Prescription drug price increases are felt by patients, employers, and insurers; however, the long-term implications are not fully understood. In a recent study in JAMA Internal Medicine, titled: "Changes in Prescription Drug and Health Care Use Over 9 Years After the Large Drug Price Increase for Colchicine," Associate Professor of Health Care Policy and Medicine, Zirui Song, MD, PhD, and coauthors investigated changes in economic and health outcomes associated with a sharp 16-fold increase in the price of colchicine, a key medication used to treat gout.
In 2010, the US Food and Drug Administration (FDA) approved a specific brand of colchicine called Colcrys, which led to the removal of all other versions of colchicine from the market. This reduction in competition led to the average price of a colchicine script to rise rapidly from $11 in 2009 to $190 in 2011, which embedded a 4.4-fold increase in patient out-of-pocket spending.
In this study, Song and coauthors evaluated this FDA policy and the association of such a large-scale price increase on patient care and disease control. The authors analyzed data from 2007 to 2019, obtained from the MarketScan database, which included over 2.7 million patient-year observations. They focused on three main outcomes: colchicine prices, medication use, and health care visits related to gout. Their analysis included both unadjusted and adjusted analyses, and considered factors such as patient demographics, health status, insurance type, and region.
The study’s findings revealed that among individuals with gout, the large price increases resulted in an immediate decrease in colchicine use that endured for nearly a decade. Specifically, colchicine use exhibited a 16.7% reduction in year 1 and a 27.0% reduction over the decade. They also saw increased use of other medications for gout, such as allopurinol and oral corticosteroids, as well as increased Emergency Department and rheumatology visits for gout. These findings suggest that large prescription drug price increases could have lasting effects on drug utilization, substitution patterns, and health care services, as well as potentially result in poorer disease control.