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. 2022 May 13;9:68–72. [Article in Italian] doi: 10.33393/grhta.2022.2366

Analysis of the evolution of the price of oncology drugs after the loss of their patent and the marketing of generic medicines

José M Martínez-Sesmero 1, Borja Smith 2, Julen Madurga 2, 
PMCID: PMC9768611  PMID: 36628314

Abstract

Background and research question:

Loss of exclusivity of oncology drugs causes an important drop in their price due to the marketing of generic medicines. In this article we study how the price of certain oncology drugs evolves throughout time after the loss of their patent, both in terms of the notified price and at a level of the public tenders for the purchase of medicines.

Methods:

The variation in the price of oral oncology drugs was assessed from the public information provided by the Interministerial Medicinal Products Pricing Committee (Comisión Interministerial de Precios de los Medicamentos, CIPM) and the data from public tenders for the purchase of medicines.

Results:

The data show a significant drop in price of the medicines assessed after the expiry of their patent, both at a notified price level (70% of average drop in price in 2.6 years) and at the level of the public tenders (drops exceeding 90% in a year for the most innovative drugs).

Discussion:

The drop in the price of the oncology drugs after the expiry of their patent is seen in all the medicines assessed. The trends seen allow to predict the evolution of the price of another innovative medicine that is nearing the expiry of its patent (Lenalidomide), with an expected drop in price by 90% with respect to the current price of the innovative drug.

Keywords: Generic medicines, Lenalidomide, Oncology drugs

Introduction

Currently, cancer is the second cause of death in Spain, with 26.4% of the deceases in 2018 related to this group of diseases (112,714 deaths). Despite the alarming and high figures, the impact of these diseases decreases progressively. In fact, mortality due to cancer in Spain has been dropping steadily in the last years (1). This drop in the mortality caused by cancer is due, among other causes, to the appearance of new therapeutic innovations that allow to improve the prognosis of the oncology patients.

Patents protect and stimulate the development of new therapeutic innovations by the exclusive marketing rights provided by the protection guaranteed by the patents. Nevertheless, once this period has ended with the expiry of the patent, the price of the medicines drops because of the appearance of generic medicines (Gx). As the Spanish Generic Medicines Association (Asociación Española de Medicamentos Genéricos, AESEG) underlines, the drop in price caused by the appearance of the generic medicines and approved by the Interministerial Medicinal Products Pricing Committee (Comisión Interministerial de Precios de los Medicamentos, CIPM) fluctuates between 40% and 60% with respect to the cost of the brand drug (2). In the case of drugs for hospital use, as is the case of the oncology drugs, their purchase is carried out through a public tender process that favours competition between different suppliers (in this case, pharmaceutical companies). Tender process causes important drops in price that are greater than those seen in the approved prices notified by the CIPM.

Price drops allow to free public resources, optimising the health expenditure, therefore being able to relocate resources to other areas, so that the sustainability of the system is favoured, and the medical care improves (2).

This is especially relevant in the field of oncology, as highlighted in a recent study by Cheung et al (3). This study concludes that oncology generic medicines could significantly modify the cost-effectiveness and cost-utility ratios of the studied treatments.

The objective of this report is to analyse the influence of the generic medicines on the evolution of the price of oral oncology drugs after the loss of exclusive marketing rights, with the aim of showing the impact of generic medicines on the drop in price of oncology drugs and, therefore, on the drop in price of oncology treatments, in a quick and powerful way. Likewise, we look for the identification of trends in these drops in price that allow assessing the evolution in the price of oral oncology treatments that are nearing the end of their exclusive marketing rights period.

Methodology

Selection of drugs

With the intention of delimiting the analysis to a manageable sample size, oral oncology treatments, recommended for monotherapy or in combination with other drugs, whose patent had expired and that have generic medicines in the market, so there is a price competition that allows to see its evolution after the loss of their exclusive marketing rights, were chosen.

According to the previously mentioned criteria and using the BotPlus drug databases and the Medicine Online Information Centre (Centro de Información Online de Medicamentos, CIMA) of the Spanish Agency of Medicine and Medical Devices (Agencia Española de Medicamentos y Productos Sanitarios), we have selected the eight following drugs: Vinorelbine, Capecitabine, Imatinib, Pemetrexed, Erlotinib, Dasatinib, Gefitinib and Everolimus.

Sources of information

For each of these drugs, the evolution of the “List price” (LP) and/or the tender price (TP) was analysed in the case of public tenders, using the following data sources:

  • Minutes and Agreements of the CIPM: Used to decide the authorised LPs for the initial marketing of the innovative drugs (Supplementary tables S I to S IX), as well as the first authorised LP for each generic medicine. When gathering the LPs of the generic medicines, we have only borne in mind the generic medicines with the lowest LP, the presentation that provides the most advantageous economic offer.

  • BotPlus: It is used for obtaining the current LPs of the different analysed drugs (both innovative and generic) as well as their marketing authorisation dates.

  • Public tenders: A gathering of public tender data provided by Acobur (Advice in public health contracting) has been carried out regarding the purchase of each medicine during the years after and before the loss of the exclusive marketing rights, including tenders from hospitals and the healthcare services of different regions to ensure a representative sample.

Analysis of the evolution of the prices

From the information gathered, a double analysis was carried out. On the one hand, the variations in the LPs experienced by each drug as a function of the time passed from the LPs were approved for each generic medicine presentation. The percent decrease in the notified LP of each new generic medicine with respect to the innovative drug was calculated, and their evolution throughout time was analysed. On the other hand, the evolution of the prices obtained in the public tenders of the drugs and the TPs throughout time was analysed, focusing on the period before and after the loss of the exclusive marketing rights and the appearance of generic medicines, being therefore able to see decreases in the TPs.

Prediction of the decreases in price as a function of the trends seen

From the trends seen in this analysis, the possible evolution in the price of an oncologic drug similar to those included in the analysis, as in the case of Revlimid® (Lenalidomide), an innovative drug by Bristol Myers Squibb, whose patent expires in the first quarter of 2022 (4), will be estimated. To strengthen the prediction, we have relied on the advice of hospital pharmacists with a view to having in mind their knowledge regarding the evolution of the prices of drugs.

Results

Evolution of the LPs notified after the appearance of generic medicines

The analysis of the evolution throughout time of the notified LPs shows how the analysed drugs experience an average initial drop in price by 46%, although the drop increases with time, as we can see in Table I, with an average maximum decrease in the notified LP by 70% in an average interval of 2.6 years.

TABLE I -.

Maximum drops in the notified LPs experienced by the analysed oncologic drugs, first drops experienced, and time intervals passed until reaching the minimum notified LP since the approval of the LP of the first generic medicine

Drug Patent expiration Date First descent notified LP Maximum descent notified LP Years to minimum LP
Vinorelbine Not available −37% −56% 4.3
Capecitabine 14/12/2013 −39% −68% 1.9
Imatinib 01/12/2016 −40% −97% 4.6
Pemetrexed 10/06/2021 −40% −45% 4.4
Erlotinib 01/03/2020 −42% −74% 1.1
Dasatinib 01/11/2019 −69% −70% 1.3
Gefitinib 01/09/2019 −40% −84% 1.1
Everolimus 17/01/2019 −58% −66% 1.7

LP = list price.

There is not a homogeneity in the decreases in the LPs seen in each of the analysed drugs, and we can find very dissimilar cases, such as that of Imatinib, that reaches a drop by 97% in 4.6 years, versus the rapid drop in the notified LP of Gefitinib of 84% in 1.1 years.

The fact that the four most recently approved drugs (Erlotinib, Dasatinib, Gefitinib and Everolimus) experience a drop in their LP greater than 65% in 1 year must be highlighted. The data suggest that the process of the drop in the LP as a consequence of the marketing of generic medicines has accelerated in the last years, both in terms of magnitude and time (an average of 1.3 years to reach the maximum drop versus the 3.8 years in the group of older drugs).

The presented data show how the marketing of generic drugs after the loss of the patent of the innovative medicine causes a decrease in the notified LP of the analysed oncologic drugs. Nevertheless, the hospital medicines are purchased through public tenders in which the LP only acts as a guide and a maximum price ceiling. This entails that the decrease in the TP due to the competition between pharmaceutical companies can be, in real-world conditions, much lower than the notified LP.

Evolution of the TPs in public tenders after the appearance of generic drugs

As previously highlighted, the analysed drugs are medicines used in hospitals. Their purchase is carried out through tenders that, due to their own nature, generate a competition between pharmaceutical companies when presenting an offer that results in a price war, being the TP, and not the LP, the price paid by the healthcare centres.

The evolution of the TPs has been analysed after the loss of the exclusive marketing rights of the following drugs: Capecitabine, Imatinib, Erlotinib, Gefitinib and Everolimus. The analysis of the tenders in the case of Dasatinib and Pemetrexed could not be carried out due to the recent loss of their patent, this preventing the generic medicines pharmaceutical companies from being able to participate in public tenders when this study was carried out. It was also not possible to study the evolution of the TP of Vinorelbine after the loss of its exclusive marketing rights. Vinorelbine lost its exclusive marketing rights in 2009 and the database used to obtain the information regarding tenders only provides information from 2010. Therefore, the study of these data does not allow to see the real drop in price after the marketing of generic medicines.

