t a time when drug makers are under intense scrutiny for their pricing, Ariad Pharmaceuticals does not appear to have any concerns about continually raising the price of an already expensive medicine.
Since the beginning of the year, the company raised the price of its Iclusig chronic myeloid leukemia treatment four times, which has amounted to a cumulative increase of 27 percent. As a result, the drug now has a list price of $16,560 a month, or almost $199,000 a year, before any rebates or discounts. And Ariad had also raised the price twice last year.
This string of price hikes come amid increasing national angst over prescription drug prices. The issue has become a talking point in the presidential campaign, sparked numerous congressional hearings and investigations, and spurred lawmakers in Congress and many state legislatures to introduce bills to contain costs.
Ariad, however, is bucking the trend. In explaining the rising prices, an Ariad spokeswoman sent us a statement saying the company assesses “pricing based on a range of factors, including efforts to make sure that pricing appropriately reflects the benefit the therapy delivers to patients and to the healthcare system.
“We have substantial clinical data highlighting the benefits of Iclusig, as you know, which addresses an area of high unmet medical need in an ultra-orphan patient population of around 1,000 to 2,000 patients per year. We believe that our pricing actions also consistently reflect our significant investment in R&D and our ongoing commitment to the patient population we serve through our medicines.”
Interestingly, the price hikes, which were first reported by TheStreet, began a year after a labeling change that restricted usage to a smaller patient population. In December 2012, the US Food and Drug Administration approved Iclusig for patients who did not respond to other treatments. But a subsequent health scare prompted the agency to restrict its use.
In October 2013, the FDA began investigating reports of serious and life-threatening blood clots and severe narrowing of blood vessels, and asked Ariad to suspend sales. Two months later, the agency allowed the company to resume marketing, but as TheStreet pointed out, usage was then limited to only certain patients with a genetic mutation that made them resistant to other drugs.
At that time, the list price was $10,350 for a month’s supply of 45 mg tablets, which was the recommended dose, but Ariad later took two price hikes in 2015 that brought the cost to $11,950, according to Truven Health Analytics. As we noted, the company then began raising the price still more this past January.
“This drug has a tattered history,” said Dr. Peter Bach, who heads the Center for Health Policy and Outcomes at Memorial Sloan-Kettering Cancer Center. “If the drug works well and has a good side effect profile, it should have a higher price. But there have been signals about problems. So both of things can’t be true, yet there’s no downward pressure on price. They just decide what they think they can get away with and serially raise the price every few months.”
These price hikes, however, are fueling Wall Street.
Analysts, not surprisingly, want to know whether the drug maker can meet revenue and profit expectations. “If Ariad is able to meet or exceed product guidance for Iclusig this would move the stock higher, given strong execution in both US and EU given prior concerns about safety and competition,” RBC Capital Markets analyst Michael Yee wrote in an investor note shortly after a July price hike.
We should note that Ariad also effectively doubled the price of its 15 mg tablet. Until September 2014, a two month’s supply, which was 60 tablets, carried a list price of $10,350, but Ariad discontinued sales of this quantity. Instead, the company began charging the same price for 30 tablets of the 15 mg dose, according to Truven.
“There are a growing number of situations where there are no legitimate alternative treatment choices,” said Dr. Clifford Hudis, who heads the American Society of Clinical Oncology. “Instead, a very narrowly targeted and highly effective drug is the accepted standard of care making it inappropriate to consider other approaches. This highlights some of the ongoing challenges we must confront as we recognize that conventional market forces do not readily lead to efficient pricing of cancer treatments.”