Health Insurers Could Save Millions Using Generic Cancer Drug

New research has demonstrated that over the span of 5 years, the cost of treatment per patient with chronic myeloid leukemia (CML) would be $100,000 less then it currently is, if the generic form of Gleevec (imatinib) was initiated upon diagnosis.

The study, which compared cost-effectiveness of different medications, says that insurance companies have the chance for large cost savings as a result of the January 2016 expiration of the patent on Gleevec, the first drug to successfully treat CML. As a result, researchers estimated the cost of imatinib should drop 60% to 90%, making the annual cost <$6000 as opposed to the current price of $60,000.

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If insurers decide not to allow providers to choose and to only pay for imatinib as a first line drug, savings could be >$100,000 in 5 years—the amount of time typically used to progression-free and overall survival from remission in patients.

According to the study, patients with CML often switch drugs during treatment as result of side effects or apparent effectiveness. Two new drugs—Sprycel (dasatinib) and Tasinga (nilotinib)—are often given because of physican preference. Dasatinib and nilotinib in the same category as imatinib, although the generic versions are not available and the branded version cost around $75,000 annually. Research indicates that all 3 drugs have equivalent overall 5-year survival rates.

“There is minimal risk to starting all patients on imatinib first,” the study authors said. “If the patient can’t tolerate the medication or it seems to be ineffective in that patient, then we can switch the patient to a more expensive drug. Insurance companies have the ability to dictate which drugs physicians prescribe first, and they regularly do. Doing so here would mean very little risk to health and a lot of cost savings.”

If health insurers have 100 patients with CML, they could save $9.1 million over 5 years by using the generic version.

The study is published online in the the Journal of the National Cancer Institute.

Reference: Padula WV, Larson RA, Dusetzina SB. Cost-effectiveness of Tyrosine Kinase Inhibitor Treatment Strategies for Chronic Myeloid Leukemia in Chronic Phase After Generic Entry of Imatinib in the United States. J Natl Cancer Inst. 2016;108(7): doi: 10.1093/jnci/djw003.