The analysis of the tenders of the most innovative oncology drugs (excluding chemotherapy, as in the case of capecitabine) shows two differentiated trends (Fig. 1). Everolimus dropped its TP by 42% versus LP in the first year after the loss of its patent. This could be due to this drug only losing its exclusive marketing rights regarding the indications of advanced breast cancer and neuroendocrine tumours but not in renal cell carcinoma. Nevertheless, this effect disappears after the first year, with a drop of 85% in TP versus LP during the second year after the partial loss of its exclusive marketing rights.

Fig. 1 -.

Fig. 1 -

Drops in the tender price in public bids experienced by the analysed oncologic drugs during the first (blue bars) and second (orange bars) years after the loss of the exclusive marketing rights.

Imatinib, Erlotinib and Gefitinib present common trends (Fig. 1). These three drugs experience a drop in their TP greater than 90% versus LP in the first year after the loss of their exclusive marketing rights. Capecitabine, another analysed drug, dropped its TP by 89% versus LP after its first year without exclusive marketing rights (Fig. 1). Nevertheless, because it is a chemotherapeutic treatment, it is considered that it must be analysed separately from Imatinib, Erlotinib and Gefitinib.

All the assessed drugs experience a pronounced and significant drop in their TP after the loss of the exclusive marketing rights, in a period of 1 year, decreases exceeding 80%, reaching figures above 90% in innovative drugs. Because of this, it seems that the savings in costs generated by the marketing of generic medicines are even higher than that deduced from the notified LPs.

Prediction of the evolution of the price of Revlimid® (Lenalidomide)

As mentioned in the methodology section, the analysed data and price trends allow to estimate the LP of other drugs that are nearing the marketing of generic medicines, as in the case of Revlimid® (Lenalidomide), by BMS, whose patent expires in the first quadrimester of 2022 (4). This drug is recommended for the treatment of oncohaematologic disorders such as multiple myeloma, mantle cell lymphoma and follicular lymphoma, as well as myelodysplastic syndromes, reaching in 2020 global sales for USD12,100 million. Revlimid® will lose its exclusive marketing rights in March 2022.

There are currently 20 Lenalidomide generic medicines authorised in Spain; 14 of these 20 Lenalidomide generics have an approved LP (Tab. II), and therefore they would be ready for their marketing after the loss of the exclusive marketing rights. Five generics with a decrease of –59% and the other generics show a notified LP that is 65% lower than the LP notified for the innovative medicine Revlimid®. It should be noted that in some cases, such as Reddy’s Pharma, it has requested a voluntary reduction in its generic medicine price, going from the initial –59% to –65%. In case of not changing the LP of Revlimid® until the loss of the exclusive marketing rights, these data entail a great decrease in the LP that is greater than that seen in other analysed drugs.

TABLE II -.

Analysis of the evolution of the LP of the different generic Lenalidomide medicines approved in Spain with respect to the innovative drug

Drug type and company CIPM date Marketing authorisation date CIPM LP (€/mg)* Interval since 1st Gx LP approval by CIPM (years) Price difference vs innovative price Price difference vs 1st Gx LP
Innovative (BMS) 25/05/2007 14/06/2007 11.518 NA NA NA
Generic 1 (Cipla) 14/10/2020 10/03/2020 4.678 0 −59% NA
Generic 2 (Accord) 28/02/2021 27/11/2020 4.678 0.4 −59% 0%
Generic 3 (Reddy Pharma) 01/12/2020 01/12/2020 4.678 0.1 −59% 0%
Generic 4 (Stada) 27/11/2020 20/03/2021 4.678 0.1 −59% 0%
Generic 5 (Kern) 31/03/2021 01/10/2020 4.678 0.5 −59% 0%
Generic 6 (Krka) 31/05/2021 20/03/2021 4.678 0.6 −59% 0%
Generic 7 (Viso) 30/06/2021 09/02/2021 4.678 0.7 −59% 0%
Generic 8 (Teva) 31/07/2021 01/08/2019 4.678 0.8 −59% 0%
Generic 9 (Fresenius) 31/10/2021 09/02/2021 3.977 1.0 −65% −15%
Generic 10 (Mylan) 31/10/2021 25/06/2021 3.977 1.0 −65% −15%
Generic 11 (Sandoz) 31/10/2021 09/02/2021 3.977 1.0 −65% −15%
Generic 12 (Aurovitas) 30/11/2021 01/10/2021 3.977 1.1 −65% −15%
Generic 13 (Sun) 31/12/2021 01/10/2021 3.977 1.2 −65% −15%
Generic 14 (Tarbis) 31/12/2021 01/09/2020 3.977 1.2 −65% −15%

* In the case of the innovative drug, the LP indicated is the one prior to the marketing of the f irst generic, not the initial LP.

CIPM = Comisión Interministerial de Precios de los Medicamentos; Gx = generic medicines; LP = list price.

In the case of the drug tenders, it is reasonable to predict that Lenalidomide will follow the same pattern seen in other analysed oncologic drugs, with a decrease in their TP by 90% during their first year of marketing as generic medicines. Hospital pharmacists consulted on the expected trend of Lenalidomide in drug tenders have stated that it is expectable that the TP of Lenalidomide in tenders decreases by approximately 75%, at least with respect to its current price, in the first year.

Conclusions

The data analysed in this study show that the marketing of generic medicines causes a significant drop in the notified LP of the drug. This drop is especially quick in the TP of the bids, that experience a fall by 90% in a year with respect to the LP of the innovative drug.

In 2022, Lenalidomide (Revlimid®), whose global invoicing was USD12,100 million, will lose its patent. There are already nine approved generic medicines with an LP 65% lower than that of Revlimid®. Voluntary drops such as that applied by Reddy’s Pharma in its generic could suggest a rapid drop in the price of generic Lenalidomide due to competition between different laboratories.

The analysis carried out in this report of tenders of generic oral oncologic drugs together with the interviews made to hospital pharmacists allow to consider that the marketing of generic Lenalidomide medicines will entail a drop by 90% in the LP of Revlimid®.

Disclosures

Conflict of interest: The authors declare no conflict of interest.

Financial support: This research has been possible thanks to Incyte Biosciences Iberia, which has financed the project and the publication of the manuscript.

Authors contribution: All authors contributed equally to this manuscript.

Data regarding the list price (LP) and dates of approval of the drugs

Table S I.

Analysis of the evolution of the LP of the different generic Vinorelbine medicines approved in Spain with respect to the innovative drug.

Drug type & company CIPM approval date Marketing authorization date CIPM LP (€/mg)* Interval since 1st Gx approval by CIPM (years) Price difference vs innovative price Price difference vs 1st Gx approved by CIPM
Innovative (Pierre Fabre) 20/01/2001 01/07/1993 1.43 NA NA NA
Generic 1 (Actavis) 12/03/2009 04/11/2008 0.9 0 -37% NA
Generic 2 (IPS Pharma) 29/11/2010 09/07/2010 0.69 1.7 -52% -23%
Generic 3 (Sandoz) 30/06/2013 30/04/2009 0.63 4.3 -56% -30%
Generic 4 (Accord) 28/02/2018 16/11/2007 0.63 9.0 -56% -30%

* In the case of the innovative drug, the authorized LP at the time of marketing of the first generic drug is indicated.

Table S II.

Analysis of the evolution of the LP of the different generic Paclitaxel medicines approved in Spain with respect to the innovative drug.

Drug type & company CIPM approval date Marketing authorization date CIPM LP (€/mg)* Interval since 1st Gx approval by CIPM (years) Price difference vs innovative price Price difference vs 1st Gx approved by CIPM
Innovador (BMS) 01/10/2006 01/11/1999 4.27 NA NA NA
Generic 1 (Merck) 08/11/2007 30/05/2007 1.87 0 -56% NA
Generic 2 (GP-Pharm) 09/10/2008 05/05/2008 1.87 0.9 -56% 0%
Generic 3 (Stragen) 07/05/2009 15/12/2008 1.35 1.5 -68% -28%
Generic 4 (Accord) 29/02/2012 27/10/2011 1.31 4.3 -69% -30%
Generic 5 (Swan Pond) 30/06/2012 14/02/2012 1.31 4.6 -69% -30%
Generic 6 (Fresenius) 31/07/2012 15/10/2010 1.31 4.7 -69% -30%
Generic 7 (Cipla) 31/12/2015 09/10/2015 1.31 8.2 -69% -30%

*1 In the case of the innovative drug, the most recent obtained (October 2006) is taken as LP.

*2 In the case of the innovative drug, the authorized LP at the time of marketing of the first generic is indicated.

Table S III.

Analysis of the evolution of the LP of the different generic Capecitabine medicines approved in Spain with respect to the innovative drug.

