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Pricing of Monoclonal Antibody Therapies: Higher If Used for Cancer?
Inmaculada Hernandez, PharmD, PhD; Samuel W. Bott, BS; Anish S. Patel, BS; Collin G. Wolf, BS; Alexa R. Hospodar, BS; Shivani Sampathkumar, BS; and William H. Shrank, MD, MSHS
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Pricing of Monoclonal Antibody Therapies: Higher If Used for Cancer?

Inmaculada Hernandez, PharmD, PhD; Samuel W. Bott, BS; Anish S. Patel, BS; Collin G. Wolf, BS; Alexa R. Hospodar, BS; Shivani Sampathkumar, BS; and William H. Shrank, MD, MSHS
The annual price of monoclonal antibody therapies used in oncology and hematology is about $100,000 higher than those used in other disease states.
ABSTRACT

Objectives: The rising prices of specialty drugs have prompted a debate about how medications are priced. With the average price of cancer drugs doubling in the last decade, the unsustainability of drug prices is especially concerning in oncology and hematology. The objective of this study was to compare the prices of monoclonal antibodies (mAbs) approved in the last 20 years by the FDA across disease states.

Study Design: We identified all indications approved by the FDA for mAbs from 1997 to 2016 and calculated the annual price of 1-year treatment for each mAb–indication combination as the product of the US average wholesale price per milligram and the recommended dose.

Methods: We compared the annual price of treatment with each mAb across disease states using generalized linear models with gamma distribution and log link, controlling for route of administration, chemical structure, source, and time since FDA approval.

Results: The average annual price of a mAb was $96,731, exceeding $100,000 for 34 mAb–indication combinations. Oncology and hematology mAbs represented 40% of the mAb–indication combinations approved, yet they accounted for more than 85% of those priced $100,000 or higher. After adjusting for factors that can affect production costs, the annual price of oncology or hematology mAbs was $149,622 higher than those used in cardiovascular or metabolic disorders; $98,981 higher than in immunology; $128,856 higher than in infectious diseases or allergy; and $106,830 higher than in ophthalmology (all P <.001).

Conclusions: The annual price of mAb therapies is about $100,000 higher in oncology and hematology than in other disease states.

Am J Manag Care. 2018;24(2):109-112

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Author Affiliations: Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh (IH, SWB, ASP, CGW, ARH, SS), Pittsburgh, PA; Insurance Division, University of Pittsburgh Medical Center (WHS), Pittsburgh, PA.

Source of Funding: University of Pittsburgh internal funds.

Author Disclosures: Mr Bott owns stock in Merck, Incyte, and Johnson & Johnson. Mr Wolf is employed as an intern by Bristol-Myers Squibb. Dr Shrank is employed in the Insurance Division, University of Pittsburgh Medical Center, and has received consulting fees from Johnson & Johnson. The remaining authors report no relationship or financial interest with any entity that would pose a conflict of interest with the subject matter of this article.

Authorship Information: Concept and design (IH, SWB, ASP, CGW, ARH, SS, WHS); acquisition of data (SWB, ASP, CGW, ARH, SS, WHS); analysis and interpretation of data (IH, SWB, ASP, ARH, WHS); drafting of the manuscript (IH, SWB, CGW, ARH, SS, WHS); critical revision of the manuscript for important intellectual content (ARH, WHS); statistical analysis (IH); obtaining funding (IH); and supervision (IH, WHS).

Address Correspondence to: Inmaculada Hernandez, PharmD, PhD, Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, 3501 Terrace St, Pittsburgh, PA 15261. Email: inh3@pitt.edu.
 
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