Costs of Anticancer Agents Increase Significantly After Launch

10/17/17

A recent report suggests that there is a steady increase in costs of US Food and Drug Administration (FDA) approved anticancer drugs over time, regardless of competition or supplemental indications, published in the Journal of Clinical Oncology (online October 10, 2017; doi:10.1200/JCO.2016.72.2124).

Research indicates that cancer drug prices at launch are trending upwards. However, limited data exist regarding how individual drug prices change after launch and what—if any—market factors influence these changes.

Daniel A Goldstein, MD, Davidoff Cancer Center, Rabin Medical Center (Israel), and colleagues studied that price trajectories of cancer drugs after their launch in the US market and subsequently assessed the influence of market determinants on price changes. Researchers studied a cohort of 24 FDA approved (from 1996-2012), injectable anticancer drugs and measured their mean monthly costs over time. Cumulative and annual drug cost changes were calculated for each drug.

Researchers used average sales prices published by the Centers for Medicare and Medicaid Services  to account for discounts and rebates. Inflation rates were also considered. A multivariable regression model was created to assess any association between market and cost changes over time.

After a mean follow-up of 8 years, researchers reported that the mean percentage change in cost for all drugs was increased by 25% (range, -14% to +96%). Adjustment for inflation yielded a mean cost increase of 18% (range, -16% to +59%).

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Two drugs which exemplified this change in cost relationship were rituximab and trastuzumab; inflation-adjusted monthly costs increased since approval by 49% and 44%, respectively.

Among the factors determined not to have an impact on the annual cost of change rates were new supplemental FDA approvals, new off-label indications, and new competitors.

Findings from the study indicate that anticancer drug costs may increase significantly after launch in the US, regardless of competition or supplemental indications. “One potential solution toward managing this problem is to introduce new regulations into the marketplace,” they wrote.—Zachary Bessette