Biogen Idec Inc. and Bayer AG would have to cut the price of their multiple sclerosis drugs by at least two-thirds in the U.S. to make them cost effective at boosting quality of life, a study found.
Disease-modifying drugs for MS like Avonex from Weston, Massachusetts-based Biogen, and Betaseron, sold by Leverkusen, Germany-based Bayer, are at least eight times costlier than what researchers consider reasonable when putting a price on quality-of-life improvement, according to the study published today in the journal Neurology. The study also found that prescribing the drugs in earlier stages of MS improved cost effectiveness.
Multiple sclerosis affects about 400,000 people in the U.S., and 2.1 million worldwide, according to the National Multiple Sclerosis Society. The chronic disease attacks the central nervous system and can cause paralysis, numbness in limbs and vision loss. The disease-modifying drugs, which delay progression and reduce relapse of MS, can cost about $34,000 a year in the U.S., compared with about 8,000 pounds ($12,920) in the U.K., the study said.
“Simply reducing the price of these drugs to a level for what they’re sold in the U.K. and Europe will bring the number to a much more acceptable level,” Katia Noyes, lead author of the study and chief of the Division of Health Policy and Outcomes Research at the University of Rochester School of Medicine in New York, said today in a telephone interview.
Researchers generally accept $100,000 per quality-adjusted life year, or QALY, as a “reasonable” threshold, Noyes said. The metric incorporates the effect of treatment on duration and quality of life. For the MS drugs examined in the study, the measure exceeded $800,000 per QALY.
In addition to Biogen and Bayer’s medicines, the researchers looked at Copaxone, which is sold by Petah Tikva, Israel-based Teva Pharmaceutical Industries Ltd., and Rebif, from Darmstadt, Germany-based Merck KGaA.
The study also found prescribing medicines at earlier stages of the disease improved their cost effectiveness. For Biogen’s Avonex, the cost per QALY when starting the drug at stage 2 of the disease, when most patients start to show symptoms, falls to about $730,000 compared with $898,000 for stage 3, Noyes said.
“As soon as they’re diagnosed, if they go on this medication, that will have observable benefit,” she said. “You can see why people may not do it. They say, ‘This is so expensive, I want to save it as my last resort.’”
That’s not as effective as using the medicines as first-line therapies, Noyes said. About half of MS patients don’t use any disease-modifying drugs, “probably because cost is a barrier,” she said.
Avonex’s “pricing is consistent with the real world value it delivers to patients with MS,” Jeff Boyle, a spokesman for Biogen, wrote in an e-mail today. “Avonex remains the least expensive option for those looking to slow the progression of their MS.”
Biogen has a “significant commitment” to patient access, Boyle wrote. “If there is a patient in need, we will find a way to help.”
Denise Bradley, a spokeswoman for Teva, said the study’s “short timeframe” was a “data limitation.”
“Multiple sclerosis is a lifelong disease, and when longer timelines that are consistent with the disease are used, the cost per QALY is similar to those in other high-burden illnesses,” Bradley wrote in an e-mail.
Renee Connolly, a spokeswoman for EMD Serono Inc., a unit of Merck KGaA, said her company has “comprehensive patient-assistance programs.”
“The overall clinical benefit of disease-modifying therapies, including Rebif, or interferon beta-1a, have been established in well-controlled Phase 3 clinical studies,” Connolly said in a statement.