Estimated generic prices of cancer medicines deemed cost-ineffective in England: a cost estimation analysis

Abstract

ObjectivesThe aim of this study was to estimate lowest possible treatment costs for four novel cancer drugs, hypothesising that generic manufacturing could significantly reduce treatment costs.SettingThis research was carried out in a non-clinical research setting using secondary data.ParticipantsThere were no human participants in the study. Four drugs were selected for the study: bortezomib, dasatinib, everolimus and gefitinib. These medications were selected according to their clinical importance, novel pharmaceutical actions and the availability of generic price data.Primary and secondary outcome measuresTarget costs for treatment were to be generated for each indication for each treatment. The primary outcome measure was the target cost according to a production cost calculation algorithm. The secondary outcome measure was the target cost as the lowest available generic price; this was necessary where export data were not available to generate an estimate from our cost calculation algorithm. Other outcomes included patent expiry dates and total eligible treatment populations.ResultsTarget prices were £411 per cycle for bortezomib, £9 per month for dasatinib, £852 per month for everolimus and £10 per month for gefitinib. Compared with current list prices in England, these target prices would represent reductions of 74–99.6%. Patent expiry dates were bortezomib 2014–22, dasatinib 2020–26, everolimus 2019–25 and gefitinib 2017. The total global eligible treatment population in 1 year is 769 736.ConclusionsOur findings demonstrate that affordable drug treatment costs are possible for novel cancer drugs, suggesting that new therapeutic options can be made available to patients and doctors worldwide. Assessing treatment cost estimations alongside cost-effectiveness evaluations is an important area of future research.

Pricing of oral generic cancer medicines in 25 European countries; findings and implications

“…The price reductions for capecitabine, flutamide, imatinib and temozolomide that have been achieved in practice (Table 2) confirm the findings of Hill et al that the costs of goods for cancer medicines can be very low in reality (52,53). This fuels the debate for greater transparency in the pricing of new medicines for cancer when pharmaceutical companies request premium prices especially where there is limited health gain for their new cancer medicines versus current standards.…”

“…As a result, substantial differences can occur in the prices of generics across Europe (37,50,51). Overall, low prices can potentially be achieved for generic cancer medicines because of the low cost of goods that have been reported at just 1% or more of originator prices for some new cancer medicines (52,53). These low cost of goods have already resulted in considerable discounts for generic imatinib across countries versus pre-patent loss prices (54,55).…”

Proposal for a regulation on health technology assessment in Europe – opinions of policy makers, payers and academics from the field of HTA

“…One way forward is to have realistic price expectations especially with the low cost of goods (e.g. low cost for ingredients and manufacturing compared to price of the product on the market) of some new cancer medicines [53]. This follows increasing calls for moderation in the pricing of new cancer medicines for long term sustainability [54][55][56], with world-wide sales of medicines for cancer at $107billion globally in 2015 and rising with more than 500 companies actively pursuing new oncology medicines [57].…”

Dealing with the spiralling price of medicines: issues and solutions

“…Several studies have shown that the cost of medicine production is low, with some oncology medicines costing less than 1% of the selling price. 15 A key justification for the high cost of medication is the expense incurred in bringing a new medicine to market, that is, the research and development costs. The Tufts Center estimated that the cost of a medicine's development was approximately US $2.6 billion in 2014, up from US$802 million in 2003.…”