing product. It also allows its own treatment to be well-placed should it receive approval in the non-inhibitor space.