TABLE 1.
Changes in Annual Costs of Treatment and Percentage of List Price Increases Offset by Discounts
| Etanercept | Adalimumab | Golimumab | Certolizumab | |
|---|---|---|---|---|
| List price | ||||
| Initial annual cost of treatment, $ (year) | 17,364 (2007) | 17,689 (2007) | 20,358 (2010) | 22,992 (2010) |
| Final annual cost of treatment, $ (year) | 68,277 (2019) | 69,850 (2019) | 57,610 (2019) | 64,911 (2019) |
| Relative change, % | 293.2 | 294.9 | 183.0 | 182.3 |
| Mean annual change, % | 12.2 | 12.3 | 12.3 | 12.3 |
| Net price | ||||
| Initial annual cost of treatment, $ (year) | 15,951 (2007) | 14,242 (2007) | 15,243 (2010) | 15,828 (2010) |
| Final annual cost of treatment, $ (year) | 43,148 (2019) | 43,088 (2019) | 30,939 (2019) | 33,146 (2019) |
| Relative change, % | 170.5 | 202.5 | 103.0 | 109.4 |
| Mean annual change, % | 10.7 | 9.9 | 8.7 | 9.2 |
| % of list price increase offset by discounts | 46.6 | 44.7 | 57.9 | 58.7 |
Notes: This table shows list and net estimates of the annual cost of treatment for etanercept, adalimumab, golimumab, and certolizumab in the first and last year of inclusion in our study period. Additionally, for each product, the table depicts the relative changes in annual costs of treatment across the study period, calculated as (final cost – initial cost)/(initial cost); the mean annual change, calculated as the mean year-over-year percent price change over the study period; and the percentage of list price increases offset by discounts, calculated as the difference between the absolute change (i.e., final cost – initial cost) in list and net prices divided by the absolute change in list prices. We defined annual cost of treatment based on FDA dosing recommendations as the mean cost for treating a standard patient with rheumatoid arthritis for a year. Net prices capture all manufacturer concessions including rebates, prompt pay discounts, volume discounts, copay cards, and any other concessions accounted for in the reporting of net sales.5 We excluded price observations in 2009 for golimumab and certolizumab due to data instability introduced by inventory variability of these drugs in their launch year. All price estimates are expressed in nominal dollars.
FDA = U.S. Food and Drug Administration.