The cost of prescription drugs for patients with multiple sclerosis (MS) nearly tripled over 7 years and the generic version of 1 of the most common drugs had little overall effect on prices, according to a study published in Neurology.

The study examined costs for disease-modifying drugs for patients with MS between 2011 and 2017 based on a Medicaid database. Researchers found spending on 15 MS drugs within the Medicaid program increased from $453 million to $1.32 billion during this time.

Increased spending was driven by increases in prescription costs that doubled during the 7 years, according to the study. Most of the drugs cost more than $70,000 per year on average and costs for these drugs are among the highest spending areas for private insurers, as well as Medicare and Medicaid.

After adjusting for average rebate amounts paid to the Medicaid program, spending was lower but still more than doubled from $278 million to $600 million per year. Spending more than doubled from $2.00 per Medicaid enrollee to $4.06 per enrollee during the study period. However, researchers found that some of the increase was due to the expansion of Medicaid through the Affordable Care Act.

A generic version of the drug glatiramer acetate was introduced in 2015. The study showed that when the generic version was introduced, the cost of the brand name drug immediately increased by $441 per prescription, followed by a slowing of the upward monthly trend.

“Before the introduction of the generic drugs, the maker of the brand name drug worked to push its market share from the 20 mg dose to the 40 mg dose, which was not interchangeable with the new generic. The low market share for the generic drug was also because of the generic drug at 20 mg at approximately the same cost as the 40 mg dose when it launched,” Daniel Hartung, PharmD, MPH, study author said in a press release.

A second company introduced a generic version of glatiramer acetate in October 2017, near the end of the study. By the end of 2017, 36% of all glatiramer acetate was generic, according to Hartung. Despite this release, there is an urgent need for more robust competition from generics for these MS drugs.

One limitation of the study is that it is based on the Medicaid program for patients from low-income households and patients with disabilities. It may not reflect the entire population of patients with MS, the authors noted.

Reference
Study: MS Drug Costs Nearly Triple over Seven Years, Even With Introduction of Generic [press release]. American Academy of Neurology. Published January 15, 2020. https://www.aan.com/PressRoom/Home/PressRelease/3766. Accessed January 20, 2020.