
ICER calls out three drugs from BMS and Lilly in report on unsupported price increases in California
Drug pricing watchdog ICER on Thursday released its final report on drug price increases in California that were unsupported by new clinical evidence, pointing to three outliers — Bristol Myers Squibb’s cancer drugs Revlimid and Sprycel, and Eli Lilly’s migraine drug Emgality.
The report builds on a price transparency law passed in California in 2017, which requires manufacturers to report year-over-year spending increases to prescription drugs’ WAC prices, but does not include net prices, which ICER took issue with.
The nonprofit watchdog said it winnowed down lists of the most expensive drugs in California from 2020, seeking input as to whether its figures on net prices, if available, were correct. While conversations with manufacturers on net prices canceled out many of the top ones listed, ICER said in all three of these cases, the price increases were high and unjustified by new clinical evidence.
In the case of BMS’ Revlimid (lenalidomide), which began facing generic competition this year, ICER said it was ranked 14th on California’s 2020 list of specialty drugs with the highest year-over-year increases in total spending, with the WAC increasing by about 6% in 2020, although the net price increase was unknown.
BMS’ Sprycel (dasatinib) similarly saw a 6% WAC price spike in 2020, unsupported by new data, and ICER said its change in net price in 2020 amounted to about 10%.
More increases may have occurred in the intervening years too as India-based generic manufacturer Apotex settled with BMS in 2013 and agreed to not launch its generic version of Sprycel until Sept. 2024.
In the case of Lilly’s Emgality (galcanezumab), which the company says is protected from generics with patents through 2033, the WAC increased by about 5%. The net price increase in the same period for Emgality remains unknown, ICER said, noting that SSR Health considered its estimates of change in net price over the same 12-month period to be potentially not reliable and the manufacturer did not provide new info.
All in all, ICER, which received funding from the California HealthCare Foundation to produce this report, called on states to ensure net price info is included in any future drug price transparency laws.
“States seeking to identify drugs for which increases in spending may be inappropriate should incorporate a requirement for reporting of net price increases at the state level across all payers,” the report concludes.