Study Shows Generic Chemo Is Too Costly To Help Cut Cancer Spending


The start of immuno-oncology treatments such as checkpoint inhibitors and personalized CAR-T engineered immune cells has magnified fears over the increasing costs of prescription drugs, specifically in cancer care. Though critics of high drug prices hardly point to chemotherapy as part of the issue. Chemo, is considered old technology, so when chemo treatments turn generic they’re suppose to be inexpensive, no? Not necessarily.

A new study has surfaced focusing on capecitabine, an chemotherapy pill that’s marketed under the brand name Xeloda by the Roche unit Genentech. It tanked, the authors anticipated. Though by last year, the price of capecitabine had fallen only 36% to $2,328 for a 30-day supply, regardless of the fact that four generic drug makers had hiked in to compete for a piece of the market. Usually, the price of a generic drug with four competing manufacturers would fall 61% predicted the researchers, who teach at the University of North Carolina.

Though, some patients did benefit from the generic capecitabine. For example, in the three years prior to the drug losing its patent protection, 40% of insured cancer patients put out co-payments for their prescriptions of $50 or more. Three years following the entry of generic capecitabine, that number dropped to 20% and 61% of patients didn’t have to come out of pocked for the lower-cost alternative of the drug.

It remains the fall in capecitabine’s price isn’t sufficient enough to endorse the notion that encouraging generic competition will help drive down the cost of high priced drugs, the author points out. If “similar modest price decreases are observed for other orally administered anticancer drugs following generic entry, generic competition alone may not be sufficient to curb oncology spending,” they reported in the paper, which was published in JAMA Internal Medicine.

The study comes just one month following Duke University researchers publishing a survey reporting that one-third of insured cancer patients are bearing higher out-of-pocket costs for their treatments than they anticipated having to pay. On average, the cancer patients surveyed were dishing out 11% of their household income on cancer treatments. Cancer patients who report financial distress are more likely to reject the care that could save their lives, the authors added.

The problem of high drug costs hiked into the spotlight last year when President Donald Trump accused pharmaceutical companies of “getting away with murder” on pricing. It’s still weary of how much of a legislative priority the issue is currently, though former Democratic presidential candidate Bernie Sanders has expressed his opinion on the topic lately. He has backed two articles of proposed legislation, including one that would allow Americans to buy low-priced prescription drugs from Canada.

“The price of capecitabine has more than doubled since 2002, so even after generic entry, the price paid by health plans is still higher than the branded drug’s original list price after you adjust for inflation,” said the study’s senior author, Stacie Dusetzina, assistant professor at the UNC Eshelman School of Pharmacy stated. “If prices after generic entry are ultimately higher than original list prices, then it isn’t clear that patients will have easier access to treatment following generic entry.”


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