Popular cancer pill goes generic

Donald Jones used to pay at least $500 a month for a brand-name drug, Gleevec, that's kept his leukemia at bay for five years.

Lately, he's been paying almost as much for a generic version of the same pill.

It's not supposed to work that way. For decades in the United States, generic drugs have been cheap, effective alternatives to expensive brand-name treatments. But that's changing with drugs such as Gleevec, Novartis AG's household-name cancer treatment. Generic forms of the drug can cost $150 or more a pill.

'If I don't take it, I'm going to die,” Jones, 73, said in a phone interview. He lives in Desloge, Mo., and wants to retire from his $14-an-hour part time job refurbishing electric motors, which keeps him on his feet for hours. But he says he can't because he needs the money to pay for the generic version of a drug he thought would be far less expensive.

A handful of factors might explain the trend. Several large companies dominate the market for generics, potentially reducing competition.

Also, the starting prices of newer cancer drugs are higher than many mass-market treatments. And generics manufacturers said that pills for cancer can be more expensive to produce.

Jones's frustration helps explain why U.S. consumers have made drug prices a major political issue. Democrats in Congress this month pushed President Donald Trump to hold to a promise to go after drug costs, and the Food and Drug Administration also has promised to take action to try and get prices of generics down.

'It is a very clear market failure,” said Andrew Hill, a researcher at the University of Liverpool who says that generic drugs should reflect their often inexpensive production costs. He calculates that a year's worth of the cancer pills can be produced for under $350.

About 300 generic drugs had 'extraordinary” price increases of 100 percent or more from 2010 to 2015, even as generic drug prices fell overall, according to a Government Accountability Office study of prices in Medicare. The report didn't specifically focus on drugs such as generic versions of Gleevec, which start at high prices and only come down gradually.

'When a drug becomes generic, it should be treated like a commodity,” Hill said. For many drugs, that's what happens. A 30-day supply of the generic version of Lipitor, Pfizer's blockbuster cholesterol pill, lists for less than $20, compared to more than $350 for the brand.

Gleevec, approved in 2001, was considered a medical breakthrough that markedly increased the survival rate for patients with chronic myeloid leukemia. For a decade and a half, Novartis enjoyed exclusive sales rights, eventually charging about $10,000 a month before discounts.

That made it a mega-blockbuster with $2.5 billion in U.S. sales in 2015. The list price for the cheapest generic version of Gleevec still is more than $4,700 a month, according to data compiled by First Databank and Bloomberg Intelligence.

Now that generic versions are available, Jones is using one that he hoped would lower his out-of-pocket costs dramatically. But after spending about $5,000 to get through the main part of his Medicare insurance plan's drug coverage gap, he's still spending $383 a month on a generic version made by Apotex Inc.