Has generic imatinib reduced Medicare beneficiaries’ cost for this expensive drug?

Imatinib is one of the most effective cancer drugs available, but many patients cannot afford the steep price.

In a cross-sectional study examining whether costs have come down for Medicare beneficiaries with the introduction of generic versions of the drug starting in 2016, researchers analyzed Medicare Part D plan, contract, and formulary records for each year from 2017 to 2022.

When they looked specifically at what pharmacies paid for generic imatinib and how much health plans, PBMs, and patients paid when filling prescriptions, they found that pharmacy acquisition costs declined dramatically to $59 per fill from $8,618. Despite lower prices, Medicare beneficiaries still faced out-of-pocket costs of $80 to $400 each time they filled a prescription.

“The gap between generic imatinib point-of-sale prices and average pharmacy acquisition costs supports […] efforts to evaluate spending across PBMs, health plans, and pharmacies to avoid overpayment for medications covered under Medicare Part D,” wrote corresponding author Stacie B. Dusetzina, PhD, with Vanderbilt University School of Medicine.

The research was published in JAMA Internal Medicine.