Drug type & company CIPM approval date Marketing authorization date CIPM LP (€/mg)* Interval since 1st Gx approval by CIPM (years) Price difference vs innovative price Price difference vs 1st Gx approved by CIPM
Innovador (Roche) 26/05/2008 02/02/2001 0.0057 NA NA NA
Generic 1 (Actavis) 30/04/2013 21/01/2013 0.0035 0 -39% NA
Generic 2 (Fresenius) 31/07/2013 25/03/2013 0.0023 0.3 -60% -34%
Generic 3 (Kern) 30/11/2013 25/06/2012 0.0023 0.6 -60% -34%
Generic 4 (Combino) 30/11/2013 17/09/2013 0.0023 0.6 -60% -34%
Generic 5 (Sun) 31/12/2013 23/07/2013 0.0023 0.7 -60% -34%
Generic 6 (Cipla) 31/03/2015 01/12/2014 0.0018 1.9 -68% -49%
Generic 7 (Normon) 30/11/2015 28/07/2015 0.0018 2.6 -68% -49%
Generic 8 (Labosuan) 29/02/2016 11/09/2015 0.0018 2.8 -68% -49%
Generic 9 (Fair-Med) 30/04/2016 07/10/2015 0.0018 3.0 -68% -49%

* In the case of the innovative drug, the authorized LP at the time of marketing of the first generic drug is indicated.

Table S IV.

Analysis of the evolution of the LP of the different generic Imatinib medicines approved in Spain with respect to the innovative drug.

Drug type & company CIPM approval date Marketing authorization date CIPM LP (€/mg)* Interval since 1st Gx approval by CIPM (years) Price difference vs innovative price Price difference vs 1st Gx approved by CIPM
Innovative (Novartis) 25/05/2007 07/11/2001 0.20 NA NA NA
Generic 1 (Aurovitas) 30/06/2016 26/01/2016 0.12 0 -40% NA
Generic 2 (Accord) 30/06/2016 28/03/2016 0.118 0.0 -40% 0%
Generic 3 (Sandoz) 30/07/2016 31/03/2016 0.118 0.1 -40% 0%
Generic 4 (Teva) 30/07/2016 01/06/2016 0.118 0.1 -40% 0%
Generic 5 (Ranbaxy) 31/10/2016 14/07/2015 0.118 0.3 -40% 0%
Generic 6 (Normon) 31/10/2016 05/07/2016 0.118 0.3 -40% 0%
Generic 7 (Ferrer) 30/11/2016 16/03/2015 0.118 0.4 -40% 0%
Generic 8 (Krka) 30/11/2016 19/09/2016 0.118 0.4 -40% 0%
Generic 9 (Cipla) 31/12/2016 29/09/2016 0.118 0.5 -40% 0%
Generic 10 (Kern) 31/12/2016 17/10/2016 0.118 0.5 -40% 0%
Generic 11 (Farmalider) 30/04/2017 11/03/2016 0.118 0.8 -40% 0%
Generic 12 (Fresenius) 30/04/2017 10/01/2017 0.118 0.8 -40% 0%
Generic 13 (Viso) 01/09/2017 26/01/2016 0.118 1.2 -40% 0%
Generic 14 (Reddy) 30/06/2019 27/07/2018 0.011 3.0 -94% -91%
Generic 15 (Labosuan) 31/07/2019 01/03/2019 0.011 3.1 -94% -91%
Generic 16 (Tarbis) 31/01/2021 10/06/2020 0.006 4.6 -97% -95%
Generic 17 (Qilu) 31/05/2021 26/01/2021 0.006 4.9 -97% -95%

* In the case of the innovative drug, the authorized LP at the time of marketing of the first generic drug is indicated.

Table S V.

Analysis of the evolution of the LP of the different generic Pemetrexed medicines approved in Spain with respect to the innovative drug.

Drug type & company CIPM approval date Marketing authorization date CIPM LP (€/mg)* Interval since 1st Gx approval by CIPM (years) Price difference vs innovative price Price difference vs 1st Gx approved by CIPM
Innovative (Lilly) 08/07/2008 20/09/2004 2.400 NA NA NA
Generic 1 (Sandoz) 30/04/2016 18/09/2015 1.440 0 -40% NA
Generic 2 (Ferrer) 30/11/2016 01/07/2016 1.440 0.6 -40% 0%
Generic 3 (Fresenius) 31/12/2016 22/07/2016 1.440 0.7 -40% 0%
Generic 4 (Ranxaby) 31/07/2017 17/04/2017 1.440 1.3 -40% 0%
Generic 5 (Prasfarma) 31/12/2017 01/06/2017 1.440 1.7 -40% 0%
Generic 6 (Krka) 30/11/2019 22/05/2018 1.440 3.6 -40% 0%
Generic 7 (Accord) 30/09/2020 18/01/2016 1.332 4.4 -45% -7%
Generic 8 (Fresenius) 31/01/2021 10/06/2020 1.332 4.8 -45% -7%

* In the case of the innovative drug, the authorized LP at the time of marketing of the first generic drug is indicated.

Table S VI.

Analysis of the evolution of the LP of the different generic Erlotinib medicines approved in Spain with respect to the innovative drug.

Drug type & company CIPM approval date Marketing authorization date CIPM LP (€/mg)* Interval since 1st Gx approval by CIPM (years) Price difference vs innovative price Price difference vs 1st Gx approved by CIPM
Innovative (Roche) 25/05/2007 19/09/2005 0.553 NA NA NA
Generic 1 (Teva) 25/04/2019 24/07/2018 0.319 0 -42% NA
Generic 2 (Hetero) 29/02/2020 21/09/2018 0.319 0.8 -42% 0%
Generic 3 (Cipla) 31/05/2020 09/01/2020 0.143 1.1 -74% -55%

* In the case of the innovative drug, the authorized LP at the time of marketing of the first generic drug is indicated.

Table S VII.

Analysis of the evolution of the LP of the different generic Dasatinib medicines approved in Spain with respect to the innovative drug.

Drug type & company CIPM approval date Marketing authorization date CIPM LP (€/mg)* Interval since 1st Gx approval by CIPM (years) Price difference vs innovative price Price difference vs 1st Gx approved by CIPM
Innovative (BMS) 07/02/2009 NA 1.559 NA NA NA
Generic 1 (Teva) 30/10/2019 01/05/2019 0.49 0 -69% 0%
Generic 2 (Stada) 28/02/2021 01/07/2020 0.472 1.3 -70% -4%

* In the case of the innovative medicine, the authorized PVL at the time of marketing of the first generic drug is indicated.

Table S VIII.

Analysis of the evolution of the LP of the different generic Gefitinib medicines approved in Spain with respect to the innovative drug.

Drug type & company CIPM approval date Marketing authorization date CIPM LP (€/mg)* Interval since 1st Gx approval by CIPM (years) Price difference vs innovative price Price difference vs 1st Gx approved by CIPM
Innovative (AstraZeneca) 01/02/2010 24/06/2009 0.273 NA NA NA
Generic 1 (Accord) 30/06/2019 28/03/2019 0.164 0 -40% NA
Generic 2 (Aristo) 30/06/2019 19/11/2018 0.164 0 -40% 0%
Generic 3 (Mylan) 30/06/2019 02/01/2019 0.164 0 -40% 0%
Generic 4 (Reig Jofre) 30/06/2019 08/02/2019 0.164 0 -40% 0%
Generic 5 (Sandoz) 30/06/2019 28/12/2018 0.164 0 -40% 0%
Generic 6 (Teva) 30/06/2019 21/02/2019 0.164 0 -40% 0%
Generic 7 (Qilu) 31/08/2019 08/04/2019 0.164 0.2 -40% 0%
Generic 8 (Cipla) 31/07/2020 14/01/2020 0.043 1.1 -84% -74%

* In the case of the innovative medicine, the authorized LP at the time of marketing of the first generic drug is indicated.

Tabla S IX.

Analysis of the evolution of the LP of the different generic Everolimus medicines approved in Spain with respect to the innovative drug.

Drug type & company CIPM approval date Marketing authorization date CIPM LP (€/mg)* Interval since 1st Gx approval by CIPM (years) Price difference vs innovative price Price difference vs 1st Gx approved by CIPM
Innovative (Novartis) 08/07/2010 17/09/2009 16.89 NA NA NA
Generic 1 (Stada) 30/11/2018 01/07/2018 7.094 0 -58% NA
Generic 2 (Accord) 28/02/2019 01/10/2018 7.094 0.2 -58% 0%
Generic 3 (Krka) 28/02/2019 01/10/2018 7.094 0.2 -58% 0%
Generic 4 (Reddy Pharma) 28/02/2019 01/09/2018 7.094 0.2 -58% 0%
Generic 5 (Sandoz) 30/06/2019 01/03/2019 7.094 0.6 -58% 0%
Generic 6 (Tamarang) 29/02/2020 01/05/2019 5.777 1.2 -66% -19%
Generic 7 (Mylan) 31/05/2020 09/01/2020 5.777 1.5 -66% -19%
Generic 8 (Medicare) 31/07/2020 19/09/2019 5.777 1.7 -66% -19%

* In the case of the innovative medicine, the authorized LP at the time of marketing of the first generic drug is indicated.

Data regarding the list price (LP) and dates of approval of the drugs

Public tender data

Table S X.

