April 28, 2016

headshot, Dr. Stacie Dusetzina

Dr. Stacie Dusetzina

A study authored by Stacie Dusetzina, PhD, assistant professor of health policy and management at the UNC Gillings School of Global Public Health, found that oral cancer drugs introduced in 2014 were six times more expensive than those introduced in the year 2000. The findings raised concerns, as patients must bear the cost burden of those increases.

Dusetzina also is assistant professor of pharmaceutical outcomes and policy in the UNC Eshelman School of Pharmacy and member of UNC Lineberger Comprehensive Cancer Center.

New cancer drugs taken in pill form have become dramatically more expensive in their first year on the market compared with drugs launched 15 years ago, Dusetzina’s study found. The findings call into question the sustainability of a system that sets high prices at market entry in addition to rapidly increasing those prices over time.

The researchers report April 28 in JAMA Oncology that, after adjusting for medical inflation, one month of treatment with orally-administered cancer drugs introduced in 2014 was, on average, six times more expensive at launch than cancer drugs introduced in 2000. Drugs approved in 2000 cost an average of $1,869 per month compared to $11,325 for those approved in 2014.

“The major trend here is that these products are just getting more expensive over time,” said Dusetzina.

During the past 10 years, there has been a push toward developing orally administered drugs for cancer patients, but the high prices increasingly may be passed along to the patient, potentially affecting a patient’s access to the drug and their ability to use them, Dusetzina said.

Imatinib, also known as Gleevec, was among the drugs with large increases in monthly cost. Between its launch in 2001 and 2014, the price increased from $3,346 to $8,479, reflecting an average annual increase of 7.5 percent.

Dusetzina also explained that the amount that patients pay for these drugs depends upon their health care benefits. Patients increasingly pay more for these high-cost specialty drugs, despite the fact that commercially insured health plans historically have had generous coverage for orally administered cancer drugs.

“Patients increasingly take on the burden of paying for these high-cost specialty drugs, as plans move toward higher deductibles and co-insurance, through which a patient will pay a percentage of the drug cost rather than a flat copay,” Dusetzina said.

Dusetzina analyzed the amounts paid by commercial health insurance companies and patients for oral cancer drug prescriptions between 2000 and 2014. The data came from the TruvenHealth MarketScan Commercial Claims and Encounters database.

Dusetzina noted that while the study did account for payments by commercial health plans, it did not account for spending by Medicaid and Medicare, which may differ. Only the products that were dispensed and reimbursed by commercial health plans were included, which may have excluded rarely used or recently approved products.

Gillings School of Global Public Health contact: David Pesci, director of communications, (919) 962-2600 or dpesci@unc.edu


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