Canadian researchers have called for the cost-effectiveness of drug products to be routinely reassessed. Their study, published in Current Oncology [1], has shown that cost-effectiveness of products alters significantly after generics are introduced. This has big implications for healthcare budgets and access to medicines, in Canada and worldwide.

The team, based at the University of Alberta, investigated drug products used in four controlled clinical cancer trials. They looked at the original economic analyses of these trials carried out prior to market entry. They then compared this to their own economic analyses repeated using the original costing methods, but replacing the prices of the branded drugs with those of their generic drug equivalents.

In all cases, the cost-effectiveness and cost-utility of medical intervention was found to have improved after genericization. For example, erlotinib was used in a trial to treat metastatic lung cancer. The generic version of erlotinib costs US$1,460.25 per 30 days and the use of this resulted in an incremental cost-effectiveness ratio of US$45,746 per life-year gained, compared with US$94,638 for branded erlotinib. In addition, generic cetuximab was used in a trial to treat metastatic colon cancer and costs US$275.80 per 100 mg. The introduction of this generic drug product produced an incremental cost-effectiveness ratio of US$261,126 per quality-adjusted life-year gained, compared with US$299,613 for branded cetuximab.

Despite finding that generics do offer healthcare systems welcome relief, the team have found that many generics are still too expensive. They indicate that price of many generic oncology drugs, such as cetuximab, still need to be reduced for some treatments become economically viable and sustainable.

The team hope that the results of their economic analysis provide evidence to support further future reassessment of the cost-effectiveness and cost-utility of medical interventions. To help healthcare systems allocate funds effectively, regular economic reassessment of medical interventions should be carried out to keep up with the changing price of the drugs available. Cancer treatment is particularly costly and oncology drugs can be central to funding debates. With better analysis of the economics following genericization, healthcare resources can be better allocated. Patients will then have improved access to effective treatment.

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Reference
1. Cheung WY, Kornelsen EA, Mittmann N. The economic impact of the transition from branded to generic oncology drugs. Curr Oncol. 2019 Apr;26(2):89-93.

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