Assessment of Price Changes of Existing Tumor Necrosis Factor Inhibitors After the Market Entry of Competitors | Rheumatoid Arthritis | JAMA Internal Medicine | JAMA Network
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    Research Letter
    February 18, 2019

    Assessment of Price Changes of Existing Tumor Necrosis Factor Inhibitors After the Market Entry of Competitors

    Author Affiliations
    • 1Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, Pennsylvania
    • 2Insurance Services Division, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
    JAMA Intern Med. 2019;179(5):713-716. doi:10.1001/jamainternmed.2018.7656

    Before 2009, etanercept, infliximab, and adalimumab were the only tumor necrosis factor (TNF) inhibitors approved by the US Food and Drug Administration for rheumatoid arthritis. Subsequently, 3 therapies have gained US Food and Drug Administration approval: subcutaneous golimumab (April 2009),1 certolizumab pegol (May 2009),2 and intravenous golimumab (July 2013).3 All 6 agents are brand-name drugs. We assessed how the prices of existing TNF inhibitors changed in response to the market entry of new TNF inhibitors.

    Using 2006-2016 wholesale acquisition costs obtained from Analysource (reprinted with permission from First Databank),4 we calculated monthly estimates of the annual costs of TNF inhibitor treatment. Using claims data from a 5% random sample of Medicare beneficiaries, we also calculated monthly estimates of annual costs of TNF inhibitor treatment (gross drug costs for drugs typically reimbursed under Medicare Part D [etanercept, adalimumab, subcutaneous golimumab, and certolizumab pegol] and total claim payment amounts for drugs typically reimbursed under Part B [infliximab and intravenous golimumab]). Estimates based on wholesale acquisition costs and Medicare Part D payment data were adjusted for increases in manufacturer rebates reported for Medicare Part D.5 This study was approved by the University of Pittsburgh Institutional Review Board as exempt because it used unidentifiable data.