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Never-ending Gleevec Drug Price Increases Are Prime Example of Market Failure and Greed

Gleevec 400 mg tablets

Gleevec 400 mg tablets.  photo adapted from [CC BY-SA 3.0], Patrick Pelletier via Wikimedia Commons

An article in the Washington Post yesterday covered the steep rise in the cost of a cancer medication called Gleevec, drug company Novartis’ brand name for imatinib, which is incredibly successful in treating people with chronic myeloid leukemia (CML). Despite its concern with public perception over price at the time, Novartis charged $26,400/year when the drug hit the market in 2001. With today’s price for Gleevec now $126,000/year it seems any concerns by Novartis have gone by the wayside (or did they really exist at all?). One would think and hope that new, similar products would bring down – or at least slow increases of – the price of Gleevec. After all, competition is supposed to drive down prices.

Not in the pharmaceutical industry, at least not until a drug goes off patent. The launch of therapeutically equivalent brand medications to treat CML actually coincided with Gleevec’s steepest price increases. Bristol-Myers Squibb launched Sprycel (dasatinib) in 2006 and Novartis launched a second generation drug called Tasinga (nilotinib) in 2007, both at much higher prices than Gleevec. In 2007, the monthly prices for Gleevec, Sprycel and Tasinga were $3,757, $5,477 and $6,929, respectively. The details can be found in the Post’s article but essentially Gleevec started to play “catch up” to its competitors.

In 2007, the price of Gleevec was 46% less than Tasinga. By 2014, the discount had shrunk to 12% with Gleevec’s price at $8,156/month compared to Tasinga’s price of $9,300/month. Let’s keep in mind that the newer drugs were shown to treat people that Gleevec could not treat, which would soften the argument that these are truly competing products. But soon after their introduction, Sprycel and Tasinga were found to successfully treat people with newly diagnosed cases of CML, to more directly compete with Gleevec, yet the latter’s price soared!

Source: Graph below from the Washington Post.

Graph - increase in Gleevec Rising drug prices New drugs treating chronic myeloid leukemia were introduced at prices higher than Gleevec's. their prices have gradually risen since, and Gleevec's price has increased at a greater clip.

One source cited in the post’s article summed it up perfectly. A hematologist from the University of Chicago, Richard Larson, stated: “Ordinarily, you might think with three equally effective drugs on the market, the price should go down through competition, but it’s been a failure of the competitive pricing process.”

While the Washington Post’s article delved into the problem of out of pocket costs for Gleevec, it didn’t hammer home that the suffering in America is extreme when it comes to Gleevec’s drug price (and other medication prices as well). Gleevec is not a new topic on these blog pages, which has solicited comments from people and families crushed by drug costs. Yes, the irony is glaring: cancer medications that alleviate suffering also create suffering, too, in the form of cancer patients facing bankruptcy, feeling guilt, and causing anxiety.

It’s not just market failure – it is greed, too. I’ll let one American, Penny Kincaid, a commenter on this blog, bring it home:

“I guess I am luckier than many on Gleevec. I am paying 5% of the cost each month but the cost keeps going up. Our lives depend on this drug but still the cost is obscene. They praise themselves for creating [these] drugs for patients with [CML] but still we are forced to pay and many go broke. It is the cancer patient who has to pay up or die and they keep raising the cost. This is just wrong in so many ways and here we have the creators wanting to deny us the generic because they want that big money to keep rolling in. They should be ashamed of themselves.”

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The Price of Gleevec: A Tale of Two Supreme Courts

Gleevec 400 mg tablets

Gleevec 400 mg tablets photo credit: Patrick Pelletier Creative Commons CC-BY-SA-3.0

Americans interested in generic drug prices and pharmaceutical patent law have been closely following the U.S. Supreme Court as it hears arguments in a case over “pay-for-delay”  –  the practice of brand-name drug-makers seeking greater profits by paying off generic manufacturers to delay introduction of low-cost generic drugs. If “pay-for-delay” tactics are declared unconstitutional, then generics would reach pharmacy shelves faster, translating to lower prices for consumers, health insurers, and taxpayers.