Tenders identified for the Capecitabine drug between years 2012 and 2016.

ORGANISM BATCH DATA AWARD DATA
Region Convening body Product requested by the agency Volume for tender’s duration (mg) Maximum bid price (€/mg) Awardee Award price (€/mg) Award date
Madrid Servicio Madrileño de Salud Capecitabina 1,334,512,000 0.0004 ACCORD HEALTHCARE 0.0004 27/03/2017
Madrid Servicio Madrileño de Salud Capecitabina 1,334,512,000 0.0004 CIPLA EUROPE 0.0004 27/03/2017
Baleares Servicio de Salud de las Islas Baleares Capecitabina 500mg comprimidos 225,000,000 0.0004 ACCORD HEALTHCARE 0.0004 26/07/2017
Baleares Servicio de Salud de las Islas Baleares Capecitabina 500mg comprimidos 225,000,000 0.0004 CIPLA EUROPE 0.0004 26/07/2017
Cataluña Consorci de Salut i Atenció Social de Catalunya CAPECITABINA 150 MG 60 COMPRIMIDOS CUBIERTA PELICULAR 42,939,300 0.0005 ACCORD HEALTHCARE 0.0005 10/07/2018
Cataluña Consorci de Salut i Atenció Social de Catalunya CAPECITABINA 150 MG 60 COMPRIMIDOS CUBIERTA PELICULAR 42,939,300 0.0005 CIPLA EUROPE 0.0005 10/07/2018
Cataluña Consorci de Salut i Atenció Social de Catalunya CAPECITABINA 150 MG 60 COMPRIMIDOS CUBIERTA PELICULAR 42,939,300 0.0005 LABORATORIOS NORMON 0.0005 10/07/2018
Cataluña Consorci de Salut i Atenció Social de Catalunya CAPECITABINA 500 MG 120 COMPRIMIDOS CUBIERTA PELICULAR 754,828,000 0.0004 ACCORD HEALTHCARE 0.0004 10/07/2018
Cataluña Consorci de Salut i Atenció Social de Catalunya CAPECITABINA 500 MG 120 COMPRIMIDOS CUBIERTA PELICULAR 754,828,000 0.0004 CIPLA EUROPE 0.0004 10/07/2018
Cataluña Consorci de Salut i Atenció Social de Catalunya CAPECITABINA 500 MG 120 COMPRIMIDOS CUBIERTA PELICULAR 754,828,000 0.0004 LABORATORIOS NORMON 0.0004 10/07/2018
Canarias Servicio Canario de la Salud CAPECITABINA - CAPECITABINA 150 MG COMPRIMIDOS ORAL 12,699,000 0.0005 CIPLA EUROPE 0.0004 10/08/2018
Canarias Servicio Canario de la Salud CAPECITABINA - CAPECITABINA 500 MG COMPRIMIDOS ORAL 197,400,000 0.0004 CIPLA EUROPE 0.0004 10/08/2018
Comunidad Valenciana Generalitat Valenciana. Conselleria de Sanidad Universal y Salud Pública Capecitabína 500 COMPRIMIDOS 939,110,000 0.0004 ACCORD HEALTHCARE 0.0004 28/03/2019
Andalucía Plataforma de Logística Sanitaria de Granada CAPECITABINA 500MG, COMPRIMIDOS 81,300,000 0.0004 CIPLA EUROPE 0.0004 24/04/2019
Murcia Servicio Murciano de Salud CAPECITABINA ORAL 378,996,000 0.0004 CIPLA EUROPE 0.0004 28/08/2019
Extremadura Servicio Extremeño de Salud Capecitabina 500mg 1 Comprimido 200,579,500 0.0004 ACCORD HEALTHCARE 0.0004 16/10/2019
Galicia Servicio Gallego de Salud Capecitabina (D.O.E.) oral 869,200,000 0.0004 CIPLA EUROPE 0.0004 20/11/2019
Andalucía Plataforma de Logística Sanitaria de Jaén CAPECITABINA 500MG, COMPRIMIDOS 26,000,000 0.0006 CIPLA EUROPE 0.0004 12/03/2020
Cataluña Institut Català de la Salut (ICS) CAPECITABINA 150 mg comp 2,254,500 0.0005 KERN PHARMA 0.0005 22/06/2020
Cataluña Institut Català de la Salut (ICS) CAPECITABINA 500 mg comp 60,930,000 0.0004 KERN PHARMA 0.0004 22/06/2020
País Vasco Osakidetza-S.v.s. CAPECITABINA (DOE) COMPRIMIDO DE 150MG 10,950,000 0.0005 KERN PHARMA 0.0005 26/11/2020
País Vasco Osakidetza-S.v.s. CAPECITABINA (DOE) COMPRIMIDO DE 500MG 185,000,000 0.0004 KERN PHARMA 0.0004 26/11/2020
País Vasco Osakidetza-S.v.s. CAPECITABINA (DOE) COMPRIMIDO DE 300MG 9,000,000 0.0004 KERN PHARMA 0.0004 26/11/2020
Andalucía Plataforma de Logística Sanitaria de Huelva CAPECITABINA 500MG, COMPRIMIDOS 78,240,000 0.0006 LABORATORIOS NORMON 0.0004 30/12/2020
Asturias Servicio de Salud del Principado de Asturias (Sespa) CAPECITABINA CAPSULA/COMPRIMIDO 228,730,000 0.0008 KERN PHARMA 0.0005 03/03/2021
Navarra Servicio Navarro de Salud - Osasunbidea Capecitabina 150 mg comprimidos 7,389,000 0.0005 KERN PHARMA 0.0005 30/03/2021
Navarra Servicio Navarro de Salud - Osasunbidea Capecitabina 500 mg comprimidos 72,780,000 0.0004 KERN PHARMA 0.0004 30/03/2021

Table S XI.

Tenders identified for the Imatinib drug between years 2017 and 2021.

