MS Drug Prices Soar

Progress in treating multiple sclerosis (MS) has come at a price—rapidly escalating drug costs, according to an opinion piece analysis published online today in Neurology.

Daniel Hartung, PharmD, MPH, and colleagues at Oregon State University, Portland, OR, looked at drug cost data for 9 disease-modifying therapies for MS, tracking them over the past decade. They found that while first-generation versions of these drugs cost between $8,000 and $10,000, the same products now cost about $60,000.

“Costs for these agents have increased annually at rates 5 to 7 times higher than prescription drug inflation,” the authors wrote.

Additionally, newer MS drugs commonly entered the market with a cost 25% to 60% higher than drugs already available.

The escalation appears to have begun with the US Food and Drug Administration’s 2003 approval of Interferon-beta 1 Ba (Betaseron/Bayer) and natalizumab (Tysabri/Biogen), and remained high following introduction of fingolimod (Gilenya/Novartis), they noted.

They also say that MS drugs cost about 2 to 3 times more in the US than in other countries. “There is an urgent need for clinicians, payers, and manufacturers in the US to confront the soaring costs of disease modifying treatments” for MS, they concluded.

Discussing the price increases, the researchers said they were most puzzled by the jump in costs for drugs for first-generation agents that have been available for up to 2 decades.

“We would expect that legitimate advances, such as the development of oral disease modifying treatments might garner higher prices,” they wrote, but they could not see any justification for escalating prices of the older drugs. “These results suggest that the dramatic increases in costs of the first-generation therapies may have been a response to the introduction of competing treatments with higher prices,” a trend that goes against classic economic theory but makes sense in the competitive world of pharma pricing.

Hartung and colleagues noted their data "suggest prices of existing therapies paradoxically rise, quickly matching prices set by the newest competitor.”

The authors also criticized the US’ lack of a national health care system that could directly negotiate drug prices, something Medicare is not legally allowed to do. “Government-issued patent monopolies, third-party payers, lack of reimbursement transparency and imperfect clinical information all contribute to a seemingly dysfunctional marketplace where expanded choice has led to higher, rather than lower, prices,” they charged.

The authors called on neurologists and their professional organizations to fight the increases.