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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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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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No Prosecution for Prescription Access Hero Charged with Counterfeit Drug Sales in China

At the beginning of this year, we brought you the story of Lu Yong, a Chinese citizen with Leukemia who was facing severe financial hardship due to the $3,783 monthly cost of his cancer medication, Gleevec. Mr. Lu found out he could order Veenat, a generic version of Gleevec, from India for a more affordable $640 a month. Soon thereafter he started helping fellow Leukemia sufferers – a thousand of them – access Veenat, in effect helping save their lives. Mr. Lu was rewarded by being charged with selling counterfeit drugs and credit card fraud!

The problem was that Veenat, an entirely genuine, legally manufactured and effective medication approved in India, is designated as “counterfeit” and unapproved in China. The credit card fraud charge was brought because Mr. Lu used other patients’ credit cards to order their medicine.

So, our earlier blog post on this story was called “Low Cost Counterfeit Drugs Save Lives in China…What?!” Seem like a stretch? Not really. Medication deemed “counterfeit” was in fact saving lives. A Chinese court seemed to agree, determining that Mr. Lu’s action should not be construed as “selling counterfeit drugs” since the medication was genuine. Additionally, because his use of other people’s credit cards was to help them, it was not “criminal behavior.” For more read about it in Chinese Radio International.

Lu Yong is a prescription access hero and we applaud him rancorously. Kudos to the Chinese legal system as well.

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