ORGANISM BATCH DATA AWARD DATA
Region Convening body Product requested by the agency Volume for tender’s duration (mg) Maximum bid price (€/mg) Awardee Award price (€/mg) Award date
Navarra Servicio Navarro de Salud - Osasunbidea Imatinib 100 mg. 178,300 0.0987 NOVARTIS FARMACEUTICA 0.0907 30/06/2017
Navarra Servicio Navarro de Salud - Osasunbidea Imatinib 400 mg. 1,353,600 0.0986 NOVARTIS FARMACEUTICA 0.0907 30/06/2017
Navarra Servicio Navarro de Salud - Osasunbidea Imatinib 100 mg 713,300 0.0058 CIPLA EUROPE 0.0014 30/06/2017
Navarra Servicio Navarro de Salud - Osasunbidea Imatinib 400 mg 5,415,200 0.0057 CIPLA EUROPE 0.0014 30/06/2017
Murcia Servicio Murciano de Salud IMATINIB 100 MG COMPRIMIDOS RECUBIERTOS/CAPSULAS 4,200,000 0.0075 ACCORD HEALTHCARE 0.0016 18/02/2018
Murcia Servicio Murciano de Salud IMATINIB 400 MG COMPRIMIDOS RECUBIERTOS/CAPSULAS 14,280,000 0.0075 ACCORD HEALTHCARE 0.0015 18/02/2018
Cataluña Consorci de Salut i Atenció Social de Catalunya IMATINIB 400 MG 30 COMPRIMIDOS/CAPSULAS 24,015,200 0.1184 ACCORD HEALTHCARE 0.0015 10/07/2018
Cataluña Consorci de Salut i Atenció Social de Catalunya IMATINIB 400 MG 30 COMPRIMIDOS/CAPSULAS 24,015,200 0.1184 CIPLA EUROPE 0.0013 10/07/2018
Cataluña Consorci de Salut i Atenció Social de Catalunya IMATINIB 400 MG 30 COMPRIMIDOS/CAPSULAS 24,015,200 0.1184 KERN PHARMA 0.0031 10/07/2018
Cataluña Consorci de Salut i Atenció Social de Catalunya IMATINIB 100 MG 60 COMPRIMIDOS/CAPSULAS 2,823,600 0.1184 ACCORD HEALTHCARE 0.0026 10/07/2018
Cataluña Consorci de Salut i Atenció Social de Catalunya IMATINIB 100 MG 60 COMPRIMIDOS/CAPSULAS 2,823,600 0.1184 CIPLA EUROPE 0.0012 10/07/2018
Cataluña Consorci de Salut i Atenció Social de Catalunya IMATINIB 100 MG 60 COMPRIMIDOS/CAPSULAS 2,823,600 0.1184 KERN PHARMA 0.0015 10/07/2018
Cataluña Consorci de Salut i Atenció Social de Catalunya IMATINIB 100 MG COM (indicació GIST) 1,400,400 0.0544 NOVARTIS FARMACEUTICA 0.0544 10/07/2018
Cataluña Consorci de Salut i Atenció Social de Catalunya IMATINIB 400 MG COM (indicació GIST) 22,269,600 0.0544 NOVARTIS FARMACEUTICA 0.0544 10/07/2018
Andalucía Plataforma de Logística Sanitaria de Córdoba IMATINIB 100MG, COMPRIMIDOS-Forma farmacéutica:COMPRIMIDOS 2,200,000 0.0055 ACCORD HEALTHCARE 0.0016 26/07/2018
Andalucía Plataforma de Logística Sanitaria de Córdoba IMATINIB 400MG, COMPRIMIDOS-Forma farmacéutica:COMPRIMIDOS 21,600,000 0.0058 ACCORD HEALTHCARE 0.0013 26/07/2018
Madrid Hospital Clínico San Carlos GLIVEC 100 MG 540,000 0.0566 NOVARTIS FARMACEUTICA 0.0544 30/07/2018
Madrid Hospital Clínico San Carlos GLIVEC 400 MG 3,120,000 0.0566 NOVARTIS FARMACEUTICA 0.0544 30/07/2018
Canarias Servicio Canario de la Salud IMATINIB - IMATINIB 400 MG 30 CÁPSULAS 19,480,000 0.1184 CIPLA EUROPE 0.0015 10/08/2018
Canarias Servicio Canario de la Salud IMATINIB - IMATINIB 100 MG 60 CÁPSULAS 2,650,000 0.1184 CIPLA EUROPE 0.0015 10/08/2018
Cataluña Institut Català de la Salut (ICS) IMATINIB 100 mg comp (EFG) 2,616,000 0.0015 ACCORD HEALTHCARE 0.0014 12/12/2018
Cataluña Institut Català de la Salut (ICS) IMATINIB 400 mg comp (EFG) 12,120,000 0.0015 ACCORD HEALTHCARE 0.0014 12/12/2018
Comunidad Valenciana Generalitat Valenciana. Conselleria de Sanidad Universal y Salud Pública Imatinib 100 MG COMPRIMIDOS, CÁPSULAS 16,568,000 0.0090 ACCORD HEALTHCARE 0.0021 20/02/2019
Comunidad Valenciana Generalitat Valenciana. Conselleria de Sanidad Universal y Salud Pública Imatinib 100 MG COMPRIMIDOS, CÁPSULAS 16,568,000 0.0090 CIPLA EUROPE 0.0035 20/02/2019
Comunidad Valenciana Generalitat Valenciana. Conselleria de Sanidad Universal y Salud Pública Imatinib 100 MG COMPRIMIDOS, CÁPSULAS 16,568,000 0.0090 SANDOZ FARMACEUTICA 0.0089 20/02/2019
Comunidad Valenciana Generalitat Valenciana. Conselleria de Sanidad Universal y Salud Pública Imatinib 100 MG COMPRIMIDOS, CÁPSULAS 16,568,000 0.0090 TEVA PHARMA 0.0070 20/02/2019
Comunidad Valenciana Generalitat Valenciana. Conselleria de Sanidad Universal y Salud Pública Imatínib 400 MG COMPRIMIDOS, CÁPSULAS 76,275,200 0.0091 ACCORD HEALTHCARE 0.0025 20/02/2019
Comunidad Valenciana Generalitat Valenciana. Conselleria de Sanidad Universal y Salud Pública Imatínib 400 MG COMPRIMIDOS, CÁPSULAS 76,275,200 0.0091 CIPLA EUROPE 0.0029 20/02/2019
Comunidad Valenciana Generalitat Valenciana. Conselleria de Sanidad Universal y Salud Pública Imatínib 400 MG COMPRIMIDOS, CÁPSULAS 76,275,200 0.0091 KERN PHARMA 0.0088 20/02/2019
Comunidad Valenciana Generalitat Valenciana. Conselleria de Sanidad Universal y Salud Pública Imatínib 400 MG COMPRIMIDOS, CÁPSULAS 76,275,200 0.0091 SANDOZ FARMACEUTICA 0.0091 20/02/2019
Comunidad Valenciana Generalitat Valenciana. Conselleria de Sanidad Universal y Salud Pública Imatínib 400 MG COMPRIMIDOS, CÁPSULAS 76,275,200 0.0091 TEVA PHARMA 0.0050 20/02/2019
Murcia Servicio Murciano de Salud IMATINIB 100MG 60 COMPRIMIDOS RECUBIERTOS 3,000,000 0.0907 NOVARTIS FARMACEUTICA 0.0114 13/05/2019
Murcia Servicio Murciano de Salud IMATINIB 400MG 30 COMPRIMIDOS RECUBIERTOS 28,800,000 0.0906 NOVARTIS FARMACEUTICA 0.0114 13/05/2019
Andalucía Plataforma de Logística Sanitaria de Granada IMATINIB 100MG, COMPRIMIDOS 1,296,000 0.0024 CIPLA EUROPE 0.0012 31/05/2019
Madrid Hospital Universitario de Getafe IMATINIB 100 MG. COMP. 474,000 0.0066 TEVA PHARMA 0.0055 27/01/2020

Table S XI.

Tenders identified for the Imatinib drug between years 2017 and 2021.

ORGANISM BATCH DATA AWARD DATA
Region Convening body Product requested by the agency Volume for tender’s duration (mg) Maximum bid price (€/mg) Awardee Award price (€/mg) Award date
Madrid Hospital Universitario de Getafe IMATINIB 400 MG. COMP. 4,020,000 0.0067 TEVA PHARMA 0.0014 27/01/2020
Andalucía Plataforma de Logística Sanitaria de Jaén IMATINIB 400MG, COMPRIMIDOS 1,400,000 0.0170 TEVA PHARMA 0.0013 12/03/2020
Asturias Servicio de Salud del Principado de Asturias (Sespa) IMATINIB 100 MG 1,438,000 0.0022 CIPLA EUROPE 0.0012 15/05/2020
Asturias Servicio de Salud del Principado de Asturias (Sespa) IMATINIB 400 MG 12,252,000 0.0022 CIPLA EUROPE 0.0012 15/05/2020
Cataluña Institut Català d’Oncologia (ICO) IMATINIB 100 mg comprimits/caps 4,140,000 0.0024 CIPLA EUROPE 0.0011 21/05/2020
Cataluña Institut Català d’Oncologia (ICO) IMATINIB 400 mg comprimits/caps 43,272,000 0.0015 CIPLA EUROPE 0.0011 21/05/2020
Asturias Servicio de Salud del Principado de Asturias (Sespa) GLIVEC 100 mg/60 comprimidos 432,000 0.0114 NOVARTIS FARMACEUTICA 0.0114 07/07/2020
Asturias Servicio de Salud del Principado de Asturias (Sespa) GLIVEC 400 mg/30 comprimidos 4,176,000 0.0114 NOVARTIS FARMACEUTICA 0.0114 07/07/2020
Cataluña Consorci Hospital Clínic de Barcelona (HCB) IMATINIB MESILATO 100 MG COMP o CAPS (generico) 3,438,600 0.0012 ACCORD HEALTHCARE 0.0011 16/12/2020
Cataluña Consorci Hospital Clínic de Barcelona (HCB) IMATINIB 100 MG COMP (original) 357,100 0.0114 NOVARTIS FARMACEUTICA 0.0114 16/12/2020
Cataluña Consorci Hospital Clínic de Barcelona (HCB) IMATINIB 400 MG COMP/CAPSULAS ORIGINAL 2,028,000 0.0114 NOVARTIS FARMACEUTICA 0.0114 16/12/2020
País Vasco Osakidetza-S.v.s. IMATINIB (DOE) 3,150,000 0.0114 NOVARTIS FARMACEUTICA 0.0058 16/03/2021
País Vasco Osakidetza-S.v.s. IMATINIB (DOE) 12,600,000 0.0114 NOVARTIS FARMACEUTICA 0.0058 16/03/2021
País Vasco Osakidetza-S.v.s. IMATINIB (DOE) 6,000,000 0.0040 ACCORD HEALTHCARE 0.0009 16/03/2021
País Vasco Osakidetza-S.v.s. IMATINIB (DOE) 24,000,000 0.0040 ACCORD HEALTHCARE 0.0012 16/03/2021
Andalucía Plataforma de Logística Sanitaria de Sevilla IMATINIB 400MG - ORAL 12,000,000 0.0012 ACCORD HEALTHCARE 0.0012 13/04/2021
Andalucía Plataforma de Logística Sanitaria de Sevilla IMATINIB 100MG - ORAL 2,500,000 0.0019 ACCORD HEALTHCARE 0.0010 13/04/2021

Table S XII.

Tenders identified for the Erlotinib drug between years 2017 and 2021.

