The cost of multiple sclerosis drugs in the US and the pharmaceutical industry

Abstract

Objective:To examine the pricing trajectories in the United States of disease-modifying therapies (DMT) for multiple sclerosis (MS) over the last 20 years and assess the influences on rising prices.Methods:We estimated the trend in annual drug costs for 9 DMTs using published drug pricing data from 1993 to 2013. We compared changes in DMT costs to general and prescription drug inflation during the same period. We also compared the cost trajectories for first-generation MS DMTs interferon (IFN)–β-1b, IFN-β-1a IM, and glatiramer acetate with contemporaneously approved biologic tumor necrosis factor (TNF) inhibitors.Results:First-generation DMTs, originally costing $8,000 to $11,000, now cost about $60,000 per year. Costs for these agents have increased annually at rates 5 to 7 times higher than prescription drug inflation. Newer DMTs commonly entered the market with a cost 25%–60% higher than existing DMTs. Significant increases in the cost trajectory of the first-generation DMTs occurred following the Food and Drug Administration approvals of IFN-β-1a SC (2002) and natalizumab (reintroduced 2006) and remained high following introduction of fingolimod (2010). Similar changes did not occur with TNF inhibitor biologics during these time intervals. DMT costs in the United States currently are 2 to 3 times higher than in other comparable countries.Conclusions:MS DMT costs have accelerated at rates well beyond inflation and substantially above rates observed for drugs in a similar biologic class. There is an urgent need for clinicians, payers, and manufacturers in the United States to confront the soaring costs of DMTs.

Multiple sclerosis in Canada 2011 to 2031: results of a microsimulation modelling study of epidemiological and economic impacts

“…Although the rate of hospitalization has declined in the MS population over time, rates remain higher than in an age-and sex-matched population without MS. 42 Other health care services are also used more heavily by the MS population than the general population. 38 Prescription drug expenditures are particularly high, likely reflecting the very high costs of disease-modifying therapies for MS. 43 We observed that among those aged 20 to 34 years, the group most likely to be using disease-modifying therapies, prescription drug expenditures constituted 62.5% to 69% of total health care expenditures. In a survey of 1909 Americans with MS in 2006, disease-modifying therapies constituted the single biggest MSrelated cost, 44 and in a US-based study that used administrative data, pharmacy expenditures constituted 65% of total MS-related health care costs in 2004.…”

Denkbeeldige Wereld: The New Dutch Guidelines for Economic Evaluations in Healthcare

“…In the case of disease modifying treatments (DMTs) in multiple sclerosis a recent study of the trend in annualized drug costs for nine DMTs from 1993 to 2014 found changes ranging from 7.9%. to 35.7% 16 . Four of the DMTs had annualized cost increases greater than 20% and four in the range 13% to 16.8%.…”

Intelligent Design and Imaginary Worlds in Cost-Effectiveness Claims: An Overview of Commentaries in INNOVATIONS in Pharmacy from July 2016 to February 2017

“…This issue has been raised in the commentaries, again with specific reference to the two ICER evaluations 44 45 . In the case of multiple sclerosis, reference was made to a recent study by Hartnung et al, of the trend in annual drug costs for nine disease modifying therapies (DMTs) from 1993 to 2014 48 . Apart from the fact that DMT costs are two to three time bigger in the US than other countries, the principal finding is that DMT costs have accelerated well beyond inflation and substantially above rates for drugs observed in a similar biologic class.…”