Assessment of Price Changes of Existing Tumor Necrosis Factor Inhibitors After the Market Entry of Competitors | Rheumatoid Arthritis | JAMA Internal Medicine | JAMA Network
[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 34.204.186.91. Please contact the publisher to request reinstatement.
Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words
    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.

    ×