Variation in the prices of oncology medicines across Europe and the implications for the future

Godman, Brian and Simoens, Steven and Kurdi, Amanj and Selke, Gisbert and Yfantopoulos, John and Hill, Andrew and Gulbinovic, Jolanta and Martin, Antony P and Timoney, Angela and Gotham, Dzintars and Wale, Janet and Bochenek, Tomasz and Selke Krulichová, Iva and Allocati, Eleonora and Hoxha, Iris and Malaj, Admir and Hierländer, Christian and Nachtnebel, Anna and Hamelinck, Wouter and Mitkova, Zornitza and Petrova, Guenka and Laius, Ott and Sermet, Catherine and Langner, Irene and Joppi, Roberta and Jakupi, Arianit and Poplavska, Elita and Greiciute-Kuprijanov, Ieva and Vella Bonanno, Patricia and Piepenbrink, Hans and de Valk, Vincent and Plisko, Robert and Wladysiuk, Magdalene and Marković-Peković, Vanda and Mardare, Ileana and Novakovic, Tanja and Parker, Mark and Fürst, Jurij and Tomek, Dominik and Banasova, Katarina and Cortadellas, Merce Obach and Zara, Corrine and Pontes, Caridad and Juhasz-Haverinen, Maria and Skiold, Peter and McTaggart, Stuart and Wong-Rieger, Durhane and Campbell, Stephen and Hill, Ruaraidh (2021) Variation in the prices of oncology medicines across Europe and the implications for the future. Generics and Biosimilars Initiative journal, 10 (2). pp. 72-82. ISSN 2033-6403

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Introduction/ Objectives: There are increasing concerns among health authorities regarding the sustainability of healthcare systems with growing expenditure on medicines including new high-priced oncology medicines. Medicine prices among European countries may be adversely affected by their population size and economic power to negotiate. There are also concerns that prices of patented medicines do not change once the prices of medicines used for negotiations substantially change. This needs to be investigated as part of the implications of low-cost generic oncology medicines. Methodology: Analysing principally reimbursed prices of patented oral oncology medicines (imatinib, erlotinib and fludarabine) between 2013 and 2017 across Europe and exploring correlations between GDP, population size, and prices. Comparing the findings with previous research regarding prices of oral generic oncology medicines. Results: The prices of imatinib, erlotinib and fludarabine did vary among European countries but showed limited price erosion over time in the absence of generics. There appeared to be no correlation between population size and prices. However, higher prices were seen among countries with higher GDP per capita which is a concern for lower income countries referencing these. Discussion and Conclusion: It is likely that the limited price erosion for patented oncology medicines will change across Europe with increased scrutiny over their prices and value as more medicines used for pricing decisions lose their patents combined with growing pressures on the oncology drug budget. In addition, discussions will continue regarding fair pricing for new oncology medicines and other approaches given ever rising prices with research showing substantial price reductions for oral oncology medicines (up to -97.8% for imatinib) once generics become available. We are also seeing appreciable price reductions for biosimilars further increasing the likelihood of these developments.