Out-of-Pocket Costs Grew 7-Fold for Medicare Beneficiaries with Multiple Sclerosis

For Medicare Part D beneficiaries, rising prices for multiple sclerosis (MS) treatments have translated to a more than 7-fold increase in out-of-pocket costs, according to a new study published in JAMA Neurology.

Since 1993, when the first disease-modifying therapy (DMT) for MS was approved, costs for MS drugs have continued to rise as newer therapies emerged. Even with increasing drug prices, some argue that manufacturer rebates and other kinds of discounts prevent these rising list prices from being passed down to patients. The study authors sought to determine whether price increases affected both patient and Medicare spending.

In the study, the researchers examined Medicare claims data from 2006 to 2016 to identify trends in MS drug costs over time for self-administered DMTs for MS, including glatiramer acetate, interferon beta-1a, fingolimod hydrochloride, teriflunomide, dimethyl fumarate, and peginterferon beta-1a.

“The prices for DMTs for MS have risen dramatically over the last 15 years, far outpacing inflation, and now have a mean price of more than $86,000 per year,” the authors wrote in an accompanying editorial.

Over the 10-year period, the annual list prices of the drugs examined more than quadrupled, increasing from approximately $18,000 to approximately $76,000 per patient per year. This represented an increase at a mean annual rate of 12.8%, according to the study.

Overall, brand-name glatiramers accounted for the largest market share during the study period, ranging from between $25,552 of $79,411 per 1000 Medicare beneficiaries and $10,342 of $21,365 per 1000 Medicare beneficiaries.

Despite increasing competition in the market, prices for the most popular drugs treating MS have steadily risen. The researchers found that out-of-pocket costs per patient increased 7.2-fold, from $372 to $2673, for Medicare beneficiaries. The results also showed that throughout the study, Medicare spending per 1000 beneficiaries increased 10-fold from $7794 to $79,411.

“One of the most significant findings was that the prices of these drugs have increased in parallel,” lead author Alvaro San-Juan Rodriguez, PharmD, a pharmacy fellow at University of Pittsburgh, said in a press release. “Only a couple exceptions deviate from that general trend.”

References

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. JAMA Neurology. 2019. Doi: 10.1001/jamaneurol.2019.2711

Drug Costs Soar for Multiple Sclerosis Patients on Medicare [news release]. University of Pittsburgh. https://www.upmc.com/media/news/082619-hernandez-ms-drug-pricing. Accessed August 27, 2019.