Prices rise for prescription dermatologic drugs

Drugs for skin conditions such as psoriasis have increased in cost.

The rising price of health care has an important impact on the US economy. With the “Baby boomer” generation coming into their 60s, high health care prices directly affect federal spending, which adds to the national deficit.

The Patient Protection and Affordable Care Act aims to reduce long-term health care spending by focusing on preventive care, patient responsibility and competition among health care professionals.

However, the reform has not succeeded in curbing the rising price of prescription drugs. The result is that medications are becoming less accessible to patients who need them.

The US pays the most per capita of all the Organization for Economic Cooperation and Development (OECD) countries for prescription drugs.

In the current study, Dr. Steven P. Rosenberg, of the Miller School of Medicine at the University of Miami, and colleagues aimed to find out how much prices of commonly prescribed dermatologic medications had changed since 2009, and to identify trends in price increases for different classes of drugs.

They surveyed prescription drug prices at four national chain pharmacies in West Palm Beach, FL, in 2009, 2011, 2014 and 2015.

1,240% rise in price of cancer-preventing antineoplastics

A total of 19 name-brand prescription dermatologic drugs were selected and grouped by treatment indication: acne and rosacea, psoriasis, topical corticosteroids, antiinfectives and antineoplastics.

The antineoplastic class did not include systemic medications for metastatic melanoma or basal cellcarcinoma because such medications were not available in 2009.

Prices increased rapidly between 2009-15, with prices for topical antineoplastic drugs to prevent the spread of cancer cells increasing an average of 1,240%.

The authors found that between 2009-15:

• Prices of all surveyed classes of brand-name drugs increased by an average of 401%
• The highest increase was in prices of topical antineoplastic drugs, at nearly 1,240%
• Psoriasis medications had the smallest average percentage price increase of 180%
• Seven drugs more than quadrupled in retail price, with most increases occurring after 2011.

The study concludes that prices for multiple, frequently prescribed medications have risen at a pace greater than inflation, national health expenditure growth and increases in reimbursement for physician services.

Why have prices increased?

Specific reasons for the increases in the costs of dermatologic prescription drugs were not detected, nor were they investigated at this stage. However, the team puts forward a number of possible factors.

Mergers and acquisitions enable pharmaceutical companies to corner specific drug markets, thereby using a large market presence to leverage higher prices for products within a therapeutic class.

Drugs may retain their patent longer than originally intended. The main patent for Enbrel, for example, was due to expire in October 2012, but changes to patent laws mean have extended protection from generic competition through 2028.

Medication shortages because of manufacturing complications and limited availability of active ingredients have been cited as a reason for significant price increases in some cases. However, two such drugs are now readily available and no longer on the US Food and Drug Administration (FDA) list of drug shortages, but their prices have not returned to previous levels.

In some countries, such as France, government health programs can legally negotiate drug prices for beneficiaries; in the US, however, this is only permitted for the Department of Veterans Affairs and the Department of Defense’s Tricare program.

Patients with prescription drug coverage on their insurance may not notice the retail price of medications, but high drug prices are reflected in increasingly expensive monthly insurance premiums.

Patients without insurance pay high retail list prices for their medications. Medicare patients are ineligible for pharmaceutical coupon savings, and even those with insurance are finding that formularies increasingly restrict accessibility to medications, unless they pay out of pocket.

The researchers propose future investigations to focus on reasons for the price increases.

Medical News Today recently reported on a drop in spending on public health in the US.