Despite increased competition from an expanded number of approved multiple sclerosis (MS) medications and the introduction of a generic agent, drug prices have nearly doubled, and spending on these agents has nearly tripled over the past 7 years.
Investigators found that spending on 15 disease-modifying therapies (DMTs) within the Medicaid program increased from $453 million in the first quarter of 2011 to $1.32 billion in the fourth quarter of 2017.
The average cost per prescription increased from $3080 to $6420 during that period.
"We pursued this research because some attribute the escalating prices in the MS space to a lack of generic competition," lead author Daniel M. Hartung, PharmD, MPH, of the Oregon Health and Science University College of Pharmacy in Portland, told
Medscape Medical News.
The US Food and Drug Administration (FDA) approved the first generic DMT for MS in the United States,
glatiramer (
Glatopa, Sandoz), in April 2015. However, this failed to curb the trend of rising MS drug prices.
"It was unfortunate, but perhaps not surprising, that the entrance of a new generic for one of the most commonly prescribed MS medications, Copaxone (glatiramer acetate injection, Teva), had little effect on the continued cost escalation for drugs within the same class," said Hartung....The study was
published online January 15 in
Neurology.
Ongoing Trend
The new findings build on previous research showing that prices for MS DMTs increased four- to fivefold between 2000 and 2013...In the current study, investigators examined total Medicare spending and use for 15 DMTs. Their analysis was based on CMS drug utilization data.
"
Generic Paradox"
"The strategy of moving sales of a product that is nearing the end of its period of market exclusivity
to a slightly altered, but non-interchangeable, version is a common industry tactic that likely blunted the impact of this new generic," the researchers note.
... The "
generic paradox" phenomenon, in which the price of a branded drug increases shortly after its generic counterpart becomes available, has been
reported with other agents, In the current study, the researchers note that the Sandoz generic of glatiramer acetate was only 15% less expensive than the branded 20-mg Sandoz version. In addition, the generic agent cost almost the same as the 40-mg Sandoz formulation.
Both factors could have contributed to lower uptake of the generic, they note.
"The continued use of branded glatiramer acetate may also reflect reticence for conversion to a generic by patients and clinicians for clinical reasons," the investigators write.
Commenting on the findings for
Medscape Medical News, Alvaro San-Juan-Rodriguez, PharmD, said the findings are concerning
and noted that rising drug prices limit MS patients' access to treatment.