Cost Trends of New-To-Market Neurologic Medications: An Insurance Claims Database Analysis

Area of Science:

• Neurology
• Health Economics
• Pharmacoeconomics

Background:

• Neurologic medication costs have risen substantially in recent years.
• Over 30 new neurologic medications have been approved by the FDA since 2014.
• Characterizing cost trends for these new drugs is crucial for understanding patient and societal financial burdens.

Purpose of the Study:

• To analyze annual and aggregate spending trends for new-to-market (NTM) neurologic medications.
• To compare costs of NTM medications versus older, guideline-supported treatments.
• To examine out-of-pocket (OOP) and total medication costs for 9 neurologic conditions from 2012 to 2021.

Main Methods:

• Utilized Merative MarketScan databases (commercial and Medicare supplemental).
• Observed patients with 9 neurologic conditions (ALS, ATTR, DMD, HD, MG, migraine, OH, TD, SMA) receiving newly FDA-approved medications (2014-2021).
• Analyzed annual medication fills and associated OOP and total costs for NTM and older medications.

Main Results:

• Migraine medications showed the largest aggregate cost increase (1993%) and a 234% rise in OOP costs.
• Eculizumab for myasthenia gravis (MG) was an outlier, with OOP costs increasing by 4,099%.
• Significant OOP cost increases were also observed for edaravone (1,775%) and deutetrabenazine (971%).

Conclusions:

• New-to-market (NTM) neurologic medications incur substantial and escalating individual and societal costs.
• Older, generic medications did not exhibit similar cost increases.
• Policy interventions are needed to mitigate the financial impact of NTM medications on patients with neurologic diseases.