ORGANISM BATCH DATA AWARD DATA
Region Convening body Product requested by the agency Volume for tender’s duration (mg) Maximum bid price (€/mg) Awardee Award price (€/mg) Award date
Extremadura Servicio Extremeño de Salud Erlotinib 100 mg comprimido 640,700 0.4914 ROCHE FARMA 0.4914 03/04/2017
Extremadura Servicio Extremeño de Salud Erlotinib 150 mg comprimido 774,450 0.4036 ROCHE FARMA 0.4036 03/04/2017
Asturias Gerencia Atención Sanitaria Área IV - Hospital Universitario Central de Asturias ERLOTINIB 100MG 30 COMP 72,000 0.4914 ROCHE FARMA 0.4914 13/06/2017
Asturias Gerencia Atención Sanitaria Área IV - Hospital Universitario Central de Asturias ERLOTINIB 150MG 30 COMP 108,000 0.4036 ROCHE FARMA 0.4036 13/06/2017
Castilla la Mancha Gerencia de Atencion Integrada de Albacete ERLOTINIB 100 MG COMPRIMIDO 12,000 0.1442 ROCHE FARMA 0.1442 10/01/2019
Castilla la Mancha Gerencia de Atencion Integrada de Albacete ERLOTINIB 150 MG COMPRIMIDO 100,800 0.3407 ROCHE FARMA 0.3407 10/01/2019
Comunidad Valenciana Generalitat Valenciana. Conselleria de Sanidad Universal y Salud Pública Erlotinib 25 MG COMPRIMIDOS 134,750 0.5540 ROCHE FARMA 0.5540 20/02/2019
Comunidad Valenciana Generalitat Valenciana. Conselleria de Sanidad Universal y Salud Pública Erlotinib 100 MG COMPRIMIDOS 1,080,000 0.4906 ROCHE FARMA 0.4906 20/02/2019
Comunidad Valenciana Generalitat Valenciana. Conselleria de Sanidad Universal y Salud Pública Erlotinib 150 MG COMPRIMIDOS 3,775,800 0.4030 ROCHE FARMA 0.4030 20/02/2019
Canarias Servicio Canario de Salud ERLOTINIB 100 MG COMPRIMIDOS ORAL C/30 90,000 0.4914 ROCHE FARMA 0.4668 30/04/2019
Canarias Servicio Canario de Salud ERLOTINIB 150 MG COMPRIMIDOS ORAL C/30 478,500 0.4036 ROCHE FARMA 0.3835 30/04/2019
Madrid Hospital General Universitario Gregorio Marañón ERLOTINIB 100 MG COMP. C/30 102,000 0.4914 ROCHE FARMA 0.4914 20/06/2019
Aragón Servicio Aragonés de Salud TARCEVA (ERLOTINIB)100 MG COMPRIMIDOS RECUBIERTOS 900,000 0.6325 ROCHE FARMA 0.5312 01/10/2019
Aragón Servicio Aragonés de Salud TARCEVA (ERLOTINIB)150 MG COMPRIMIDOS RECUBIERTOS 450,000 0.6325 ROCHE FARMA 0.4363 01/10/2019
Aragón Servicio Aragonés de Salud TARCEVA (ERLOTINIB)25 MG COMPRIMIDOS RECUBIERTOS 60,000 0.6325 ROCHE FARMA 0.6000 01/10/2019
Andalucía Plataforma de Logística Sanitaria de Sevilla ERLOTINIB 150MG, COMPRIMIDOS 354,000 0.4036 ROCHE FARMA 0.4036 18/10/2019
Castilla y León Gerencia Regional de Salud de Castilla y León ERLOTINIB COMPRIMIDOS ORAL 25 MG 34,500 0.5550 ROCHE FARMA 0.5550 30/12/2019
Castilla y León Gerencia Regional de Salud de Castilla y León ERLOTINIB COMPRIMIDOS ORAL 100 MG 834,000 0.4914 ROCHE FARMA 0.4914 30/12/2019
Castilla y León Gerencia Regional de Salud de Castilla y León ERLOTINIB COMPRIMIDOS ORAL 150 MG 963,000 0.4036 ROCHE FARMA 0.4036 30/12/2019
Murcia Servicio Murciano de Salud ERLOTINIB 100MG 30 COMPRIMIDOS RECUBIERTOS 840,000 0.4914 ROCHE FARMA 0.4914 11/01/2020
Murcia Servicio Murciano de Salud ERLOTINIB 150MG 30 COMPRIMIDOS RECUBIERTOS 2,070,000 0.4036 ROCHE FARMA 0.4036 11/01/2020
Murcia Servicio Murciano de Salud ERLOTINIB 25MG 30 COMPRIMIDOS RECUBIERTOS 180,000 0.5550 ROCHE FARMA 0.5550 11/01/2020
Madrid Hospital Universitario la Paz ERLOTINIB - TARCEVA 100mg compr C/30 - CN 652160 150,000 0.4914 ROCHE FARMA 0.4914 10/02/2020
Madrid Hospital Universitario la Paz ERLOTINIB - TARCEVA 150mg comp C/30 - CN 652161 630,000 0.4036 ROCHE FARMA 0.4036 10/02/2020
Cataluña Institut Català de la Salut (ICS) ERLOTINIB 150 mg comp 51,750 0.4036 SANDOZ FARMACEUTICA 0.0288 23/09/2020
Cataluña Institut Català de la Salut (ICS) ERLOTINIB 100 mg comp 33,000 0.4914 SANDOZ FARMACEUTICA 0.0351 23/09/2020
Andalucía Plataforma de Logística Sanitaria de Córdoba ERLOTINIB 150MG, COMPRIMIDOS 240,000 0.1282 TEVA PHARMA 0.0333 24/09/2020
Madrid Hospital Universitario Puerta de Hierro ERLOTINIB 25 MG COMPR 3,000 0.1800 SANDOZ FARMACEUTICA 0.0900 11/11/2020
Madrid Hospital Universitario Puerta de Hierro ERLOTINIB 100 MG COMPR 510,000 0.1867 SANDOZ FARMACEUTICA 0.0349 11/11/2020
Madrid Hospital Universitario Puerta de Hierro ERLOTINIB 150 MG COMPR 375,000 0.0999 SANDOZ FARMACEUTICA 0.0286 11/11/2020
País Vasco Osakidetza-S.v.s. ERLOTINIB (DOE) COMPRIMIDO DE 100MG 240,000 0.1597 SANDOZ FARMACEUTICA 0.0350 26/11/2020
País Vasco Osakidetza-S.v.s. ERLOTINIB (DOE) COMPRIMIDO DE 150MG 390,000 0.1311 SANDOZ FARMACEUTICA 0.0287 26/11/2020
Cataluña Consorci Hospital Clínic de Barcelona (HCB) ERLOTINIB 150 MG COMP REC PELIC 101,700 0.4036 TARBIS FARMA 0.0400 16/12/2020
Cataluña Consorci de Salut i Atenció Social de Catalunya ERLOTINIB 100 MG COMPRIMIDO 1,749,400 0.3187 ROCHE FARMA 0.3187 29/12/2020
Cataluña Consorci de Salut i Atenció Social de Catalunya ERLOTINIB 100 MG COMPRIMIDO 1,749,400 0.3187 SANDOZ FARMACEUTICA 0.0317 29/12/2020
Cataluña Consorci de Salut i Atenció Social de Catalunya ERLOTINIB 100 MG COMPRIMIDO 1,749,400 0.3187 TARBIS FARMA 0.0298 29/12/2020
Cataluña Consorci de Salut i Atenció Social de Catalunya ERLOTINIB 100 MG COMPRIMIDO 1,749,400 0.3187 TEVA PHARMA 0.3187 29/12/2020

Table S XII.

Tenders identified for the Erlotinib drug between years 2017 and 2021.

ORGANISM BATCH DATA AWARD DATA
Region Convening body Product requested by the agency Volume for tender’s duration (mg) Maximum bid price (€/mg) Awardee Award price (€/mg) Award date
Cataluña Consorci de Salut i Atenció Social de Catalunya ERLOTINIB 150 MG COMPRIMIDO 2,415,600 0.2618 ROCHE FARMA 0.2618 29/12/2020
Cataluña Consorci de Salut i Atenció Social de Catalunya ERLOTINIB 150 MG COMPRIMIDO 2,415,600 0.2618 SANDOZ FARMACEUTICA 0.0286 29/12/2020
Cataluña Consorci de Salut i Atenció Social de Catalunya ERLOTINIB 150 MG COMPRIMIDO 2,415,600 0.2618 TARBIS FARMA 0.0212 29/12/2020
Cataluña Consorci de Salut i Atenció Social de Catalunya ERLOTINIB 150 MG COMPRIMIDO 2,415,600 0.2618 TEVA PHARMA 0.2618 29/12/2020
Cataluña Consorci de Salut i Atenció Social de Catalunya ERLOTINIB 25 MG COMPRIMIDO 365,550 0.3600 ROCHE FARMA 0.3600 29/12/2020
Cataluña Consorci de Salut i Atenció Social de Catalunya ERLOTINIB 25 MG COMPRIMIDO 365,550 0.3600 SANDOZ FARMACEUTICA 0.0716 29/12/2020
Cataluña Consorci de Salut i Atenció Social de Catalunya ERLOTINIB 25 MG COMPRIMIDO 365,550 0.3600 TARBIS FARMA 0.0392 29/12/2020
Cataluña Consorci de Salut i Atenció Social de Catalunya ERLOTINIB 25 MG COMPRIMIDO 365,550 0.3600 TEVA PHARMA 0.0392 29/12/2020
Cataluña Institut Català d’Oncologia (ICO) ERLOTINIB 25 MG 187,500 0.0424 TARBIS FARMA 0.0240 10/02/2021
Cataluña Institut Català d’Oncologia (ICO) ERLOTINIB 100 MG 435,000 0.0356 TARBIS FARMA 0.0218 10/02/2021
Cataluña Institut Català d’Oncologia (ICO) ERLOTINIB 150 MG 742,500 0.0289 TARBIS FARMA 0.0162 10/02/2021

Table S XIII.