The Court’s decision isn’t expected until June, but last Monday the Supreme Court of another country rendered another decision related to generics that may affect American prices. India’s Supreme Court ruled against the drug company Novartis’ patent claim on Gleevec, a cancer medication. Since India’s decision allows drug companies to continue manufacturing generic versions of Gleevec, called imatinib mesylate, prices will remain exceedingly low in India and low-income countries that import Indian pharmaceuticals.

So how much cheaper is generic Gleevec in Indian pharmacies than brand name Gleevec in American pharmacies? The New York Times reported that a one-year supply of brand name Gleevec in the U.S. is a staggering $70,000. The generic in India is only $2,500!

Additionally, even though Gleevec is under patent in other high-income countries like it is in the U.S., it is far less expensive internationally. At a local New York City pharmacy the price for 30 pills of Gleevec (400mg) is $6,980. The same brand name Gleevec (400 mg) from a Canadian pharmacy is just under $3,700. The same drug (but marketed by Novartis as Glivic), can be ordered online from Turkey for $2,979.  That’s a potential savings of $4,000 a month! If you choose to buy Gleevec or any medication online, to protect your health, stick to verified online pharmacies, such as those approved by PharmacyChecker.com.

In the wake of the Indian Supreme Court’s decision, it would not be surprising if Novartis reacts by raising Gleevec prices here in America to bolster profits.  Governments of other high-income countries probably won’t allow Novartis to raise prices on Gleevec, due to price controls. This is patently unfair to Americans, who should not have to pay so much more for the same medication than citizens of other high-income countries.

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Cancer drug costs and desperation: a reality for Americans

This blog post concerns real people who are desperate, angry, and facing terminal illness because of the cost of a cancer medication. A woman named Lisa recently placed a comment on a blog post we wrote back in March 2013 called “The Price of Gleevec: A Tale of Two Supreme Courts.”  We noted at the time that the Indian Supreme Court told drug company Novartis to go fly a kite in its effort to stop lower cost generic versions of Gleevec, a cancer medication, from being sold in India, and that the U.S. Supreme Court was hearing arguments against a practice known as Pay-to-Delay involving a different medication.

But this post is not about policies and intellectual property or patent rights, the rightness or wrongness of India’s looser patent laws, pay-to-delay, personal drug importation or online pharmacies. It’s just about a woman’s husband and others who have cancer and can’t afford the medicine they need to get better or live.

Lisa gave me permission to re-publish her comment as a blog post here. I have made very, very slight edits, as you can see if you look at the original comment.

Lisa wrote:

This is very interesting news and gives us a little hope. My husband has Chronic Myeloid Leukemia (CML). He has been on Gleevec (here in So. California for the past 12 years. I thought I should mention Gleevec here in the U.S. is $10,600.00 a month for 400mg (30 pills). I thought should mention this because your prices listed here in the U.S. are inaccurate. That would bring the total cost to $126,000 a year.

We are going broke, will probably lose our home and my husband will probably never be able to retire (even though his body is breaking down from 40+ years of a very physical job as a pipe fitter. I (the wife), am permanently disabled. We will die homeless before this drug ever comes within an affordable price.

Many children and adults are cutting their pills in half, which defects the purpose. They too, will die before seeing Gleevec reach an affordable price here in the U.S.

All the countries you listed in the article, do NOT accept U.S. insurance companies and/or ObamaCare.

Why doesn’t anyone bring this to the press? Why does Congress and ObamaCare turn a blind eye? How many hundreds have to die before this drug and options are researched. I have written many letters to Norvartis, only to be ignored. I have written to Media Outlets only to be ignored. Now I am desperately asking for your help in bringing this to the media and anyone that will listen. We and many others are scared out of our minds. We are really loosing hope and it is tearing families apart. Some patients are becoming suicidal, because they don’t know how they are going to afford the next month supply of Gleevec. Novartis (GREEDARTIS) should be ashamed of themselves. You should research the substantial increases (quarterly), since the drug first went on the market. It will blow you mind! What if this was your child or loved one?

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