Multiple Sclerosis Medication Costs Rising at "Alarming" Rate in Past 20 Years

Over the past 20 years, the costs of multiple sclerosis (MS) medication have risen at an “alarming” rate, according to research published in Neurology.

Researchers from Oregon Health & Science University (OHSU) and Oregon State University (OSU) compared the trends in annual drug costs for 9 disease modifying therapies (DMT) for MS over the past 2 decades in order to determine the influences on rising costs. The researchers examined DMT costs to general and prescription drug inflation during the period between 1993 and 2013. Specifically, the path of the rising cost of MS first generation DMTs interferon (IFN) beta 1b, IFN beta 1a IM, and glatiramer acetate were examined alongside contemporary biologic tumor necrosis factor (TNF) inhibitors.

“The inexplicable increase in the cost of MS drugs, particularly older, first-generation drugs, is at odds with how we think the marketplace should work,” the study’s lead author Daniel M. Hartung, PharmD, MPH, explained in a press release. “A growth in the number of MS drugs should lower costs for patients. What we see here is the opposite happened: costs have risen sharply, and at a pace that’s far greater than drugs in a similar biologic class.”

The researchers found that first generation DMTs — which originally cost between $8,000 and $11,000 annually in the earlier portion of the study period – cost approximately $60,000 annually today. These agents have increased annually at rates of 5 to 7 percent greater than prescription drug inflation, the authors estimated.

Newly introduced DMTs often were found to cost 25 to 60 percent more than existing DMTs when they entered the marketplace. The researchers noted significant increases in the cost paths of first generation DMTs when the US Food and Drug Administration (FDA) approved the drugs; specifically, costs of IFN beta 1a SC (introduced in 2002) and natalizumab (reintroduced in 2006) increased after approvals. Additionally, costs jumped again following the 2010 introduction of fingolimod by the FDA. Biologics were not affected during these time intervals.

“As a doctor, I’m deeply concerned about making sure these life changing drugs are within reach for patients,” study co author Ruth H. Whitham, MD, FAAN continued in the statement. “The driving force behind this study was our experience that the high cost of MS drugs interferes with our ability to take good care of our patients. We decided to shine a light on this growing problem so that those of us who care for patients with chronic illness can work together and advocate for changes to drug pricing mechanisms.”

The authors added that DMT costs in the United States are about 2 to 3 times higher than in other comparable countries.

“MS DMT costs have accelerated at rates well beyond inflation and substantially above rates observed for drugs in a similar biologic class,” the authors wrote. “There is an urgent need for clinicians, payers, and manufacturers in the United States to confront the soaring costs of DMTs.”