Generic Version of Gleevec Could Save Millions in Chronic Myeloid Leukemia

In the wake of the patent expiration for Gleevec, which treats chronic myeloid leukemia (CML), researchers believe using the generic counterpart imatinib could save millions.

A majority of CML patients require lifelong and costly treatment, but if patients are initially given imatinib, the cost of treatment per patient over 5 years would be nearly $100,000 less than it is now.

The study estimated health insurers with 100 CML patients can save $9.1 million over 5 years.

“If we start all patients on the generic form of Gleevec and it works, then they are on a generic for the rest of their lives," said study leader William V. Padula, PhD. “This amounts to a huge cost savings for them and their insurers.”

Gleevec was the first drug to come onto the market that successfully treated CML, which once had a poor prognosis. However, in recent years, the tyrosine kinase inhibitors dasatinib (Sprycel) and nilotinib (Tasinga) have joined the market.

The annual cost for these treatments is approximately $75,000 and there will not be generic versions available for many years.

Although research has shown the overall 5-year survival rate is equal among the 3 drugs, nearly 90% of cases have patients taking 1 of the newer drugs based on physician preference.

Researchers from Johns Hopkins Bloomberg School of Public Health discovered that if insurers paid for Gleevec as a first line drug instead of allowing physicians to choose, it could result in more than $100,000 in savings over 5 years if the patient stayed on Gleevec the entire time.

Since the Gleevec patent protection has expired, researchers estimate that the per-patient per-month cost of imatinib will likely drop 60% to 90% from the current $60,000 annaul cost, as generic manufacturers continue to produce and sell imatinib.

For those who stay on the drug, it has the potential to cost less than $6000 a year.

“There is minimal risk to starting all patients on imatinib first,” Padula said. “If the patient can't tolerate the medication or it seems to be ineffective in that patient, then we can switch the patient to a more expensive drug. Insurance companies have the ability to dictate which drugs physicians prescribe first, and they regularly do. Doing so here would mean very little risk to health and a lot of cost savings.”

For the study, published in the Journal of the National Cancer Institute, researchers compared the cost effectiveness of different medications. The analysis included newly diagnosed CML patients between January 1, 2011 and December 31, 2012, from the Truven Health Analytics MarketScan.

According to IMS Health, total prescription drug spending in the United States in 2014 was $374 billion, which is a 13% increase from 2013.

Prescription drug pricing has more to do with the cost of research and development and the value provided to patients than the actual cost of product manufacturing and distribution, the study found.

“When patent protection is lost, the prices are set closer to the true cost of the drug,” Padula said. “They're making 'General Motors' profits as opposed to pharma profits and that savings can be shared with the consumer, but only if doctors and insurers work together to make sure patients are being prescribed the more cost-effective medication.”