Early clinical evidence indicated that patients with chronic lymphocytic leukemia might have similar outcomes with lower doses of Imbruvica (ibrutinib) – one or two pills daily after completing an initial round of treatment at three pills daily.
As momentum built around trial results, Janssen and Pharmacyclics – the companies that partner to sell ibrutinib – decided to stop making the 140 mg pill and instead offer tablets in four strengths, each at a flat price that is triple the cost of the original 140 mg pill. The new pricing scheme ensures dose reduction will not save patients money or reduce pharmaceutical company revenue.
Manufacturers said the single-tablet dosing regimen will improve adherence; however, doctors note that patients often complain about cost, not the inconvenience of taking multiple pills. Furthermore, oncologists argue the discontinuation of the 140 mg pill could undermine patient safety because if physicians want to initiate a lower dose, they must contact the drug maker to initiate a dose-switching protocol instead of simply telling the patient to take fewer pills.
Source: The Washington Post, April 18, 2018.