[Ip-health] Xtandi prices

James Love james.love at keionline.org
Fri May 18 06:06:09 PDT 2018


To follow up from yesterday request on prices, we now have 26 data points
on the Xtandi/Enzalutamide prices for a 40 mg capsule. (The normal dose is
4 x 40 mg capsules daily).   Enzalutamide is a drug to treat prostate
cancer.

According to Joe Fortunak's data, in 2016, the average cost of the APIs was
less than a penny per capsule ($.0024).

Based upon what we have collected so far, the median Astellas price per
capsule in non-US upper income countries is $33 per capsule ($132 per
day).  In South America, the median is $43. ($172 per day).

The Astellas Goodrx coupon price in the US is $101 per capsule ($404 per
day).  The VA FSS price is $44. ($176).

This is a drug invented on grants from the NIH and the Army at UCLA, a
public institution.  Access is very limited, even in upper income
countries.

Who thinks prices of $176 to $404 PER DAY for a chronic treatment that does
not offer a cure, for a drug invented at a public university on government
grants, is "available to the public on reasonable terms"?

Why does the David Geffen School at UCLA/U of California) continue to fight
to extend patent protection India, when access is so restricted globally?

Jamie




On Fri, May 18, 2018 at 5:25 AM, Joseph Fortunak <jfortunak at comcast.net>
wrote:

> Dear Jamie,
>
>
>
> I’m only putting sending as an aside to your real discussion, but the API
> pricing of Xtandi (enzalutamide) may be of interest to some of your many
> followers.  Pharma Compass is freely available online at:
> https://www.pharmacompass.com/.   It lists transactions up to November,
> 2016 when the Indian Government stopped releasing this data publicly
> (updated information is now available on DataMyne at about $5,000/year).
>
>
>
> Those transactions showed slightly more than 43 kg of enzalutamide API
> entering the US, with an average sale price of $13,460/kg.  Other countries
> were somewhat lower, with a lowest price average of about $6,000/kg.
> Enzalutamide is given as a 160 mg/day dose according to the label.  Thus,
> presuming a patient took enzalutamide every day for a year, the API value
> of this would be = $783 in the US.
>
>
>
> Imports listed to the US of formulated capsules were available on Zauba:
> https://www.zauba.com/import-enzalutamide-hs-code.html. Although there is
> a lot of variability in size/pricing of shipments to various countries, the
> typical prize per box to the US (box of 112 x 40 mg capsules = 28 days
> dosing at 4 capsules/day) was listed as INR 19,526 or approximately
> $310/month.
>
>
>
> Kind regards,
>
> Joe
>
>
>
> Sent from Mail <https://go.microsoft.com/fwlink/?LinkId=550986> for
> Windows 10
>
>
>
> *From: *Ruth Lopert <ruth.lopert at gmail.com>
> *Sent: *Friday, May 18, 2018 7:10 AM
> *To: *James Love <james.love at keionline.org>
> *Cc: *Ip-health <ip-health at lists.keionline.org>
> *Subject: *Re: [Ip-health] Xtandi prices
>
>
>
> Jamie
>
>
>
> NB enzalutamide is subject to 'special pricing arrangements' in Australia
>
> which means that the actual price will be somewhat lower than the price
>
> appearing in the PBS schedule
>
>
>
> Ruth
>
>
>
> On Thu, May 17, 2018 at 6:50 PM, James Love <james.love at keionline.org>
>
> wrote:
>
>
>
> > I've been asked for some price comparisons for Xtandi, which is sold in
>
> > 40mg tabs, of which a patient normally takes 4 per day.
>
> >
>
> >
>
> > These are four prices, but I would be grateful or any additional data
>
> > points, including the US WAC price, and any foreign prices.
>
> >
>
> >
>
> > We will put the data we collect here as we get it.
>
> >
>
> >
>
> > http://drugdatabase.info/databases/
>
> >
>
> >
>
> >
>
> > ---------------------------
>
> >
>
> > Prices for Xtandi (INN:Enzalutamide)
>
> >
>
> > May 16, 2018
>
> >
>
> > The drug is sold in 40mg tabs.  The dose is 4 tabs per day.
>
> >
>
> > Australia
>
> >
>
> > Australia PBS, 40 mg x 112, for AUD 3702.82
>
> >
>
> > At exchange rate .7516,  USD $2,738, or $24.85 per pill.
>
> >
>
> > Source: http://www.pbs.gov.au/medicine/item/10174L
>
> >
>
> >
>
> > UK
>
> >
>
> > The 2016 NICE review (will be updated in 2019)
>
> >
>
> > In 2016, list price of  £2734.67 for a 112-capsule pack of 40 mg
>
> > enzalutamide.
>
> >
>
> > This is $3,699 USD, at today’s exchange rate (1.35), or $33 per pill.
>
> > However, the drug is selling at a discount. According to NICE: “The
> company
>
> > has agreed a patient access scheme with the Department of Health. This
> is a
>
> > simple discount to the list price of enzalutamide. The level of the
>
> > discount is commercial in confidence”
>
> >
>
> > Source: https://www.nice.org.uk/guidance/ta377/chapter/1-Recommendations
>
> >
>
> > Canada
>
> >
>
> > Ontario Canada, Exceptional Access Program
>
> >
>
> > CAD 29.1954 per 40 mg tab.  At current exchange rate of .78, this is
> $22.77
>
> > USD
>
> >
>
> > http://www.health.gov.on.ca/en/pro/programs/drugs/odbf/
>
> > odbf_except_access.aspx
>
> >
>
> >
>
> > USA
>
> >
>
> > Goodrx coupon price, is $12,139.42 for 120 40mg tabs.  Equal to $101.16
> per
>
> > tab.
>
> >
>
> >
>
> >
>
> >
>
> >
>
> >
>
> > --
>
> > James Love.  Knowledge Ecology International
>
> > http://www.keionline.org/donate.html
>
> > KEI DC tel: +1.202.332.2670, US Mobile: +1.202.361.3040, Geneva Mobile:
>
> > +41.76.413.6584, twitter.com/jamie_love
>
> > _______________________________________________
>
> > Ip-health mailing list
>
> > Ip-health at lists.keionline.org
>
> > http://lists.keionline.org/mailman/listinfo/ip-health_
> lists.keionline.org
>
> >
>
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-- 
James Love.  Knowledge Ecology International
http://www.keionline.org/donate.html
KEI DC tel: +1.202.332.2670, US Mobile: +1.202.361.3040, Geneva Mobile:
+41.76.413.6584, twitter.com/jamie_love


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