Costs of Disease-Modifying Drugs for MS Are Just Too Damn High
A new cost-effectiveness study in Neurology, the possibly legitimate methods of which elude me and an editorialist, suggests that disease-modifying drugs* (DMTs) for multiple sclerosis are not cost-effective over the long haul. This conclusion is largely informed by the very high cost of the drugs over a 10-year period, which was balanced against the benefits of the drugs for averting work loss and use of the healthcare system during the same time period. The calculated cost-effectiveness of all DMTs, expressed per the standard quality-adjusted life-year (QALY), was a staggering $800,000. For the purposes of comparison, a range of less than or within $50,000-$100,000/QALY has been generally chosen as the arbitrary benchmark for the cost-effectiveness of a medical intervention.*
While I'm not in a position to justify or criticize the methods of this study, I am able to examine the cost of DMTs in the study (Table 2) and perform simple math to conclude that the monthly price of these drugs has increased substantially—no, ridiculously—since 2008 (the year of the cited Red Book reference in the study). The following is my table comparing the average monthly costs of available DMTs for the time of the study and those supplied currently by destinationrx.com. And while jacked-up costs for these drugs over the last year are nothing new (see here, for instance), the price increases during the last 3 years are really astonishing—especially in the case of Teva's Copaxone, which has nearly doubled in price for no apparent good reason.
Authors of the cost-effectiveness study wrote that reducing the cost of DMTs would have "by far the greatest impact on the cost-effectiveness of these treatments." For instance, reducing the cost of Biogen Idec's Avonex by two-thirds (to approximate the UK-based cost) would bring the cost-effectiveness value for this drug to a somewhat more rational $164,000/QALY.
* And I don't know who decided that.
** Interferons beta and glatiramer acetate (Copaxone).
While I'm not in a position to justify or criticize the methods of this study, I am able to examine the cost of DMTs in the study (Table 2) and perform simple math to conclude that the monthly price of these drugs has increased substantially—no, ridiculously—since 2008 (the year of the cited Red Book reference in the study). The following is my table comparing the average monthly costs of available DMTs for the time of the study and those supplied currently by destinationrx.com. And while jacked-up costs for these drugs over the last year are nothing new (see here, for instance), the price increases during the last 3 years are really astonishing—especially in the case of Teva's Copaxone, which has nearly doubled in price for no apparent good reason.
|
DMT |
Average Monthly Cost |
Monthly Cost |
Increase |
|
Interferon beta |
|
|
|
|
1b, 0.3 mg, 15 doses |
$2260.00 |
$3568.57 |
58% |
|
1a, prefilled kit 30 μg, 4 doses |
$2061.43 |
$3306.96 |
60% |
|
1a, 44 μg, 6 doses |
$2124.27 |
$3048.84 |
44% |
|
Glatiramer acetate, 30 prefilled syringes |
$1952.15 |
$3753.83 |
92% |
Authors of the cost-effectiveness study wrote that reducing the cost of DMTs would have "by far the greatest impact on the cost-effectiveness of these treatments." For instance, reducing the cost of Biogen Idec's Avonex by two-thirds (to approximate the UK-based cost) would bring the cost-effectiveness value for this drug to a somewhat more rational $164,000/QALY.
* And I don't know who decided that.
** Interferons beta and glatiramer acetate (Copaxone).
