“In order to ensure that all patients receive a single tablet rather than multiple 140-mg tablets, the manufacturer has priced all tablet strengths at the same price, so that a physician who wished to prescribe 420 mg as three 140-mg tablets would be unlikely to get payer approval to do so, since the cost would be 300% of the single 420-mg tablet,” the letter states. “Furthermore, patients who have been on a daily dose of 140 mg now find that the cost of their 140-mg tablet is more than threefold higher than the cost of their prior 140-mg capsule.”
Pharmacyclics – which jointly markets the drug with Janssen – defended the new pricing regimen, asserting that it was designed to help patients take their medication as prescribed.
“The price is based on the most widely prescribed and lower of the two FDA-approved dosages, which is 420 mg per day. While a patient’s out-of-pocket cost for Imbruvica is ultimately determined by their insurance plan, the vast majority of patients [i.e., patients taking 420-mg and 560-mg doses of Imbruvica] will likely see no increase in out-of-pocket costs when transitioning to the single-tablet formulation,” Pharmacyclics said in a statement. “In fact, current patients on the 560-mg dose will likely see a decrease in their out-of-pocket costs. Out-of-pocket expenses may increase for patients who are taking a lower dose of Imbruvica [140 mg or 280 mg].”
Pharmacyclics stressed that there is “extremely limited data” on the use of lower doses of the drug and said they do not know if lower doses will yield the same clinical outcomes.