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Multiple Sclerosis Therapy Costs Rise Over 10 Years for Medicare Part D


August 27, 2019

Due to significant increases in the prices of drugs over the years, out-of-pocket costs for self-administered, disease-modifying therapies (DMT) for multiple sclerosis (MS) have increased 7.2-fold for Medicare Part D beneficiaries, according to a recent study published in JAMA Neurology.

Alvaro San-Juan-Rodriguez, PharmD, Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, and colleagues, assessed trends in prices, market share, and spending on self-administered DMTs for MS in Medicare Part D from 2006 to 2016.

Data from the study suggests that despite added competition and new MS therapies in the market, costs continued to increase. Self-administered DMTs increased a mean 12.8% each year.

"We wanted to see how increases in list prices translated to increases in out-of-pocket spending, and we discovered that actual price increases do get passed down to patients, and that can negatively affect access," study senior author Inmaculada Hernandez, PharmD, PhD, assistant professor of pharmacy at the University of Pittsburgh, said in a statement to Science Daily.

Throughout the study, Medicare spending on DMT increased 10.2-fold from $7794 to $79,411 per 1000 Medicare beneficiaries. The out-of-pocket costs for patients was found to have increased 7.2-fold from $372 to $2673. The researchers estimated overall, Medicare Part D spending increased in total from $396.6 million to $4.4 billion, and out-of-pocket costs increased in total from $18.9 million to $149.4 million, a startling increase over a decade.

“These rising prices are not only concerning because of the strong effect they had on spending, but because they demonstrate that the approval of new therapies did not ameliorate and could have even contributed to high inflation rates observed for incumbent drugs,” explained the authors of the study.

“As health care costs become unsustainable, these findings suggest that market entry of new MS drugs may have contributed to higher drug prices among incumbent agents. These higher prices were associated with large increases in Medicare spending and patient out-of-pocket costs,” concluded Dr San-Juan-Rodriguez and colleagues.

—Edan Stanley

 

Reference:
San-Juan-Rodriguez A, Good CB, Heyman RA, et al. Trends in prices, market share, and spending on self-administered disease-modifying therapies for multiple sclerosis in Medicare Part D [published online August 26, 2019]. JAMA Neurol. doi:10.1001/jamaneurol.2019.271.

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