supplement: 2017 · market intelligence report 2 supplement: 2017 biologic response modifier agents...

SUPPLEMENT: 2017

Market Intelligence Report 1 Supplement: 2017 Biologic Response Modifier Agents

INTRODUCTION

This document is a supplement to the PMPRB publication

“Market Intelligence Report: Biologic Response Modifier

Agents, 2015”1 produced under the NPDUIS initiative. The

supplement provides updated information for key market

trends identified in the original report using data for 2016 and

2017. These trends, which are captured in the corresponding

figures, represent only a subset of the results published in the

original report.

The methodology is in line with that of the original study, and

the associated introductory material, limitations, overall

conclusions, and disclaimers still apply. The results presented

in this supplement follow the general interpretation provided

in the original report.

1 Patented Medicine Prices Review Board. 2016. Market Intelligence Report: Biologic Response Modifier Agents, 2015. Ottawa: PMPRB.

LIST OF FIGURES

Figure 2.1 Biologic DMARDs sales index, Canada and the PMPRB7, 2010 to 2017

Figure 2.2 Biologic DMARD market shares of total pharmaceutical sales, Canada and the PMPRB7, 2010 to 2017

Figure 2.4 Distribution of sales by biologic DMARD, Canada and the PMPRB7, 2017

Figure 3.1 Trends in Canadian sales of biologic DMARDs, by drug product, 2010 to 2017

Figure 3.6 Annual treatment costs in public drug plans, by

biologic DMARDS, 2010 to 2017

Figure 4.1 Average foreign-to-Canadian price ratios for biologic DMARDs, Canada versus PMPRB7 and OECD countries, 2017

Figure 4.2 Foreign-to-Canadian price ratios by biologic DMARD, Canada versus PMPRB7 and OECD countries, 2017

Figure 4.3 Annual treatment costs for biologic DMARDs,

Canada versus PMPRB7 and OECD countries, 2017

Figure 4.4 Rate of consumption of biologic DMARDs, Canada versus PMPRB7 and OECD countries, 2017

Available at: http://www.pmprb-cepmb.gc.ca/view.asp?ccid=1286&lang=en

http://www.pmprb-cepmb.gc.ca/view.asp?ccid=1286&lang=en

http://www.pmprb-cepmb.gc.ca/view.asp?ccid=1286&lang=en


1.0

1.5

2.0

2.5

3.0

2010 2011 2012 2013 2014 2015 2016 2017

CAN

FRA

GER

ITA

SWE

SWI

UK

US

2. 37

$1.1B $1.3B $1.5B $1.8B $2.0B $2.2B $2.5B $2.7B

Figure 2.1 Biologic DMARDs sales* index Canada and the PMPRB7†, 2010 to 2017

Canadian sales

*Manufacturer price levels. †France, Germany, Italy, Sweden, Switzerland, the United Kingdom, and the United States. Data source: MIDAS™ Database, prescription retail and hospital markets, 2010 to 2017, IQVIA. All rights reserved.

Canadian CAGR: 13.1%


Figure 2.2 Biologic DMARD market shares of total pharmaceutical sales*, Canada and PMPRB7†, 2010 to 2017

*Manufacturer price levels. †France, Germany, Italy, Sweden, Switzerland, the United Kingdom, and the United States. Data source: MIDAS™ Database, prescription retail and hospital markets, 2010 to 2017, IQVIA. All rights reserved.

10.7%

5.8%

8.2%

4.1%

11.4%

7.9%7.5%

8.9%

0%

2%

4%

6%

8%

10%

12%

14%

CAN FRA GER ITA SWE SWI UK US

2010

2011

2012

2013

2014

2015

2016

2017


Figure 2.4 Distribution of sales by biologic DMARD Canada and the PMPRB7*, 2017

*France, Germany, Italy, Sweden, Switzerland, the United Kingdom, and the United States. Data source: MIDAS™ Database, prescription retail and hospital markets, 2017, IQVIA. All rights reserved.

40.0%

15.6%6.9% 5.3% 6.6%

21.2%

3.8%

13.4%

0.6%

7.6%

4.4% 5.9%9.9%

1.6%

12.5%0.2%

26.7%

28.8%

34.3%28.4%

29.7%22.5% 37.2% 42.1%

11.6%

13.0%

14.2%18.1%

9.3% 13.4%

8.6%

21.7%5.7%

1.7%12.7%

8.7%

9.5%

17.2%10.9%

17.9%

13.0%

13.5%

10.7%

10.0%

1.4%

2.4%

5.5%

5.6%

7.2% 8.0%6.7%

12.9%

5.0%3.0%

2.5%3.9%

3.2% 6.0% 3.8%4.1%

3.2%4.4%

2.0%4.1%

6.5%4.5% 4.7% 6.9% 4.6% 2.0%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

CAN FRA GER ITA SWE SWI UK US

Anakinra

Sarilumab

Certolizumab pegol

Tocilizumab

Abatacept

Golimumab

Rituximab - Biosimilar

Rituximab

Etanercept - Biosimilar

Etanercept

Adalimumab

Infliximab - Biosimilar

Infliximab

In 2017, the uptake of the biosimilar for infliximab in Canada was still relatively low (2.7% of all infliximab use)

compared with the average (35.2%) and median (32.9%) uptake across all OECD countries.

Note: The OECD median for 2017 was originally reported as 35.2%. The text has subsequently been revised.


$1.1B $1.3B $1.5 B $1.8B $2.0B $2.2B $2.5B $2.7B

Figure 3.1 Trends in Canadian sales* of biologic DMARDs by drug product, 2010 to 2017

*Manufacturer price levels. Data source: MIDAS™ Database, prescription retail and hospital markets, 2010 to 2017, IQVIA. All rights reserved.

