Grant: Travel Awards - Institute Community Support

More than 1 in 100 Canadians are living with forms of inflammatory arthritis (i.e. rheumatoid arthritis, psoriatic arthritis, lupus, systemic vasculitis), chronic disabling diseases which tend to affect more females than males. Biologic DMARD medications (biologics), which have transformed the lives of many patients, are a special, very expensive class of drugs (~$20,000-$40,000 per-person/year). Biologics DMARD spending is on the rise in many countries, including Canada, but the drivers are not well understood. Are more people receiving biologics, or have doses or prices increased? To learn more, we looked at recent trends in biologic spending and prices (cost per dose) within the US Medicare and Medicaid programs. Yearly spending doubled from $3.8 billion USD in 2012 to $8.6 billion in 2016. 57% of the Medicare spending increase was from price increases, and 37% was from increases in the number of people receiving biologics. Surprisingly, while prices usually decrease when there's more competition, it was the oldest biologics whose prices increased the most. This is important because when the prices of biologics go up, Medicare patients' out-of-pocket costs go up as well. These findings should help policymakers in the US, Canada, and beyond who together are looking for ways to contain the costs of these drugs for governments, employers, and patients, while ensuring they'll remain available for the patients who rely on these treatments.