With the cost of copayments for cancer pharmaceuticals varying widely, some patients end up skipping doses or stopping some treatments altogether, according to a new study.
Leukemia patients with high copayments for the targeted cancer drug Gleevec were 42 percent more likely to skip doses and 70 percent more likely to stop treatment than those with comparatively lower copayments, health researchers found in an analysis of claims data between 2002 and 2011.
Publishing their results in the Journal of Clinical Oncology, University of North Carolina health policy professor Stace Dusetzina and others studied private group health plan claims for patients with chronic myeloid leukemia, a type of white blood cell cancer that now comes with a 80 percent 10-year survival rate thanks to the new drug class Novartis created with Gleevec in 2001.
The patients' monthly copayments for Gleevec, also known as imatinib, averaged between $55 in 2002 and $145 in 2011, and in the last year 6 percent were paying more than $500 a month, Dusetzina and colleagues at Harvard and the Dana Farber Cancer Institute found.
They also found that Gleevec's monthly costs for both the health plans and the patients increased from $2,798 in 2002 to $4,892 by 2011.
"Imatinib is an expensive drug," Dusetzina said in a media release. "But it is a great example of a drug where there is not a lot of confusion about which patients will benefit. Most patients with CML will benefit. However, individuals need to take it almost perfectly, and not taking it can have severe medical consequences."
Gleevec was Novartis' best selling drug in 2012, reaching some $4.7 billion in sales. Originally priced at $30,000 a year, the drug's annual cost increased to $92,000 by 2012, although the company has said it offers discounts to patients with lower incomes or financial distress.
Gleevec, which is set to be manufactured and sold as a generic in India and other countries rejecting Novartis' latest patent, is not alone among therapies approaching or exceeding $100,000 a year in the U.S. Dusetzina suspects that other costly therapies for cancer or other chronic diseases may also be putting financial pressure on patients, many of whom, like those with CML, might expect to take them for decades.
"Our results are particularly relevant for specialty pharmaceutical products, those that cost over $10,000 a month, however, the lessons learned likely relate to any pharmaceutical product that has high out of pocket costs," said Dusetzina. "It is important that we identify strategies to make effective but expensive medications more affordable to patients."