Retail Prices of Dermatology Drugs Skyrocket

Study reveals quintupling of prices over six years

Wednesday, November 25, 2015

WEDNESDAY, Nov. 25, 2015 (HealthDay News) -- Patients using prescription creams, gels, sprays and pills for skin conditions may shell out substantially more at the pharmacy than they did just six years ago, a new study suggests.

Between 2009 and 2015, retail prices of brand-name dermatologic drugs rose 401 percent, on average, study authors reported Nov. 25 inJAMA Dermatology.

Even generics have succumbed to price inflation, up 279 percent between 2011 and 2014, based on the drugs surveyed.

Price increases for skin treatments far outpaced the general inflation rate of 11 percent during the six-year study period, the researchers said.

"Cancer drugs were the worst in terms of the numbers" -- up 1,240 percent or nearly $11,000 over the six-year study period -- primarily because of two medicines, said Dr. Steven Rosenberg, voluntary professor of dermatology at the University of Miami Miller School of Medicine, and senior author of the study.

"But if you look at some of the other products that are prescribed very frequently, they went up, some of them 10-fold just in one year, with no explanation that I can think of," said Rosenberg, who has monitored brand-name dermatologic drug prices since 2009 and generic drug prices since 2011.

Dermatology drugs have not grabbed headlines like expensive cancer and hepatitis medicines have, Rosenberg said. Yet patients increasingly are forced to pay retail prices to get their medications as health plans have adopted increasingly restrictive drug "formularies," or lists of covered drugs, according to the study.

The 2014 expansion of health insurance coverage under the Affordable Care Act has done little to curb the rising price of prescription drugs, the authors said.

Rosenberg and his co-author, daughter Miranda Rosenberg, a third-year medical student at the University of Pennsylvania Perelman School of Medicine in Philadelphia, did not identify a specific trend that would explain the price hikes.

In an accompanying editorial, Dr. William Eaglstein of the University of Miami considers one important driver of drug prices: the cost of drug development.

Dr. Mark Lebwohl, president of the American Academy of Dermatology and chairman of dermatology at the Icahn School of Medicine at Mount Sinai in New York City, said there is plenty of blame to go around for higher drug prices. These include pharmaceutical profit-taking and rebates that drug makers pay to health insurers to gain preferred placement on drug formularies.

For some Americans, prescription drug prices are out of reach. "There's a high proportion of prescriptions that go unfilled because of the cost," Lebwohl said.

Beginning in 2009, Rosenberg surveyed four national pharmacy chains -- Costco, CVS, Sam's Club and Walgreens -- in West Palm Beach, Fla., to obtain retail prices for 72 brand-name drugs. Subsequent surveys eventually included 120 brands and their generic equivalents.

The final analysis, conducted in August 2015, is based on 19 brand-name drugs and a handful of generics.

Escalating prices were seen across the board. On average, anti-infective medicines (Altabax, Oxistat cream and Xolegel) rose 309 percent, and corticosteroids such as Cloderm cream and Cutivate lotion increased 290 percent. Acne and rosacea medicines, including Benzaclin and Finacea, jumped 195 percent, and psoriasis drugs such as Oxsoralen-Ultra increased 180 percent on average.

Two drugs for cancer-related skin conditions -- Targretin (bexarotene) gel and Carac (fluorouracil) cream -- each posted increases of 1,697 percent over the six-year study period. Targretin's price jumped from $1,686 in 2009 to $15,708 in 2014 and $30,320 in 2015. Carac averaged $159 in 2009. By 2015, the median price was $2,705.

A 30-gram tube of nystatin-triamcinolone, a generic antifungal medicine, rose from $9.15 in 2011 to $103.88 in 2014, a 10-fold price increase, the authors found.

"We're getting the message, 'Prescribe generics,' but the generics are a fortune," Lebwohl said. "I do think that a public outcry will help."

SOURCES: Steven Rosenberg, M.D., voluntary professor, dermatology, Miller School of Medicine, University of Miami; Mark Lebwohl, M.D., president, American Academy of Dermatology, and chairman, dermatology, Icahn School of Medicine, Mount Sinai, New York City; Nov. 25, 2015, online,JAMA Dermatology

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