Just a thought....

[4boysmom]

Do you think as more pill-forms of treatments are released, the cost of the injectables will go down?

It seems all the meds cost about the same, go up in price about the same. Just thinking as some switch to pill form of treatment, the injectables will be less desireable, so many go down in price?

[dalechilders51]

Brenda, I would be very supprised if this happens. Patent medicines don't follow the law of supply and demand like other products. Just my take on it. Dale

[MSer102]

I think its possible that the prices of the injectibles could come down a least some. With or without a patent supply and demand absolutely does apply if there's no demand.

Some medicines have been pulled from the market when there wasn't enough demand and other medicines just don't make it to the market because there won't be enough demand to make it worthwhile. So I think its possible that the prices might come down if that makes it worth keeping the drug for sale. I think since there are three interferons available one of them might be the first to come down maybe.

I'm not sure there will be NO demand for the injectibles because they're lower risk than the pill forms, Tysabri and chemo drugs. So there will probably be people who have done well on them who will stay on them because of that. Having all of these medicines available for MS has never happened before so I think it will be interesting to see what all the companies do.

[MarkLavelle]

The costs of all the DMDs will only go down when their patents expire.

I'm pretty sure the Copaxone & interferon patents start expiring in a couple of years, but the drug companies have some tricks for keeping the prices up for a few more years after that...

[onlyairfare]

When I first began Copaxone in 2002 the list price was $985 per month, and the company made money on it at that price, so the prices could go a lot lower and they would still be very profitable.

Therefore, I could see the possibility that injectables' prices would go down if demand weakens due to patients preferring pills to shots. That could be especially true as patents run out and generic competition becomes available - if it does.

If Teva were to make "extended release Copaxone" that required one shot once per week, that could extend the patent. Or Teva could simply "pay to delay" by offering the competition money if they will delay producing a generic version.

We'll have to wait and see what happens.

[MarkLavelle]

If Teva were to make "extended release Copaxone" that required one shot once per week, that could extend the patent. Or Teva could simply "pay to delay" by offering the competition money if they will delay producing a generic version.

I'm pretty sure Teva can get a new patent if they can show that every other day works approximately as well as daily (although weekly would be much better from the marketing point of view). I know a study on that has been done.

I'm pretty sure that blatant "pay to delay" agreements are already illegal, and the Supreme Court just heard a case that might even end up outlawing the main 'tricky' version.

[its2much]

It's my understanding

that the company that wants the generic sues the company that has the patent. The lawsuit is later settled before going to trial. The plaintiff (company wanting to produce the generic) gets a hefty settlement. I guess the company that pays also increases their prices so that they can pay the settlement.
It also almost seems like price fixing. There's no longer competition.
People certainly get hurt in a number of ways when the price increases and there's a monopoly - health insurance rates go up, those with huge co-pays get hit, etc. Doesn't it also cost the government (taxpayers) more when drug costs are subsidized by the government and the company has increased their price?
Are there really people who choose to not use DMD's and let their MS will progress?

[MSer102]

that the company that wants the generic sues the company that has the patent. The lawsuit is later settled before going to trial.

Wow that's new to me! I guess i don't understand how that works. If a patent gives a company exclusive rights to a product and prevents other companies from selling it then what could other companies possibly be suing for? And why on earth would the company that already has the rights to the product settle when its already illegal for anyone else to sell it? Wouldn't those types of deals happen when the patent is about to expire and there's something to sue about?

It also almost seems like price fixing. There's no longer competition.

It sounds like that's how the government is looking at it. But I'm still not sure its quite the same thing when it comes to medicines because even tho there might not be competition for that drug there are already so many other drugs available that do the same thing. So as far as a class of drug or what it does there's plenty of competition. Think of how many blood pressure medicines and antidepressants there are! For MS there are three interferons. That sounds like competition to me even if there aren't generics.

People certainly get hurt in a number of ways when the price increases and there's a monopoly - health insurance rates go up, those with huge co-pays get hit, etc.

That could be true but the drug companies are already making deals with insurance companies so I'm not sure its as big an issue in why health insurance rates go up as some people want to make it seem. I think there are SO many more things that go into why health insurance costs so much. Doctors and hospitals cost a lot more than drugs do.

I do think its why drugs and drug copayments cost so much but the drug companies often have assistance programs so people still get help with getting medicines anyway so deals the companies make to keep generics off the market don't hurt people as much as some people want to make it seem. And I'm one of those people who thinks that if I don't like a medicine or the company that makes it or how much it costs then I don't have to take it. And for a lot of them I don't.

Does anybody actually know anyone in the US who is paying full retail price out of pocket for a DMD - like $20,000 or $50,000 a year (not counting millionaires who are silly enough to not have insurance )? Why would they when there are assistance plans available?

Are there really people who choose to not use DMD's and let their MS will progress?

MS progresses anyway! From everything I've read - and I've read a lot - it sounds like DMDs can reduce the number or relapses and work really well in SOME people but they don't stop the degenerative part of the progression.

A lot of people choose not to take DMDs for a lot of different reasons. It looks like there are people on this forum who don't take them. I've tried some of them and I don't like the side effects. If I'm going to not feel well I would much rather that I'm sick from the disease and not from the treatment.

I've read that less than half the people who have MS take a DMD tho its not always by choice. If that's true then in the US there are only about 200,000 people taking a DMD. A lot of medicines have millions of people taking them. So for MS that's not very many. I think that's maybe another reason why the MS medicines cost so much - not many people taking them but they're willing to pay for them even if their copayment is high.

You know if nobody bought the DMD's then it wouldn't matter how much they cost.

[onlyairfare]

The defendant firm (the company that owns the patent) claims that a new variation in the form of its old drug (that has just lost or is about to lose its patent protection) makes it a different product that remains patent-protected by an extension of the original patent. The would-be generic manufacturer is the plaintiff, and might sue on the grounds that the "new" product is the same as the old product, and is thus no longer protected by the patent.

My own opinion, and I am not a lawyer but just a former health insurance executive, is that the price-fixing comes in when all the MS medications "just happen" to cost the same $3,000 per month. Except that Gilenya is $4,000 per month because Novartis figures people will pay the extra $1,000 per month for a pill instead of a shot.

Yes, most insurers contract with a PBM (Pharmacy Benefits Manager) to negotiate lower prices. And pharmas offer co-pay assistance so that most patients who can't afford the high co-pay demanded by their insurer will still get the drug. When I quit taking Copaxone due to the cost (my insurer changed the co-pay to 25% of list price instead of a flat rate 0f $50 or $100 per month), Teva lost not only my $800 but also the $2,400 per month my insurer would have paid them. Or whatever the negotiated rate was.

The drug companies just manipulate the pricing to maximize profits - some people are able to take the drug because of co-pay assist, while others get priced out completely by too high a co-pay. The $800 per month I was asked to pay amounts to $9,600 per year, and that was on top of the $6,000 annual high deductible, as well as other co-pays on other prescriptions and procedures and MRI's, not to mention premiums for the insurance policy itself ($1,600 per month for COBRA after "right-sizing").

You ask if there are really people who do not take medication due to the cost? Well yes, in fact I think most people in this country cannot afford $30,000+ annually for health care costs, or even $9,600 in co-pays. If I had to, I could have managed to pay the $800 per month, but I felt that the money was better spent on my son's college tuition so he could graduate debt-free. Because yes, MS progresses or it doesn't anyway. The DMD's may slow this down somewhat. Or not.