Source/Disclosures
Disclosures: DeJong reports being deposed as an expert witness in a legal action pertaining to drug and device marketing to physicians. Please see the article for all other authors’ relevant financial disclosures.
September 14, 2020
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List prices for newer diabetes drugs up to 360 times higher than older ones

Source/Disclosures
Disclosures: DeJong reports being deposed as an expert witness in a legal action pertaining to drug and device marketing to physicians. Please see the article for all other authors’ relevant financial disclosures.
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Medicare Part D list prices in 2019 for the new, “novel” generation of second-line drugs for glycemic control sometimes cost hundreds of dollars more than the older “traditional” formulations of drugs, according to researchers.

The more expensive treatments are endorsed by the American Diabetes Association, they added.

Title: Projected annual out-of-pocket costs: Left side: Traditional glycemic control drugs $250 to $355 vs. Right side  Novel glycemic control drugs: $1,231 to $1,981
Reference: DeJong C, et al. JAMA Intern Med. 2020;doi:10.1001/jamainternmed.2020.2922. 

Colette DeJong, MD, a resident physician at the University of California, San Francisco School of Medicine, and colleagues analyzed more than 3,000 first quarter 2019 Medicare formulary and pricing files to ascertain prices for:

  • “traditional” treatments (thiazolidinediones and sulfonylureas);
  • “novel” treatments (sodium-glucose cotransporter-2 inhibitors, glucagon-like peptide-1 receptor agonists, dipeptidyl peptidase-4 inhibitors); and
  • a combination of metformin, angiotensin-converting enzyme inhibitors and statins plus either a traditional or novel treatment.     

Head-to-head comparisons between traditional vs. novel treatments, respectively, showed:

  • monthly list prices ranged from $3 to $11 vs. $434 to $935;
  • annual list prices ranged from $31 to $136 vs. $5,202 to $11,225; and
  • projected annual out-of-pocket costs ranged from $250 to $355 vs. $1,231 to $1,981.

The annual 2019 Medicare Part D list prices for the novel drugs approached 40 to 360 times the cost of the traditional ones, according to the researchers. In addition, patients who switched to the novel drugs experienced a threefold to eightfold increase in their annual out-of-pocket cost.

“Because higher copayments lead to poorer adherence and worse health outcomes, clinicians should discuss affordability with patients when changing diabetes regimens,” DeJong and colleagues wrote.

They encouraged cost containment efforts, for example, permitting Medicare to negotiate prices with pharmaceutical manufacturers and restructuring Medicare Part D plans to allow a minimum of one effective diabetes treatment per drug class be available at a reduced, fixed monthly copayment.