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M-27: Effect of Drug Shortages on Pricing of Competitor Products

Poster Presenter

Mark Hanna

PharmD Candidate
St. John's University
United States

Objectives

With drug shortages becoming more common, there is potential for competitors to increase prices due to lack of supply and corresponding increased demand. Cardiovascular (CV) drugs on the FDA shortage list and their competitors were analyzed to determine effects of drug shortages on pricing.

ORAL PRESENTATION: 5:05PM

Method

Drug prices of competitors with the same active ingredient, dosage form, and AB rating as CV drugs on the 2017 FDA shortage list were obtained via RED BOOKTM and Medi-Span Price Rx. If post-shortage price was missing, no change was assumed. Pre- and post-shortage pricing was compared.

Results

According to the FDA website, seven CV drugs were considered to be on shortage during the 2017 year. These included: atenolol, bumetanide, dobutamine, dopamine, guanfacine, labetalol and lidocaine. Overall, 154 NDCs from the seven drugs were analyzed. The number of generic products for each of the seven drugs ranged from 7 to 72 NDCs per drug (22 + 23.80 (mean + SD)). Forty-three NDCs (27.92%) were reported to be in shortage, and 111 (72.08%) were considered competitors. According to the RED BOOKTM, only 17.12% of competitor NDCs had a recorded post-shortage price. This low percentage could be due to either lack of reporting, or no change in price since the previously reported date. Of the 154 NDCs, 15 (13.5%) resulted in an increase in AWP after the reported shortage, and only 1 (0.9%) of the 111 competitors reported an increase in AWP after the shortage date. Of the 15 NDCs, the increase in AWP ranged from +$0.02 to +$0.52 per unit ($0.05 + 0.129 (mean + SD)). Three of the seven drugs analyzed resulted in a mean increase of 10.24% + 0.789 in AWP post-shortage (mean + SD). These drugs include dopamine (10.54% + 0.781 (mean + SD)), lidocaine (10.40% + 0.872 (mean + SD)) and dobutamine (9.72% + 0.606 (mean + SD)). 4 NDCs (3.60%) from one drug (labetalol) had a price reported after the shortage date, but overall resulted in no change in AWP. No prices were reported to decline post-shortage. The shortest date that a price was reported before the shortage was 0.67 years, and the longest was 7.58 years (2.54 + 2.084 (mean + SD)).

Conclusion

The results show that, compared to pre-shortage prices, the majority of competitors' prices were not raised post-shortage. After analyzing the RED BOOKTM data, it was found that AWP rose in about 13.51% CV drug NDCs after the FDA reported shortage date, and in just below 1% of the competitor manufacturers. Less than 43% of the drugs (3 of the 7) on shortage increased in price when comparing pre- to post-shortage pricing. The overall percent increase in price averaged out to be 10.22%, which for these lower priced generics was not very significant. This data is limited by the fact that the majority of pre-shortage prices were documented approximately 3 years ago. In addition, it seems that reporting is done by some companies on a yearly basis. Drug companies raise the price by a set percentage each year, usually on a set day, therefore the increases may be due to inflation rather than the shortage itself. Since the CV drug class has many generic competitors available, it may be worthwhile to repeat this analysis on drugs that have less generic competitors to compensate for the shortage.