Portland, OR—When the first form of generic glatiramer acetate was approved by the FDA for treatment of multiple sclerosis (MS) nearly 5 years ago, the hope was that the cost per prescription of self-administered disease-modifying therapies would decrease quickly.

That has not occurred, however, according to a study published ahead-of-print in the journal Neurology.

In fact, Oregon State University–led researchers determined that the cost of prescriptions for MS drugs nearly tripled over 7 years, with the generic version of a common drug having little overall effect on prices.

The study took a close look at costs for disease-modifying drugs for MS from 2011 to 2017 based on a Medicaid database. The study team calculated that spending on 15 MS drugs within the Medicaid program increased from $453 million to $1.32 billion during this time.

“Increased spending was primarily driven by increases in prescription costs, which doubled during this time period,” explained lead author Daniel Hartung, PharmD, MPH, of Oregon State University in Portland. “Most of these drugs cost more than $70,000 per year on average and costs for these drugs are among the highest drug cost areas for private insurers as well as Medicare and Medicaid. Unfortunately for people with MS, the introduction of a generic drug had a minimal effect on prices overall.”

The authors used quarterly Medicaid State Drug Utilization Data to summarize trends in spending, utilization, and costs per prescription for the DMTs, including brand and generic versions of glatiramer acetate. They found that gross annual expenditures on MS DMTs increased from $453 million to $1.32 billion between 2011 and 2017 within the Medicaid program.

“Increased spending was primarily driven by increases in per prescription costs, which doubled during the study period,” researchers write. “Although total utilization was stable, product specific utilization shifted from injectable to oral DMTs. However, throughout the study, the plurality of utilization was glatiramer acetate.”

The study notes that the introduction of generic glatiramer acetate in the second quarter of 2015 was associated with an immediate increase of $441 (95% CI, $184-$697; P <.001) in the cost per prescription of branded glatiramer acetate, followed by a gradual $52 per-prescription reduction (95% CI, -$86 to -$18) over time. At the same time, the costs for other DMTs showed minimal changes, the researchers point out.

“Spending on MS DMTs in the Medicaid program have more than doubled over the last seven years primarily as a function of higher costs per prescription,” the authors conclude. “Introduction of a generic glatiramer acetate product in 2015 had nominal effects on overall price trajectories and utilization within the class.”

The authors add that one limitation of their study is that it is based on the Medicaid program, which is for low-income people and people with disabilities, so it may not reflect the entire population of MS patients.

 « Click here to return to Weekly News Update.