Tenders identified for the Gefitinib drug between years 2018 and 2021.

ORGANISM BATCH DATA AWARD DATA
Region Convening body Product requested by the agency Volume for tender’s duration (mg) Maximum bid price (€/mg) Awardee Award price (€/mg) Award date
Madrid Hospital General Universitario Gregorio Marañón GEFITINIB (IRESSA) 250 MG 30 COMPRIMIDOS RECUBIERTOS 547,500 0.2422 ASTRAZENECA FARMACEUTICA SPAIN 0.2422 17/05/2018
Madrid Hospital Clínico San Carlos GEFITINIB (IRESSA) 250 MG COMP 600,000 0.2422 ASTRAZENECA FARMACEUTICA SPAIN 0.2422 07/06/2018
Castilla la Mancha Gerencia de Atención Integrada de Almansa GEFITINIB - IRESSA 250 MG COMP E/30 360,000 0.2523 ASTRAZENECA FARMACEUTICA SPAIN 0.2523 22/01/2019
Canarias Servicio Canario de Salud GEFITINIB 250 MG COMPRIMIDOS ORAL C/30 1,142,500 0.2523 ASTRAZENECA FARMACEUTICA SPAIN 0.2523 30/04/2019
Murcia Servicio Murciano de Salud GEFITINIB 250 MG 30 COMPRIMIDOS RECUBIERTOS 3,000,000 0.2523 ASTRAZENECA FARMACEUTICA SPAIN 0.2523 13/05/2019
Andalucía Plataforma de Logística Sanitaria de Jaén GEFITINIB 250MG COMPRIMIDOS-Forma farmacéutica:COMPRIMIDOS 812,500 0.2422 ASTRAZENECA FARMACEUTICA SPAIN 0.2422 03/07/2019
País Vasco Osakidetza-S.v.s. GEFITINIB COMPRIMIDO DE 250MG 1,250,000 0.0187 TEVA PHARMA 0.0120 11/09/2019
Asturias Servicio de Salud del Principado de Asturias (Sespa) GEFITINIB 250 MG. COMPRIMIDOS RECUBIERTOS CON PELÍCULA 937,500 0.0240 ACCORD HEALTHCARE 0.0091 05/06/2020
Asturias Servicio de Salud del Principado de Asturias (Sespa) GEFITINIB 250 MG. COMPRIMIDOS RECUBIERTOS CON PELÍCULA 1,260,000 0.0240 ACCORD HEALTHCARE 0.0091 05/06/2020
Cataluña Institut Català de la Salut (ICS) GEFITINIB 250 mg comp 399,375 0.2523 ACCORD HEALTHCARE 0.0078 22/06/2020
Andalucía Plataforma de Logística Sanitaria de Córdoba GEFITINIB 250MG, COMPRIMIDOS-Forma farmacéutica:COMPRIMIDOS 1,300,000 0.0202 TEVA PHARMA 0.0060 24/09/2020
Cataluña Consorci de Salut i Atenció Social de Catalunya GEFITINIB 250 MG COMPRIMIDOS RECUBIERTO 1,957,000 0.1600 ACCORD HEALTHCARE 0.0077 29/12/2020
Cataluña Consorci de Salut i Atenció Social de Catalunya GEFITINIB 250 MG COMPRIMIDOS RECUBIERTO 1,957,000 0.1600 CIPLA EUROPE 0.0090 29/12/2020
Cataluña Consorci de Salut i Atenció Social de Catalunya GEFITINIB 250 MG COMPRIMIDOS RECUBIERTO 1,957,000 0.1600 LABORATORIO REIG JOFRE 0.0062 29/12/2020
Cataluña Consorci de Salut i Atenció Social de Catalunya GEFITINIB 250 MG COMPRIMIDOS RECUBIERTO 1,957,000 0.1600 SANDOZ FARMACEUTICA 0.0104 29/12/2020
Cataluña Corporació Sanitària Parc Taulí GEFITINIB 250 MG COMP - GEFITINIB 240,500 0.0200 TEVA PHARMA 0.0080 26/01/2021

Table S XIV.

Tenders identified for the Everolimus drug between years 2017 and 2021.

ORGANISM BATCH DATA AWARD DATA
Region Convening body Product requested by the agency Volume for tender’s duration (mg) Maximum bid price (€/mg) Awardee Award price (€/mg) Award date
Castilla y León Complejo Asistencial Universitario de Salamanca AFINITOR 5 mg 30 COMP. 5,250 10.9365 NOVARTIS FARMACEUTICA 10.9365 04/08/2017
Castilla y León Complejo Asistencial Universitario de Salamanca AFINITOR 10 mg 30 COMP. 27,000 8.9057 NOVARTIS FARMACEUTICA 8.9057 04/08/2017
Asturias Gerencia Atención Sanitaria Área IV - Hospital Universitario Central de Asturias Everolimus 0,25 mg (60 comp.) (Certican) 225 6.1240 NOVARTIS FARMACEUTICA 6.1240 08/01/2019
Asturias Gerencia Atención Sanitaria Área IV - Hospital Universitario Central de Asturias Everolimus 0,5 mg (60 comp.) (Certican) 60 6.1240 NOVARTIS FARMACEUTICA 6.1240 08/01/2019
Asturias Gerencia Atención Sanitaria Área IV - Hospital Universitario Central de Asturias Everolimus 1 mg (60 com p.) (Certican) 840 6.1242 NOVARTIS FARMACEUTICA 6.1242 08/01/2019
Asturias Gerencia Atención Sanitaria Área IV - Hospital Universitario Central de Asturias Everolimus 5 mg (30 comp.) (Afinitor) 15,900 10.9365 NOVARTIS FARMACEUTICA 10.9365 08/01/2019
Asturias Gerencia Atención Sanitaria Área IV - Hospital Universitario Central de Asturias Everolimus 10 mg (30 comp.) (Afinitor) 36,600 8.9057 NOVARTIS FARMACEUTICA 8.9057 08/01/2019
Asturias Gerencia Atención Sanitaria Área IV - Hospital Universitario Central de Asturias Everolimus 3 mg (30 comp.) (Votubia) 1,980 9.0773 NOVARTIS FARMACEUTICA 9.0773 08/01/2019
Asturias Gerencia Atención Sanitaria Área IV - Hospital Universitario Central de Asturias Everolimus 5 mg (30 comp.) (Votubia) 1,500 9.0777 NOVARTIS FARMACEUTICA 9.0777 08/01/2019
Andalucía Plataforma de Logística Sanitaria de Sevilla EVEROLIMUS 10MG, COMPRIMIDOS-Forma 124,500 8.9057 NOVARTIS FARMACEUTICA 8.9057 13/02/2019
Andalucía Plataforma de Logística Sanitaria de Sevilla EVEROLIMUS 500MCG, COMPRIMIDOS-Forma 785 6.1241 NOVARTIS FARMACEUTICA 6.1241 13/02/2019
Andalucía Plataforma de Logística Sanitaria de Sevilla EVEROLIMUS 750MCG, COMPRIMIDOS-Forma 2,355 6.1241 NOVARTIS FARMACEUTICA 6.1241 13/02/2019
Comunidad Valenciana Generalitat Valenciana. Conselleria de Sanidad Universal y Salud Pública Everolimus 5 MG COMPRIMIDOS (HUERFANO) 40,200 9.0640 NOVARTIS FARMACEUTICA 9.0640 28/03/2019
Comunidad Valenciana Generalitat Valenciana. Conselleria de Sanidad Universal y Salud Pública Everolimus 10 MG COMPRIMIDOS 374,920 8.8920 NOVARTIS FARMACEUTICA 8.8920 28/03/2019
Comunidad Valenciana Generalitat Valenciana. Conselleria de Sanidad Universal y Salud Pública Everolimus 10 MG COMPRIMIDOS (HUERFANO) 4,800 8.8920 NOVARTIS FARMACEUTICA 8.8920 28/03/2019
Comunidad Valenciana Generalitat Valenciana. Conselleria de Sanidad Universal y Salud Pública Everolimus 2.5 MG COMPRIMIDOS (HUERFANO) 23,700 9.0640 NOVARTIS FARMACEUTICA 9.0640 28/03/2019
Cataluña Institut Català de la Salut (ICS) A-EVEROLIMUS 5 mg comp 5,775 10.9365 ACCORD HEALTHCARE 2.6900 27/06/2019
Cataluña Institut Català de la Salut (ICS) A-EVEROLIMUS 10 mg comp 32,550 8.9057 ACCORD HEALTHCARE 2.2200 27/06/2019
Extremadura Servicio Extremeño de Salud Everolimus (AFINITOR) 10 Mg 1 Comprimido 51,900 8.9058 ACCORD HEALTHCARE 4.7000 16/10/2019
Extremadura Servicio Extremeño de Salud Everolimus (AFINITOR) 5 Mg 1 Comprimido 20,400 10.9365 ACCORD HEALTHCARE 4.8400 16/10/2019
Murcia Servicio Murciano de Salud AFINITOR 10MG COMPRIMIDOS, 30 COMPRIMIDOS-663793 - 8.9057 NOVARTIS FARMACEUTICA 5.7767 28/11/2019
Murcia Servicio Murciano de Salud AFINITOR 5MG COMPRIMIDOS, 30 COMPRIMIDOS-663792 - 10.9365 NOVARTIS FARMACEUTICA 5.7767 28/11/2019
Murcia Servicio Murciano de Salud CERTICAN 1 MG COMPRIMIDOS, 60 COMPRIMIDOS-700530 - 5.6275 NOVARTIS FARMACEUTICA 5.6275 28/11/2019
Murcia Servicio Murciano de Salud CERTICAN 0,75 MG COMPRIMIDOS, 60 COMPRIMIDOS-700529 - 5.6276 NOVARTIS FARMACEUTICA 5.6276 28/11/2019
Murcia Servicio Murciano de Salud CERTICAN 0,5 MG COMPRIMIDOS, 60 COMPRIMIDOS-700528 - 5.6277 NOVARTIS FARMACEUTICA 5.6277 28/11/2019
Murcia Servicio Murciano de Salud VOTUBIA 10MG COMPRIMIDOS, 30 COMPRIMIDOS-697856 - 9.0778 NOVARTIS FARMACEUTICA 5.7767 28/11/2019
Murcia Servicio Murciano de Salud VOTUBIA 5MG COMPRIMIDOS, 30 COMPRIMIDOS-684617 - 9.0777 NOVARTIS FARMACEUTICA 5.7767 28/11/2019
Murcia Servicio Murciano de Salud VOTUBIA 2,5MG COMPRIMIDOS, 30 COMPRIMIDOS-684619 - 9.0777 NOVARTIS FARMACEUTICA 5.7767 28/11/2019
Andalucía Plataforma de Logística Sanitaria de Córdoba EVEROLIMUS 2MG, COMPRIMIDOS-Forma farmacéutica:COMPRIMIDOS 2,400 9.4560 NOVARTIS FARMACEUTICA 5.7767 19/12/2019
Andalucía Plataforma de Logística Sanitaria de Córdoba EVEROLIMUS 5MG, COMPRIMIDOS 7,500 9.4560 NOVARTIS FARMACEUTICA 5.7767 19/12/2019
Castilla la Mancha Gerencia de Atención Integrada de Cuenca VOTUBIA 5 mg comp c/30 - 684617 3,600 9.0920 NOVARTIS FARMACEUTICA 9.0778 13/01/2020
Madrid Hospital Universitario Fundación Alcorcón EVEROLIMUS - VOTUBIA 10 MG COMPRIMIDOS 30 COMPRIMIDOS - 697856 7,500 5.7767 NOVARTIS FARMACEUTICA 5.7767 02/07/2020
Cataluña Consorci Hospital Clínic de Barcelona (HCB) EVEROLIMUS 1 MG COMP 3,304 5.6275 NOVARTIS FARMACEUTICA 5.6276 16/12/2020
Cataluña Consorci Hospital Clínic de Barcelona (HCB) EVEROLIMUS 5 MG COMP/COMP 1,160 5.7767 NOVARTIS FARMACEUTICA 5.7767 16/12/2020
Cataluña Consorci Hospital Clínic de Barcelona (HCB) EVEROLIMUS 10 MG COMP/COMP 8,660 5.7767 NOVARTIS FARMACEUTICA 5.7767 16/12/2020
Cataluña Consorci de Salut i Atenció Social de Catalunya EVEROLIMUS (ANTITUMORAL) 10 MG COMPRIMIDOS 218,220 5.7770 ACCORD HEALTHCARE 1.7600 29/12/2020
Cataluña Consorci de Salut i Atenció Social de Catalunya EVEROLIMUS (ANTITUMORAL) 10 MG COMPRIMIDOS 218,220 5.7770 MEDICARE PHARMA 1.6065 29/12/2020
Cataluña Consorci de Salut i Atenció Social de Catalunya EVEROLIMUS (ANTITUMORAL) 10 MG COMPRIMIDOS 218,220 5.7770 NOVARTIS FARMACEUTICA 5.7767 29/12/2020
Cataluña Consorci de Salut i Atenció Social de Catalunya EVEROLIMUS (ANTITUMORAL) 10 MG COMPRIMIDOS 218,220 5.7770 REDDY PHARMA IBERIA 1.6000 29/12/2020

