April 28, 2016
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Monthly cost of oral cancer drugs rises steadily over time

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The cost of oral cancer drugs in their first year on the market has increased significantly since the year 2000, according to a research letter published in JAMA Oncology.

High drug prices can affect patient adherence to cancer therapies and increase the financial burden of medical care, according to Stacie B. Dusetzina, PhD, assistant professor of pharmaceutical outcomes and policy at University of North Carolina Eshelman School of Pharmacy.

Stacie Dusetzina

Stacie B. Dusetzina

“Patients are increasingly taking on the burden of paying for these high-cost specialty drugs as plans move toward use of higher deductibles and co-insurance,” Dusetzina said in a press release. “The major trend here is that these products are just getting more expensive over time.”

Dusetzina sought to estimate changes over time in reimbursements for orally administered anticancer drugs paid by commercial health plans. She focused her research on reimbursements during the year of product launch.

Using TruvenHealth MarketScan outpatient prescription drug data from 2000 through 2014, Dusetzina identified claims for oral anticancer therapies approved in 2000 or later, excluding claims in which the total paid was $0 or less or greater than $250,000. The analysis only included pharmacy fills for a single month of therapy to ensure comparable estimates over time, which represented 483,587 drug fills.

The study included data on 32 orally administered anticancer drugs introduced since 2000, representing approvals in all study years except three (2002, 2008 and 2010). The incidence of oral therapies increased over time, with 17 therapies brought to market from 2011 to 2013.

Mean monthly spending during the year of product launch increased over time, from $1,869 (95% CI, 1,648-2,121) in 2000 to $11,325 (95% CI, 10,989-11,671) in 2014.

Monthly spending during the first year increased 63% across all products when comparing those launched between 2000 and 2010 to those launched from 2010 onward. This represented a price increase from $5,529 (95% CI, 5,444-5,615) to $9,013 (95% CI, 8,917-9,110).

The price of the majority of studied products increased between year of launch and 2014, with the largest monthly increases seen for thalidomide (Thalomid, Celgene; approval year, 2000; increase, $5,695) and imatinib (Gleevec, Novartis; approval year, 2001; increase, $5,133).

Mean monthly spending decreased over time for two products: lenalidomide (Revlimid, Celgene; approval year, 2006; decrease, $469) and vorinostat (Zolinza, Merck, approval year, 2007; decrease, $2,163).

There were wide variances in year-to-year drug prices, from –15% to 30%.

Dusetzina acknowledged study limitations, including the exclusive use of reimbursement data from commercial health plans. This reliance may have excluded rarely prescribed or recently used drugs, and did not capture data from Medicare and Medicaid.

“In addition to higher launch prices, most existing therapies have had substantial price increases since product launch,” Dusetzina wrote. “Monitoring changes in spending on anticancer medications may help to identify excessive price changes and highlight potential affordability challenges for patients.” – by Cameron Kelsall

Disclosure: Dusetzina reports no relevant financial disclosures.