Why Are Hemophilia Drugs so Expensive?

In the U.S., medications to treat hemophilia cost an average of $270,000 annually per patient, according to a 2015 Express Scripts report, making them among the costliest drugs in the nation.

There are 28 different hemophilia drugs in the U.S. market; still, drug prices have been steadily increasing over the years. No drug maker wants to be the first to budge on cost, so companies keep the high price tags and compete on clinical benefits, often vying directly for individual patients. Also, clotting factor drugs are biologic products with no cheaper biosimilars available.

Expensive factor products are a result of high development and manufacturing costs, according to Caitlin Carroll, director of public affairs for PhRMA, the pharmaceutical industry lobbying group. She also pointed to advances in how these treatments are administered that will make them less costly to payers overall.

Because the hemophiliac patient population in the U.S. is small, about 20,000 individuals, insurance companies have historically not expressed major concerns about the high cost of factor replacement.

However, recently, a few insurance companies have started to push back on costs. Bayer, manufacturer of clotting factor product Kogenate and its upgrade, Kovaltry, said several insurers have demanded rebates in exchange for offering the drugs to their customers. It is unclear how effective or widespread such actions are.

Michelle Rice, a senior vice president at the National Hemophilia Foundation, told Kaiser Health News she has been working with several insurers to help them manage costs. “We understand the need to control costs, but they can’t impede access to the product a patient needs,” she said.

Source: Kaiser Health News, March 8, 2018.

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