Table S XIV.

Tenders identified for the Everolimus drug between years 2017 and 2021.

ORGANISM BATCH DATA AWARD DATA
Region Convening body Product requested by the agency Volume for tender’s duration (mg) Maximum bid price (€/mg) Awardee Award price (€/mg) Award date
Cataluña Consorci de Salut i Atenció Social de Catalunya EVEROLIMUS (ANTITUMORAL) 5 MG COMPRIMIDO 66,310 7.0940 ACCORD HEALTHCARE 2.0400 29/12/2020
Cataluña Consorci de Salut i Atenció Social de Catalunya EVEROLIMUS (ANTITUMORAL) 5 MG COMPRIMIDO 66,310 7.0940 MEDICARE PHARMA 1.4666 29/12/2020
Cataluña Consorci de Salut i Atenció Social de Catalunya EVEROLIMUS (ANTITUMORAL) 5 MG COMPRIMIDO 66,310 7.0940 NOVARTIS FARMACEUTICA 5.7767 29/12/2020
Cataluña Consorci de Salut i Atenció Social de Catalunya EVEROLIMUS (ANTITUMORAL) 5 MG COMPRIMIDO 66,310 7.0940 REDDY PHARMA IBERIA 1.4540 29/12/2020
Cataluña Corporació Sanitària Parc Taulí EVEROLIMUS 5 MG COMP. - EVEROLIMUS 2,655 5.7767 ACCORD HEALTHCARE 2.4000 12/01/2021
Canarias Servicio Canario de la Salud EVEROLIMUS 0.25 MG ORAL-CERTICAN 0,25MG 60 COMPRIMIDOS 2,430 5.6273 NOVARTIS FARMACEUTICA 5.6273 21/01/2021
Canarias Servicio Canario de la Salud EVEROLIMUS 0.5 MG ORAL-CERTICAN 0,5MG 60 COMPRIMIDOS 7,020 5.6277 NOVARTIS FARMACEUTICA 5.6277 21/01/2021
Canarias Servicio Canario de la Salud EVEROLIMUS 0.75 MG ORAL-CERTICAN 0,75MG 60 COMPRIMIDOS 3,510 5.6367 NOVARTIS FARMACEUTICA 5.6276 21/01/2021
Canarias Servicio Canario de la Salud EVEROLIMUS 1 MG ORAL-CERTICAN 1MG 60 COMPRIMIDOS 12,840 5.6275 NOVARTIS FARMACEUTICA 5.6275 21/01/2021
Madrid Hospital Universitario Puerta de Hierro CERTICAN - EVEROLIMUS 0,25 MG COMPR DISPERS - CN 700527 1,500 5.6276 NOVARTIS FARMACEUTICA 5.6276 09/02/2021
Madrid Hospital Universitario Puerta de Hierro CERTICAN - EVEROLIMUS 0,50 MG COMPR - CN 700528 4,000 5.6276 NOVARTIS FARMACEUTICA 5.6276 09/02/2021
Madrid Hospital Universitario Puerta de Hierro CERTICAN - EVEROLIMUS 0,75 MG COMPR - CN 700529 9,000 5.6276 NOVARTIS FARMACEUTICA 5.6276 09/02/2021
Madrid Hospital Universitario Puerta de Hierro CERTICAN - EVEROLIMUS 1 MG COMPR - CN 700530 46,000 5.6276 NOVARTIS FARMACEUTICA 5.6276 09/02/2021
Madrid Hospital Universitario Puerta de Hierro VOTUBIA - EVEROLIMUS 2,5 MG COMPR - CN 684619 4,000 5.7767 NOVARTIS FARMACEUTICA 5.7767 09/02/2021
Madrid Hospital Universitario Puerta de Hierro VOTUBIA - EVEROLIMUS 5 MG COMP DISPERS - CN 684617 21,000 5.7767 NOVARTIS FARMACEUTICA 5.7767 09/02/2021
Madrid Hospital Universitario Puerta de Hierro VOTUBIA - EVEROLIMUS 3 MG COMP DISPERS - CN 702016 3,000 5.7767 NOVARTIS FARMACEUTICA 5.7767 09/02/2021
País Vasco Osakidetza-S.v.s. EVEROLIMUS (DOE) COMPRIMIDO DE 5MG 20,000 3.4660 LABORATORIO STADA 1.3280 21/05/2021
País Vasco Osakidetza-S.v.s. EVEROLIMUS (DOE) COMPRIMIDO DE 10MG 56,000 3.4660 LABORATORIO STADA 1.3290 21/05/2021

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