Costs of MS Drugs Almost Triple in 7 Years

The costs of disease-modifying drugs for patients with multiple sclerosis (MS) have almost tripled in 7 years, even with the introduction of generic options in the market, according to a study published by Neurology, the medical journal of the American Academy of Neurology.

The findings were based on data collected from Medicaid patients from 2011 to 2017. Within this window, researchers found that spending on 15 different drugs increased from $453 million to $1.32 billion. The introduction of a generic version of one of the most commonly used drugs had little overall effect on prices.

When a generic version of the drug glatiramer acetate was introduced in 2015, the cost of the name brand drug increased by $441 per prescription. According to researchers, “The phenomenon of increased branded drug pricing prior to or shortly after the introduction of a generic, also known as the ‘generic paradox’ has been described for other drugs.”

Daniel Hartung, PharmD, MPH, an author of the study and member of the American Academy of Neurology, said, “Before the introduction of the generic drug, the maker of the brand name drug worked to push its market share from the 20 mg dose to the 40 mg dose, which was not interchangeable with the new generic.” He continued, “The low market share for the generic drug was also because the generic drug was only 15 percent less expensive than the brand name drug at 20 mg at approximately the same cost as the 40 mg dose when it launched. Of course, some doctors and patients may also be reluctant to switch to a generic drug for clinical reasons.”

Increases in cost are partly attributable to expansion of Medicaid by the Affordable Care Act, but researchers point out that “spending still more than doubled from $2.00 per Medicaid enrollee to $4.06 per enrollee during the study.”

Importantly, overall utilization of treatments for MS was generally stable, with an average of 69 prescriptions per 100,000 Medicaid enrollees per quarter during the study period. This led researchers to conclude that rising prices were the primary driver of spending for MS treatment for patients covered by Medicaid, as opposed to increases in treatment use.

One limitation of this study was the fact that data included reflected utilization and cost within only the Medicaid program. “Because of this, individuals enrolled in Medicaid with MS are likely younger, have a lower socioeconomic status, and have greater disability,” researchers said.

In addition, individuals covered by Medicaid have higher rates of comorbid abnormalities, more inpatient and emergency department utilization, and higher rates of MS-related manifestations like gait abnormalities.

Researchers wrote there remains an “urgent need” for generic competition within the disease-modifying therapy class.

Reference

Hartung DM, Johnston KA, Geddes J, Bourdette DN. Effect of generic glatiramer acetate on spending and use of drugs for multiple sclerosis [published online January 15, 2020]. Neurology. doi: 10.1212/WNL.0000000000008936.