U.S. Cancer Market

U.S. Cancer Market

• Massive price increases for many "old" U.S cancer drugs since Part D began
  • 60-70% of cancer drug use typically in Part D senior citizens

• "Old" U.S cancer drugs set stage for standard $100,000-300,000 or more patient/year costs for new cancer drugs

• The PBM industry has publicly admitted that pharmaceutical company "rebates/discounts"  for U.S. cancer drugs are commonly ZERO
  • As per the the CEO of Express Scripts (now part of Cigna); “Alternatively, in oral oncology, for example, rebates are practically nonexistent. Only 2 out of the 88 products pay rebates, yet prices have gone up 100% over five years. You can’t blame rebates for that.” Express Scripts Fourth Quarter 2016 Earnings Conference Call, February 15, 2017.
  • Link to Whistleblower case PBM CEO public discussion of cancer drug "rebates/discounts"

• With minimal or non-existent pharmaceutical company cancer drug "rebates":
  • Virtually ALL massive U.S cancer drug costs from severe price increases are passed on to patients, clients and taxpayers
  • And the health insurer/PBMs make virtually ALL their profits on cancer drugs secretly from huge "pharma fees" directly tied to massive "sticker" prices
    • For extreme-priced U.S. "oral" cancer drugs ($100,000-300,000 patient/year), the health insurer/PBMs may be getting $8,000-$30,000 in "fees" per patient/year
    • For doing little more than mailing cancer prescriptions to a patient's home

Whistleblower case: U.S. Chronic Leukemia Drugs

• Novartis' Gleevec (on U.S. market since 2001)
• Novartis' Tasigna (on U.S. market since 2007)
• Bristol-Myer's Squibb's Sprycel (on market since 2006)

• Massive U.S. price increase despite severe competition
• Link to Whistleblower table showing severe U.S. leukemia drug price increases

Novartis' Gleevec - Severe U.S Pricing Abuse

• A top-selling Medicare Part D cancer drug
• • Early 2016 U.S. patent expiration
• 2005 Reported U.S. Sales: $524 million
• 2015 Reported U.S. Sales: $2.5 billion
• 2015 U.S. Sales WITHOUT Price Increases: $700 million
• 2005 U.S. “List”/“Sticker”: $30,000/patient/year
• 2015 U.S. “List”/“Sticker”: $150,000/patient/year
• Cumulative harm since start of Part D: $7.4+ billion
• Link to Gleevec Whistleblower cumulative harm chart