Table 1.
Disease modifying therapy (DMT) annual costs from market introduction to present, estimated Medicaid costs, and VA costs
| DMT (approval date) | Annual cost at market introduction ($) | Median annual cost increases (%) | 2017 annual cost ($)* | 2017 cost net standard medicaid rebate ($)† | 2017 big-4 pricing ($) | ||
|---|---|---|---|---|---|---|---|
| 1998– 2001 | 2002–09 | 2010– 16 | |||||
| IFN-β1b; Betaseron™ (July 1993) | 10,920 | 0.0 | 15.9 | 14.1 | 86,421 | 66,458 | 38,261 |
| IFN-β1a IM; Avonex™ (May 1996) | 8261 | 2.3 | 17.6 | 16.1 | 81,731 | 62,851 | 46,452 |
| Glatiramer acetate; Copaxone™ 20 mg (December 1996) | 7852 | 2.5 | 18.1 | 16.5 | 86,554 | 66,560 | 48,821 |
| IFN-β1a SC; Rebif™ (March 2002) | 13,875 | NA | 13.7 | 12.5 | 86,179 | 66,272 | 31,409 |
| Natalizumab; Tysabri™ (November 2004‡) | 23,500 | NA | 6.1 | 11.3 | 78,000 | 59,982 | 41,299 |
| IFN-β1b; Extavia™ (August 2009) | 29,842 | NA | NA | 13.4 | 72,160 | 55,491 | 35,006 |
| Fingolimod; Gilenya™ (September 2010) | 48,083 | NA | NA | 9.5 | 86,966 | 66,877 | 48,610 |
| Teriflunomide; Aubagio™ (September 2012) | 45,124 | NA | NA | 18.3 | 76,612 | 58,915 | 48,987 |
| Dimethyl fumerate; Tecfidera™ (March 2013) | 54,750 | NA | NA | 5.0 | 82,977 | 63,809 | 46,745 |
| Glatiramer acetate; Copaxone 40 mg™ (January 2014) | 60,336 | NA | NA | 7.9 | 75,816 | 58,303 | 47,661 |
| Pegylated IFN-β1a; Plegridy™ (August 2014) | 62,036 | NA | NA | 10.6 | 81,731 | 62,851 | 46,591 |
| Alemtuzumab; Lemtrada™* (November 2014) | 65,833 | NA | NA | 1.2 | 69,166 | 53,189 | 60,466 |
| Glatiramer acetate; Glatopa™ (April 2015) | 63,193 | NA | NA | 0 | 63,193 | 48,595 | 32,552 |
| Daclizumab; Zinbryta™* (May 2016) | 82,000 | NA | NA | NA | 86,838 | 66,778 | 61,251 |
| OcrevusTM* (March 2017) | 65,000 | NA | NA | NA | 65,000 | 49,985 | 49,400 |
Wholesale Acquisition Cost (WAC) data accessed through FirstDataBank. Big Four Pricing data accessed through (https://www1.va.gov/nac/Pharma/List). IFN = interferon; SC = subcutaneous; NA = not available
*June 2017
†Acquisition costs estimating using wholesale acquisition costs. Medicaid rebate estimated to be 23.1% of WAC
‡Natalizumab withdrawn from market in February 2005; reintroduced in June 2006