The Impact of International Pricing Index Models on Anti-Vascular Endothelial Growth Factor (VEGF) Drug Costs in the United States

ABSTRACT

Objective: To evaluate the impact of three international pricing index models on Medicare Part B spending for intravitreal anti-vascular endothelial growth factor (VEGF) drugs Design: Cost analysis Methods: U.S. and international sales data from the Multinational Integrated Data Analysis (MIDAS) database was used with data from the U.S. Centers for Medicare and Medicaid Services (CMS) to calculate Medicare Part B spending on anti-VEGF drugs Main Outcome: Medicare Part B expenditures of anti-VEGF drugs under various international pricing index models Results: Total Medicare Part B savings was greatest (75%) under the “most favored nation” proposal to peg the U.S. price to the lowest international price. Under the “most favored nation” proposal, prices of aflibercept are reduced from $1825.80 to $507.17, bevacizumab from $74.39 to $27.55, and ranibizumab (3 units or 0.3mg) from $1057.08 to $99.72. Conclusion: International pricing index models are one of many pricing strategies that could lead to savings in Medicare Part B costs.

KEYWORDS:

• Anti-vascular endothelial growth factor (VEGF)
• Pharmaceutical drug prices
• Medicare part B
• International pricing index

FINANCIAL SUPPORT

None

CONFLICTS

Dr. Parikh has consulted for Anthem Blue Cross Blue Shield and Dr. Sridhar is a consultant for Regeneron

DISCLOSURE OF INTEREST

Jayanth Sridhar serves as a consultant for Regeneron Pharmaceuticals. Dr. Parikh has consulted for Anthem Blue Cross Blue Shield. No conflicting relationship exists for other authors.