Cancer Drug Prices Follow a Sharp Upward Trajectory Post Launch

A group from Israel presented a study that evaluated the price trend of 30 anticancer agents following their launch, and found that prices may increase by as much as 44% even after adjusting for inflation. The study was presented at the annual meeting of the American Society of Clinical Oncology, held June 3-7, 2016, in Chicago.

Noa Gordon, MSc, MPH, Davidoff Centre, Rabin Medical Centre, presented results from their study that measured the price trajectory of 30 patented infusion cancer drugs (all Medicare Part B drugs), following their launch in the United States. Quarterly changes in prices of average monthly doses for these drugs, approved by the FDA between 1996 and 2012, were documented. The study specifically excluded cytokine therapies, hormonal therapies, autologous immunotherapies, and drugs that lost FDA approval. The group used the average sales price (ASP) to be able to account for discounts and rebates, as published by the CMS. Additionally, prices were adjusted for inflation.

Gordon said that their study found a mean annual ASP change of 3.75% and a mean cumulative ASP change of 28%. The mean cumulative inflation-adjusted ASP change was 15%. These changes were during a follow-up period of 11.5 years.

“Rituximab and trastuzumab follow a similar pattern in price increase over time and inflation-adjusted prices rose since approval by 44% and 40% respectively,” Gordon said. The inflation-adjusted price of pemetrexed rose by 26%. Clustering drugs for indication, year of approval, and company did not find any significant trends, however.

The following table lists the changes for 10 of the 30 drugs that were evaluated by Gordon's group:

Generic name

Follow-up time (years)

ASP change

(US$)

ASP change (%)

Inflation-adjusted

ASP change (%)

rituximab

11

3041

74

44

trastuzumab

11

2396

69

40

pemetrexed

11

2632

52

26

panitumumab

8

2020

25

12

bevacizumab

11

2258

24

3

nab-paclitaxel

10

1578

20

2

ipilimumab

4

4660

11

8

cetuximab

11

78

8

-10

denosumab

4

127

7

4

pertuzumab

2

143

3

3

ASP indicates average sales price.

When they evaluated off-patent drugs, they observed about a 95%-97% decrease in the price of 7 drugs after they went off-patent. Another example is increased drug price with added indications—the price of ipilimumab has increased by 11% over the last 5 years following its approval.

The major limitations of the study, Gordon said, were that they accounted for only the Medicare Part B rates. Additionally, the ASP prices may change or may differ based on consumers.

Gordon concluded that cancer drug prices may change substantially following launch, and prices may increase by as much as 44%, even after adjusting for inflation. “When discussing value, we must take into account that prices are not always static,” she said.

Reference

Gordon N, Stemmer SM, Greenberg D, Goldstein DA. Price trajectory of individual cancer drugs following launch. J Clin Oncol. 2016;34 (suppl; abstract 6502).