OBJECTIVES: Numerous oral chemotherapies have been approved and widely used for the treatment of different cancers. The objective of this study is to examine drug utilization and price trends for oral chemotherapies in US Medicaid programs. METHODS: A total of 18 oral anti-cancer drugs were included in this research. A retrospective, descriptive time-series analysis was performed using the National Medicaid pharmacy claims database from 1991 to 2008. The quarterly prescription numbers and reimbursement amounts were calculated over time by summing data for individual drug products. The quarterly per-prescription reimbursement as a proxy for drug price was computed for the price of each oral chemotherapy drug. RESULTS: Total oral chemotherapy prescriptions increased from 176,000 in 1991 to 259,000 in 2004. For individual drugs, the two top-sell drugs are Vesanoid® and Hydrea® in terms of prescription numbers. In 2006 the number of prescriptions dropped to 164,535 due to the implementation of Medicare Part D, and increased to 188,689 in 2008. Expenditure for oral chemotherapy drugs increased from $9.3 million in 1991 to $112.3 million in 2005 then dropped to $100 million in 2008. Medicaid expenditure for oral anti-cancer drugs reached to the peak in 2005 quarter 4, which was almost $29 million, then the expenditure dropped to $26.5 million in 2008 quarter 4. Average oral chemotherapy drug payment per prescription also increased dramatically from $1269 in 1991 to $14,297 in 2008. The price of newer oral chemotherapies is more expensive than older ones, and increased over time regardless other brands' competitions. CONCLUSIONS: Increased utilization of oral chemotherapy drugs was paralleled with its increased expenditure, which may be due to their efficacy and safety profiles. Increased price for oral chemotherapies may be due to biomarkers specifications with limited patient pool or the shrink demand.
Bian, B., & Guo, J. (2010). PCN36 DRUG UTILIZATION AND PRICE TRENDS OF ORAL-CHEMOTHERAPY MEDICATIONS IN MEDICAID 1991–2008. Value in Health, 13(7), A516. https://doi.org/10.1016/s1098-3015(11)73127-8