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Posted by on Jul 22, 2011 in Ethics, Neurology, Pharma

Costs of Disease-Modifying Drugs for MS Are Just Too Damn High

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 substantiallyno, ridiculouslysince 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 astonishingespecially in the case of Teva’s Copaxone, which has nearly doubled in price for no apparent good reason.

DMT

Average Monthly Cost
2008 Red Book

Monthly Cost
July 21, 2011

Increase

Interferon beta

 

 

 

1b, 0.3 mg, 15 doses
(Betaseron; Bayer Healthcare)

$2260.00

$3568.57

58%

1a, prefilled kit 30 μg, 4 doses
(Avonex; Biogen Idec)

$2061.43

$3306.96

60%

1a, 44 μg, 6 doses
(Rebif; EMD Serono/Pfizer)

$2124.27

$3048.84

44%

Glatiramer acetate, 30 prefilled syringes
(Copaxone; Teva)

$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).

bmartin (1130 Posts)

A native East Tennessean, Barbara Martin is a formerly practicing, board-certified neurologist who received her BS (psychology, summa cum laude) and MD from Duke University before completing her postgraduate training (internship, residency, fellowship) at the Hospital of the University of Pennsylvania in Philadelphia. She has worked in academia, private practice, medical publishing, drug market research, and continuing medical education (CME). For the last 3 years, she has worked in a freelance capacity as a medical writer, analyst, and consultant. Follow Dr. Barbara Martin on and Twitter.