Treatment costs increase sevenfold more for patients with multiple sclerosis receiving Medicare

According to a new study, the costs to self-administered disease-modifying (DMT) therapies for Multiple Sclerosis (MS) patients under Medicare increased more than seven-fold between 2006 and 2016.

Researchers at the University of Pittsburgh reported in a study entitled "Price Trends, Market Share and Spending on Self-Administered Therapy Modifying the Treatment of Multiple Sclerosis in Medicare, Part D", published recently in review JAMA Neurology.

In total, 11 branded DMTs have been available for people with MS since 2009. Previous studies have shown that prices for these treatments have increased at higher rates than specialty drugs used to treat other diseases. , resulting in higher additional costs for patients. .

Researchers have now assessed Medicare's 2006-2016 reimbursement claims to assess the annual costs of self-administered substitution treatments for MS.

The team analyzed data from 5% of randomly selected Medicare PartD beneficiaries, representing an average of 2.8 million Medicare beneficiaries per year. They included information on the costs associated with the use of: Copaxone (glatiramer acetate, by Teva); Rebif (interferon beta-1a, from EMD Serono) and Avonex (interferon beta-1a, from Biogen); interferon beta 1b formulations such as Betaseron (from Bayer HealthCare) and Extavia (from Novartis); Gilenya (fingolimod, Novartis); Aubagio (teriflunomide, from Sanofi Genzyme); Biogen Tecfidera (dimethyl fumarate); and Plegridy (peginterferon beta-1a).

Market share – the market share of pharmaceutical expenses represented by each treatment – and pharmaceutical expenditure per 1,000 Medicare beneficiaries were also analyzed.

The researchers determined that the annual cost of treatment (before rebates, coupons or insurance included) had increased from $ 18,660 to $ 75,847 on average between 2006 and 2016. This was more than quadruple and an increase in the average annual rate of 12 , 8%.

We have already argued that the increase in the cost of processing could not necessarily result in increased expenses because of manufacturers' rebates or other discounts. But the study found that Medicare spending per 1,000 beneficiaries increased more than tenfold, from $ 7,794 to $ 79,411, while patient expenses increased sevenfold from 372 to 2,673. dollars, over a period of 10 years.

"We wanted to see how the increases in catalog prices resulted in an increase in personal expenses and we found that real price increases were passed on to patients and that this could have a negative impact on access," Inmaculada Hernandez, PhD, assistant professor of pharmacy at Pitt and the senior author of the study, said in a press release. "We are not talking about patients without health insurance here. We are talking about insured patients under Medicare. Yet they pay much more for multiple sclerosis drugs than they did 10 years ago. "

The team also found that, despite the fact that competition in the most popular therapies market (including Copaxone, Tecfidera and Avonex) is increasing over time, the prices of most of these therapies have increased. Gilenya and Copaxone had the highest annual treatment costs over the 10 years evaluated, while Extavia and the generic formulation of glatiramer (marketed by Sandoz as Glatopa) had the lowest costs.

"One of the most significant discoveries is that the prices of these drugs have increased in parallel," said Alvaro San-Juan-Rodriguez, a Pharmacy Fellow at Pitt and lead author of the study. "Only a few exceptions deviate from this general trend."