5 replies to this topic

[Ts_Mom]

Hello all, I have been following this board for over two years now and it has been a tremendous help. My son ('T') was 11 when he was dx with CML in July 2012. A mandatory blood draw as part of a school physical requirement in Connecticut caught it but his WBC was already over 130,000. As is typical with CML, he had zero symptoms - no bruising, night sweats, fevers, barely even a cold for several years prior to his dx. He started on Gleevec at 400 mg/day but decreased after six months to 350 due to side effects. He has not quite hit the ideal milestones but is tolerating treatment well enough.

 

My question... has anyone noticed the dramatic increase in the cost of Gleevec over the past year? T is on 350 mg/day, and this used to be $6,250 per month (I get it directly through a hospital pharmacy at cost) as of September 2013 and when I picked up this month's supply today the cost had jumped to $8,200. At this rate... while I have excellent rx insurance coverage I can see further increases causing a problem. Can I be dropped from insurance? Do we have any leverage with insurance companies increasing prices like this? Holy stress.

 

[LivingWellWithCML]

Yes, I think we're all seeing this, and oh yes, it's definitely stressful - I can attest to that!  I'm on Gleevec 400mg and my pharmacy invoices have similar price increases.  My insurance hasn't been dropped, but my insurance carrier has restructured their group plans over the past couple of years, so that insurance can start passing on more of the cost to the patient.  For patients that have professional insurance *and* have challenging co-pays (e.g., my January co-pay for a 30-day refill was ~ $3,000, ouch), Novartis does offer a good co-pay assistance program that will offset down to a max $100 monthly co-pay for the patient (much more manageable).

 

I don't quite understand the business purpose behind the increase or what will happen in the future - but clearly it isn't sustainable.  The *value* that Gleevec provides is high (life-saving value), so pricing is probably being driven by that aspect.  And competitive TKIs aren't cheaper, so there's no pricing pressure.  In addition, the introduction of generic imatinib in the USA isn't too far off, so I imagine that pricing is being gradually positioned to dictate entry-level generic pricing into the US market.  Just thoughts/speculation from a patient perspective...

[Trey]

Gleevec costs should peak at this point and start downward as the Gleevec patent expiration kicks in on July 2015.  It will not be a precipitous drop after that, but should be significant over time.  I would think generic Gleevec could be obtained through Canadian pharmacies after patent expiration. 

[Ts_Mom]

So... if it's available in India as a generic right now (or at least from what I understand) for approximately $2,500 a year... what keeps us from vacationing in India and returning with a year's supply? Access once in India? Legal ramifications? I'm new to this...

[Trey]

Customs agents.  Illegal until the patent expires. 

[chriskuo]

Since Tasigna will still be under patent, Novartis has an incentive to shift as many Gleevec users to Tasigna as possible before Gleevec goes off patent.  To at least a small degree, making the prices similar helps facilitate the switching process.

 

Since most of us TKI users pay a small % of the list price, most of the price premium is absorbed by the premium-paying population generally and the government.  For patients on non-government drug plans, drug manufacturers are happy to subsidize co-pays to get the bulk of the price from insurance companies.  For government drug plans, it is illegal for the drug companies to subsidize co-pays.