Novartis(US:NVS) 21世纪经济报道·2025-11-26 09:56Core Viewpoint - The approval of Itvisma by Novartis marks a significant advancement in gene therapy for spinal muscular atrophy (SMA), with a price tag of $2.59 million, indicating the market's tolerance for high-cost life-saving drugs [1][2]. Group 1: Gene Therapy Market Dynamics - The global gene therapy market is at a turning point, expected to grow at an annual rate of over 20% in the next 5-10 years, driven by technological advancements, clearer regulatory pathways, and innovative payment models [2]. - The success of Zolgensma has validated the commercial viability of one-time curative treatments for single-gene hereditary diseases, setting a benchmark for future gene therapies in various fields [2]. - Currently, only three SMA drugs have been approved globally, with Itvisma being the only gene therapy product, highlighting its rarity and the high barriers to entry in the market [2]. Group 2: Pricing and Cost Justification - Novartis disclosed that the total R&D investment for Zolgensma reached $9.4 billion, including an $8.7 billion acquisition of AveXis [4]. - The pricing strategy for Zolgensma was significantly higher than industry estimates, with a suggested price range of $1.5 million to $5 million per patient, compared to UBS's estimate of $2 million and ICER's range of $310,000 to $1.5 million [4]. - The high price of Itvisma reflects a calculated commercial strategy, as the company aims to establish a strong market presence despite the high upfront costs associated with gene therapy development [2][4]. Group 3: Clinical Efficacy and Safety - Itvisma's approval was based on the results of the pivotal Phase 3 study STEER, which showed statistically significant improvements in motor function among treated patients, with effects sustained over a 52-week follow-up [5][6]. - The most common adverse events reported in the studies included upper respiratory infections and fever, indicating a consistent safety profile [5][6]. Group 4: Competitive Landscape - Itvisma competes directly with Spinraza, the first targeted SMA treatment, which has undergone significant price reductions in markets like China after being included in insurance coverage [7]. - The gene therapy market is expected to see explosive growth, with projections indicating a market size of $9.03 billion in 2024, increasing to $64.64 billion by 2033, driven by innovations in gene editing technologies and accelerated regulatory approvals [9]. Group 5: Industry Challenges and Future Outlook - The gene therapy sector faces challenges such as high production costs, short shelf life of viral vectors, and the need for stringent quality control, which can limit supply and increase prices [13]. - Balancing innovation incentives with drug accessibility remains a long-term issue for the industry, as the future of gene therapy will depend on its ability to reach a broader patient population beyond clinical settings [13].