Mark Cuban company could yield savings on seven Medicare generic oncology drugs
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Key takeaways:
- Researchers estimated a potential savings of $661.8 million with prices offered through the Mark Cuban Cost Plus Drug Company.
- Individuals could save about $25,000 for abiraterone annually.
Mark Cuban Cost Plus Drug Company’s pricing could yield significant savings for seven generic oncology drugs vs. Medicare Part D median formulary prices, according to study results published in Journal of Clinical Oncology.
Medicare Part D cash-pay prices for abiraterone and imatinib under the catastrophic phase of coverage exceeded even baseline prices for Mark Cuban Cost Plus Drug Company (MCCPDC), according to the researchers.
Rationale and methodology
“Self-administered oncology drugs contribute disproportionately to Medicare Part D spending; prices often remain high even after generic entry,” Brian D. Cortese, BS, researcher at Perelman School of Medicine at University of Pennsylvania, and colleagues wrote. “Outlets for low-cost drugs such as [MCCPDC] offer opportunities for decreased Medicare Part D and beneficiary spending.”
Researchers sought to estimate potential savings if Medicare Part D plans obtained prices such as those offered under the MCCPDC for seven generic oncology drugs.
They used the 2020 Medicare Part D Spending dashboard, Q3-2022 Part D formulary prices and Q3-2022 MCCPDC prices for seven self-administered generic oncology drugs, replacing Q3-2022 Part D unit costs with costs under the MCCPDC plan to estimate Medicare savings.
Findings
Overall, researchers estimated potential cost savings of $661.8 million (78.8%) for the seven oncology drugs studied.
Compared with 25th and 75th percentiles of Part D plan unit prices, total cost savings with MCCPDC pricing in 2022 were between $228.1 million (56.1%) and $2.15 billion (92.4%).
Researchers additionally found median savings for replacing Part D plan with MCCPDC pricing of $338 million for abiraterone, $1.2 million for anastrozole, $15.6 million for 100 mg imatinib, $212 million for 400 mg imatinib, $1.9 million for letrozole, $26.7 million for methotrexate, $63.8 million for raloxifene and $2.6 million for tamoxifen.
Only three 30-day prescription oncology drugs did not result in cost savings with MCCPDC pricing — anastrozole, letrozole and tamoxifen.
Study limitations include the assumption that generic drug use in 2022 would match the brand and generic volume of products filled in 2020, and difficulty estimating the exact number of potential beneficiaries.
Implications
The findings suggest that Medicare Part D plan sponsors and beneficiaries may be overpaying for the seven generic oncology drugs studied, according to the researchers.
“Physicians should be aware of cash-pay options available to patients that might offer lower prices to beneficiaries purchasing outside of their health plans and the impact that this drug price stewardship could have on Medicare and Part D sponsors,” they wrote.
References:
- Cortese BD, et al. J Clin Oncol. 2023;doi:10.1200/JCO.23.00079.
- Study finds Mark Cuban’s Cost Plus drug company could save taxpayers millions on Medicare generic oncology drugs (press release). Available at: https://www.eurekalert.org/news-releases/991965 . Published June 8, 2023. Accessed July 3, 2023.