Older Drugs, Bigger Price Increases?

A new study has found that the price of older drugs-many approved more than 20 years ago-increased more between 2010 and 2015 than that of newer drugs, with some drugs having undergone “dramatic price increases.”

“The high price of cancer drugs has increasingly drawn criticism from leading academic researchers, and threatens health care budgets,” wrote Vinay Prasad, MD, MPH, Knight Cancer Institute, Oregon Health & Science University, Portland, and colleagues in a Research Letter published in JAMA Oncology. “New drug pricing seems to bear no relationship to novelty or efficacy, or, in other words, drug prices are disconnected from the benefits provided.”

Prasad and colleagues pointed to two recent examples of older drugs significantly increasing their prices: pyrimethamine from $13.50 to $750 a tablet and a two-pack of EpiPens from $100 to more than $600.

“Raising the price of older drugs seems particularly objectionable when one considers that the outlay for research and development occurred long ago, and has almost certainly already been recouped, and it raises the question of how older drugs should be priced and valued,” they wrote.

To find out more about trends in price increases, Prasad and colleagues analyzed the change in the average sales price of cancer drugs between January 2010 and January 2015, looking at Part B drug prices listed at the Centers for Medicare & Medicaid Services website during that period. Any anticancer drug listed in both years (n = 86) was included. In addition, they looked at whether older drugs were more likely to increase in price compared with newer drugs.

All prices were adjusted for inflation. In all, 36% of drugs decreased in price from 2010 to 2015, and 64% of drugs increased in price during this same period. Eleven drugs had price increases of more than 100% from 2010 to 2015.

The researchers classified 43 drugs as “older” drugs, having been approved between March 1949 and November 1992. “Newer” drugs were approved between December 1992 and December 2008. Data showed that older drugs had a median increase in prices of 22.7% compared with 6.2% for newer drugs (P = .001).

For example, they found that the price of oral cyclophosphamide has increased 300% after adjusting for inflation.

“Our results suggest that solutions to the high price of cancer drugs must also consider the rising price of older drugs,” they concluded.