Novartis’ Pluvicto Brings New Option to mCRPC Treatment

A new prostate cancer drug is sparking interest among payers and oncologists alike, according to a survey by Zitter Insights.

On March 23, the FDA approved Novartis Pharmaceuticals Corp.’s Pluvicto (lutetium Lu 177 vipivotide tetraxetan) (formerly referred to as 177Lu-PSMA-617) for the treatment of prostate-specific membrane antigen (PSMA)-positive metastatic castration-resistant prostate cancer (mCRPC) in people who have been treated with androgen receptor pathway inhibition and taxane-based chemotherapy. The product from Novartis unit Advanced Accelerator Applications USA, Inc. is the first FDA-approved targeted radioligand therapy for eligible people with mCRPC that combines a targeting compound with a therapeutic radioisotope.

The FDA also approved Novartis’ Locametz (gallium Ga 68 gozetotide) to identify PSMA-positive lesions in adults with mCRPC through a positron emission tomography (PET) scan.

The recommended Pluvicto dose is 7.4 GBq (200 mCi) intravenously every six weeks for up to six doses. The agent’s wholesale acquisition cost is $42,500 per dose.

Pluvicto’s application had priority review and breakthrough therapy designation.

For the Managed Care Oncology Index: Q3 2021, between Aug. 23, 2021, and Oct. 11, 2021, Zitter Insights polled 41 commercial payers covering 113.8 million lives and 100 oncologists. Payers with 39% of covered lives were at least moderately aware of Pluvicto, compared with 61% of oncologists. Payers representing half of lives said they had moderate interest in the product, with respondents citing it as an additional option for members, as well as the drug’s demonstration of improved overall survival and radiographic progression-free survival in the Phase III VISION study. Sixty-one percent of oncologists said they had high interest in the drug based on its efficacy, different mechanism of action, impressive data and lack of a biomarker.

Zitter Insights and AIS Health are both MMIT companies.

Payers with 62% of covered lives said they expected to manage Pluvicto at parity with other mCRPC agents. Payers representing approximately three-quarters of lives said they were unlikely to prefer Pluvicto over other mCRPC therapies, as well as were unlikely to not cover the new treatment at all.

More than half of the oncologist respondents said they were likely to prescribe Pluvicto at parity with other mCRPC treatments, as well as were likely to prescribe the new agent over other therapies for the same indication (see chart below).

For more information on the Zitter Insights data, contact Jill Brown Kettler at jbrown@aishealth.com.