The cost savings from generic oral chemotherapy medications have been less than hoped for by experts.
A generic version of orally administered capecitabine returned less-than-anticipated cost savings over a 3-year span, according to study results published in JAMA Internal Medicine.
In addition, list prices of branded and generic capecitabine continued to rise during the 14-year study, researchers reported.
“Since around 2000, treatment of many cancers has shifted from infused chemotherapies to orally administered cancer therapies,” Ashley L. Cole, MPH,doctoral student and graduate research assistant at University of North Carolina Eshelman School of Pharmacy, told HemOnc Today. “These newer therapies tend to be much more expensive, including higher cost-sharing for patients.”
Capecitabine — a thymidylate synthase inhibitor initially manufactured by Genentech for the treatment of metastatic colorectal and breast cancers — received FDA approval in 1985 under the brand name Xeloda, representing the first approved oral chemotherapy.
When capecitabine came off patent near the end of 2013, it became the first oral chemotherapy available in generic form, entering the market through Teva Pharmaceuticals in March 2014.
In theory, once drug patents expire, generic competition should help lower prices for cancer treatment.
“[Because] capecitabine was one of the first orally administered cancer therapies to have a generic [version] come on the market, it made a great case study for the potential effect of generic competition for orally administered cancer therapies,” Cole said.
Cole and colleagues used the Truven Health MarketScan Commercial Database to analyze changes in the list price of capecitabine and patient out-of-pocket expenses from 2002 through 2016, which included 3 years after patent expiration. Researchers assessed 156,508 outpatient pharmacy claims for branded or generic capecitabine filled by adults diagnosed with colorectal or breast cancer.
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