Costs of Common Neurologic Medicines Continue to Rise

In the United States, out-of-pocket (OOP) costs for brand-name drugs for neurological diseases increased significantly from 2012 to 2021, with the largest increase for multiple sclerosis (MS) drugs, a new study found. it shows.

After adjusting for inflation, the analysis shows OOP costs for MS drugs have increased by 217%, from $750 per year in 2012 to $2378 per year in 2021.

In general, once generic versions of different drugs became available, patient costs decreased, but the OOP costs of glatiramer, a standard MS drug introduced in 2015, increased, although the total cost of medications are down.

“What we’re seeing is an increasing and disproportionate burden of these costs on patients, but not on the system as a whole,” study author Amanda Gusovsky, PhD, MPH, of Ohio State University in Columbus, said. . Medscape Medical News.

He added that OOP costs for MS drugs have increased steadily over the past 20 years, suggesting that current efforts to control these rising MS drug costs have not very successful.

The findings were published online on October 30 Neurology.

Increase in Prices of Epilepsy Drugs

Previous research shows that fewer patients have access to high-quality drugs for neurological conditions. A position statement issued by the American Academy of Neurology (AAN) in February calls for the implementation of several cost-cutting measures to ensure that effective prescription drugs remain available to patients with severe neurological conditions.

These include proposals that enable federal agencies to negotiate contracts with manufacturers of covered Part D drugs, and prices for brand-name drugs covered under Medicare as outlined in the Affordable Care Act of 2022. However, Gusovsky noted that according to the law, prices will not begin to fall until after 2026.

To learn more about prescription drug cost trends for neurologic conditions, researchers used data from two US nationally representative reports covering the period 2012-2021 that included more than a million people. 250 privately insured persons age 64 and older enrolled in Medicare. an employer-sponsored Medigap plan.

The researchers calculated annual OOP and drug costs for five common neurodegenerative diseases. These included 186,144 people with epilepsy, 169,127 with peripheral neuropathy (PN), 60,861 with Alzheimer’s or other dementias, 54,676 with MS, and 45,909 with Parkinson’s disease (PD) .

The analysis showed OOP costs for the epilepsy drugs carbamazepine, lamotrigine, levetiracetam, topiramate, and valproate remained stable. However, lacosamide, brivaracetam, and cenobamate all had costs that increased. high and rising OOP. For lacosamide OOP costs increased from $279 in 2012 to $468 in 2021, reflecting a trend in price increases that began in 2010.

For PD, OOP costs for amantadine, pramipexole, and ropinirole remained stable over time. However, carbidopa-levodopa OOP costs increased by 100%, rising from $89 in 2015 to $177 in 2021. Rasagiline OOP costs increased in 2014 by $353 and decreased by about half as the generic version was introduced in 2017.

OOP costs for the PN drug duloxetine fell by 80% from an average of $231 in 2012 to $46 in 2021 after the generic version was introduced in 2013. Similarly, the cost of OOP for pregabalin dropped 73% – from $204 in 2012 to $206 to $506 in 2013. followed by the introduction of a generic version in 2019.

The introduction of generic Alzheimer’s and dementia drugs has also caused OOP costs to drop. Memantine prices peaked at $302 in 2014, but with the introduction of a generic version in 2015, they dropped by 78%, reaching $67 in 2021.

Similarly, rivastigmine OOP costs decreased by 68%. OOP costs increased to $248 in 2014, decreasing to $80 in 2021. Generic Rivastigmine capsules were introduced in 2010 and the generic patch in 2015.

The researchers noted that general cost patterns reflect OOP costs, with few exceptions. Total costs for MS drugs rose an average of 80% during the study period, although they began to decline for other drugs through 2021. Glatiramer saw a modest drop in total costs from 2017 to 2021, while rasagiline rose in 2016 to $6064 and. later dropped to $1798 in 2021.

Cost Reduction Strategies

Several approaches to reducing drug costs are already underway, said Bruce H. Cohen, MD, chairman of the AAN’s Advocacy Committee.

“In September, the Centers for Medicare and Medicaid Services announced negotiated prices for the first ten Medicare Part D drugs selected for the Medicare Drug Price Negotiation Program,” Cohen said. Medscape Medical Newsrecognizing that empowering Medicare to negotiate prices directly for the first time is a major achievement.

He also recommended the use of generic drugs and biosimilars where available, the development of new treatment methods, and more transparency in drug pricing.

Gusovsky pointed out that some brand-name drugs have patent protection for as long as 20 years and suggested that a review of patent protection regulations could help improve access to pharmaceuticals. neurologic for many patients in need.

There was no scholarship. Gusovsky and Cohen report no relevant financial relationships.