Lemtrada & The Economics of MS Treatments
Did you hear the news? Alemtuzamab (Lemtrada) has been approved as the next MS treatment drug, But there are still lots of questions to be answered about this drug. For now, I want to focus on the cost of Lemtrada.
Disease modifying therapies for multiple sclerosis are expensive – no one can deny that fact. The price of these drugs have also escalated over the past few years to the point we might question when will insurance declare ‘enough!’ and refuse access to some if not all of these drugs? I wrote about this a while back in At What Cost can We Continue to Treat MS?
Since the time I wrote about these costs, Lemtrada was approved by the FDA and has been added to our list of MS treatment options. Lemtrada, (alemtuzamab), was also known as Campath in its previous lifetime of use. You can read more about how this drug sold by Genzyme Sanofi, went from being used for leukemia to the new wonder drug for MS, at Stephanie Butler’s Lemtrada Approved by FDA.
The sticker price for Lemtrada is $158,000 for the first round of drugs, according to the press releases; that’s for the initial five days of infusions and the three day treatment one year later.
It is hard to understand why Lemtrada will cost over $20,000 per dose compared to the cost of Campath. When Campath was pulled from being sold in the US in 2012 so Genzyme Sanofi could apply for MS use with the FDA, the annual cost was $60,000, but that treatment involved 3 infusions a week for 12 weeks.1 That is 36 vials of this wonder drug, at a cost of not quite $2,000 each dose.
Should we be angry about this difference? I know I am. How can the manufacturer, Genzyme Sanofi, justify going from $2000 to $20,000, in the cost of one dose of aletuzamab, a 900% increase ?
I heard the argument that even though $158,000 is a lot of money, in the long run it might be the most cost effective way to treat our MS. The spin on this cost increase centers around how much money will be saved if our MS is forced into dormancy by this drug. We can stop going to doctors as often, we won’t need emergent care or rehabilitation services, and this is a one-time charge that won’t be repeated again and again like the other disease modifying therapies. If this works as promoted, we will be less likely to need to quit work and go onto disability. There won’t be a need for long-term care facilities or home health care workers if those of us with MS continue to be symptom free. That is a lot of money savings, considering we could live for decades needing all these extra medical interventions. In other words, you and I as consumers, our insurance companies and the government will all save money in the long run.
Equally important to me ---- we can’t put a price on the quality of life that could be had if we can focus on family, friends and work, and ignore most of the problems with MS.
It is suggested through the Lemtrada trial results that some people, but not the majority, may need a third, fourth or fifth year of the three dose regimen to keep the effect of the Lemtrada working, but according to the numbers from the Lemtrada clinical trial, the majority of people will only need the initial five treatments and the three dose follow-up one year later.
The economic challenges of living with MS force me to revisit the numbers and cost of Lemtrada. The worst case scenario with Lemtrada’s approximate costs based on 2014 prices might be:
Years 1 & 2.............. $158,000
Year 3....................... $60,000
Year 4....................... $60,000
Year 5....................... $60,000
Lemtrada would total $338,000 for drug costs over five years, which would place it right in the midst of all the other disease modifying therapies. Using the prices from 2013, here is a list of what their use over those same five years would cost:
Looking at the numbers, it would appear insurance providers should jump at the chance to pay for Lemtrada and get us off the other MS drugs as fast as possible. BUT if Lemtrada were priced the same way as its partner, Campath, the drug cost for the first treatments would amount to about $16,000, which is a far cry from $158,000. If that were the case, I could also jump for joy that this is a drug that holds great promise, and demonstrates that Genzyme Sanofi put the needs of patients before the profit for stockholders.
I don’t expect to see great numbers of people making the switch right away because there are many questions about the use of Lemtrada and its benefits, side effects and safety profile, which many of us will be writing about in the near future as more is understood about this potent drug. Also, the FDA approval is given for use after the person has failed two other types of MS treatments, which means it is not a first line disease modifying therapy drug.
In the meantime, while the trial results for the use of this drug in relapsing forms of MS holds great promise, my excitement for Lemtrada’s possibilities as a treatment that brings us close to a cure for MS is dampened by the super inflated drug charges of 900% for each vial of alemtuzamab.
Wishing you well,
Who can relate? "Just because I could do something last year, last month, last week or yesterday doesn’t mean I can do it today. Also, it doesn’t mean I can’t."