Table 3.
Median Total Patient OOP Cost Savings for a Course of Oral Anticancer Therapies for Closing the Doughnut Hole Under Varying Assumptions With Regard to Drug Pricing
| 2010 |
Base Case (No Change in Price; $) | 50% Price Increase ($) | 50% Price Decrease ($) | ||||
|---|---|---|---|---|---|---|---|
| Drug | Estimated OOP 2010 | Estimated OOP 2020 | Savings From 2010 | Estimated OOP 2020 | Savings From 2010 | Estimated OOP 2020 | Savings From 2010 |
| Abiraterone | 7,156 | 4,621 | 2,535 | 6,023 | 1,133 | 3,220 | 3,936 |
| Afatinib | 7,817 | 5,242 | 2,575 | 6,968 | 849 | 3,532 | 4,285 |
| Axitinib | 7,877 | 5,345 | 2,532 | 7,108 | 769 | 3,582 | 4,295 |
| Cabozantinib | 8,174 | 5,597 | 2,577 | 7,508 | 666 | 3,709 | 4,465 |
| Crizotinib | 9,120 | 6,552 | 2,568 | 8,917 | 203 | 4,187 | 4,933 |
| Dabrafenib | 6,454 | 3,889 | 2,565 | 4,923 | 1,531 | 2,855 | 3,599 |
| Dasatinib | 10,075 | 7,531 | 2,544 | 10,386 | (311) | 4,676 | 5,399 |
| Enzalutamide | 8,002 | 5,480 | 2,522 | 7,320 | 682 | 3,646 | 4,356 |
| Erlotinib | 7,853 | 5,309 | 2,544 | 7,054 | 799 | 3,563 | 4,290 |
| Everolimus | 6,836 | 4,291 | 2,545 | 5,525 | 1,311 | 3,056 | 3,780 |
| Imatinib | 9,062 | 6,508 | 2,554 | 8,855 | 207 | 4,162 | 4,900 |
| Lapatinib | 6,660 | 4,121 | 2,539 | 5,280 | 1,380 | 2,970 | 3,690 |
| Lenalidomide | 7,084 | 4,561 | 2,523 | 5,932 | 1,152 | 3,189 | 3,895 |
| Nilotinib | 10,083 | 7,545 | 2,538 | 10,410 | (327) | 4,680 | 5,403 |
| Pazopanib | 7,518 | 4,981 | 2,537 | 6,566 | 952 | 3,400 | 4,118 |
| Pomalidomide | 10,800 | 8,223 | 2,577 | 11,451 | (651) | 5,006 | 5,794 |
| Regorafenib | 6,630 | 4,099 | 2,531 | 5,242 | 1,388 | 2,959 | 3,671 |
| Sorafenib | 7,598 | 5,063 | 2,535 | 6,696 | 902 | 3,440 | 4,158 |
| Sunitinib | 12,163 | 9,623 | 2,540 | 13,528 | (1,365) | 5,721 | 6,442 |
| Trametinib | 6,756 | 4,188 | 2,568 | 5,371 | 1,385 | 3,005 | 3,751 |
| Vandetanib | 11,218 | 8,650 | 2,568 | 12,092 | (874) | 5,230 | 5,988 |
| Vemurafenib | 7,149 | 4,623 | 2,526 | 6,029 | 1,120 | 3,221 | 3,928 |
| Vorinostat | 6,650 | 4,112 | 2,538 | 5,259 | 1,391 | 2,965 | 3,685 |
NOTE. Analysis is based on the July 15, 2014, quarterly release of the Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information Files from the Centers for Medicare & Medicaid Services. Input price is from the formulary files and represents the average reimbursed amount across each plan for the product listed for 1 month of therapy at the mean recommended dose. Savings in the base case scenario are attributed to the 50% manufacturer discount during the doughnut hole. These contributions from the manufacturer are included in the patient out-of-pocket limit of $4,700. After reaching this limit, beneficiaries pay 5% of the drug price until the beginning of the next calendar year.
Abbreviation: OOP, out of pocket.