US Trends In Anticancer Medicine Pricing And The Impact Of Competition, 2014–20

Prices of anticancer medicines (including chemically synthesized medicines and biologics manufactured from living organisms) are a subject of concern, as they contribute to spending by health plans and patients. We describe prices and evaluate the impact of competition among 185 anticancer medicines, using IQVIA data from the period October 2014-February 2020. We calculated the price of each medicine, defined as volume-weighted wholesale costs net of prompt-pay discounts and gross of rebates, without and with inflation adjustment, and summarized them by patent status, formulation, and therapeutic class. We evaluated the relationship between prices and competition, using regression analyses. We also conducted event studies of the impact of generic entry on the prices of three medicines from distinct clinically relevant therapeutic classes. Over the course of the study period, medicine prices increased among brand-name products and decreased among generics and biosimilars. After exclusivity loss, generic and biosimilar medicine prices decreased, whereas brand-name prices remained stable. Event study results present more divergent price trends after exclusivity loss. Consistent with previous research, our study showed that competition may improve the affordability of medicines for payers and patients. However, this effect is limited for anticancer medicines because only a minority are available as generics and biosimilars.