37.1%

21.1%

23.3%

15.0%

2010

$1.1 B $1.1 B

$1.6 B(+137%)

2010 2017

Growth in sales

Sales for biologic DMARDs

$2.7B

43%

31%

3%6%9%

Contribution togrowth

40.6%

26.7%

11.8%

9.5%

2017

2010 2011 2012 2013 2014 2015 2016 2017

InfliximabAdalimumabEtanerceptRituximabGolimumabAbataceptTocilizumabCertolizumab pegolAnakinraSarilumab

$3.0B

$2.5B

$2.0B

$1.5B

$1.0B

$0.5B

$0.0B

CAGR: 13.1%

Canadiansales

Share of sales


$29.5K

$16.4K$15.3K

$12.1K$14.3K

$13.1K$11.2K $12.0K $11.5K

$18.6K

0

5

10

15

20

25

30

Infliximab Adalimumab Etanercept Rituximab Golimumab Abatacept Tocilizumab Certolizumabpegol

Anakinra Average

2010 2011 2012 2013 2014 2015 2016 2017

Ave

rage

an

nu

al d

rug

cost

* p

er b

enef

icia

ry

Pu

blic

dru

g p

lan

s, 2

01

0 t

o 2

01

7

National sales

(market share)

$1,092.1M $717.4M $316.3M $255.7M $148.9M $66.9M $52.6M $39.1M $0.2M

40.6% 26.7% 11.8% 9.5% 5.5% 2.5% 2.0% 1.5% 0.01%

Average annual

drug cost* per

beneficiary

Public plans $29.5K $16.4K $15.3K $12.1K $14.3K $13.1K $11.2K $12.0K $11.5K

Private plans $26.8K $15.0K $13.3K $12.3K $13.3K $11.9K $11.0K $11.6K $9.4K

Annual treatment cost based on

HDAP† recommended doses –

using AQPP‡ prices

$21.9K $19.7K $20.9K $8.8K $16.5K $22.9K IV: $16.8K

SC: $18.9K $17.4K $18.3K

PMPRB HDAP† recommended

dose for annual maintenance 2,275 mg 1,040 mg 2,600 mg 2,000 mg 600 mg 9,750 mg

IV: 7,280 mg

SC: 8,424 mg 5,200 mg 36,500 mg

Figure 3.6 Annual treatment costs in public drug plans by biologic DMARD, 2010 to 2017

*Includes drug cost and excludes markup and dispensing cost; the costs reported reflect the amounts what were accepted for reimbursement by the drug plans.

†PMPRB Human Drug Advisory Panel.

‡Association Québécoise des pharmaciens propriétaires.

Data source: Public drug plans: National Prescription Drug Utilization Information System Database, Canadian Institute for Health Information, 2010 to 2017.

Private drug plans: IQVIA Private Pay Direct Drug Plan Database, 2010 to 2017.


Figure 4.1 Average foreign-to-Canadian price* ratios for biologic DMARDs, Canada versus PMPRB7† and OECD countries, 2017

0.64 0.93 0.75 0.81 1.01 0.65 1.700.0

0.2

0.4

0.6

0.8

1.0

1.2

1.4

1.6

1.8

FRA GER ITA SWE SWI UK US

0.82 0.71

PM

PR

B7

med

ian

OEC

D m

edia

n

Canadian price level = 1

*Manufacturer price levels. †France, Germany, Italy, Sweden, Switzerland, the United Kingdom, and the United States. Data source: MIDAS™ Database, January–December 2017, IQVIA. All rights reserved.

Bilateral Measures

Multilateral Measures


0.0

0.5

1.0

1.5

2.0

Remicade Humira Enbrel Rituxan Simponi Orencia Cimzia Kineret Actemra IV Actemra SC

PMPRB7 median OECD median Canada = 1EU maximumEU minimum

Strength 100 mg 40 mg/

0.8 mL

50 mg/

mL 500 mg

50 mg/

0.5 mL 250 mg

200 mg/

mL

150 mg

/mL

400 mg/

20 mL 162 mg

Canadian price = 1 $973 $762 $396 $2,288 $1,543 $490 $668 $50 $919 $364

Foreign-to-Canadian price ratio

PM

PR

B7

EU minimum 0.34 0.65 0.53 0.54 0.66 0.84 0.64 0.75 0.81 0.81

PMPRB7 median 0.76 0.95 0.79 0.80 0.99 1.11 1.01 0.86 1.21 1.01

US 0.96 3.34 3.23 1.81 3.13 2.03 3.16 2.52 2.20 3.02

EU maximum 0.96 1.37 1.27 0.98 1.36 1.29 1.35 0.93 1.51 1.42

OECD median 0.65 0.85 0.71 0.77 0.85 1.00 0.87 0.87 0.99 0.93

Figure 4.2 Foreign-to-Canadian price* ratios by biologic DMARD, Canada versus PMPRB7† and OECD countries, 2017

Note: In Canada, Remicade infusions are almost exclusively delivered in manufacturer-sponsored infusion centers, while in other countries the infusions are generally delivered in hospitals. *Manufacturer price levels. †France, Germany, Italy, Sweden, Switzerland, the United Kingdom, and the United States. Data source: MIDAS™ Database, January–December 2017, IQVIA. All rights reserved.

The 24% price differential between foreign and Canadian list prices for Remicade translates into $262 million in drug sales in Canada in 2017.


Annual treatment cost

PM

PR

B7

EU minimum $7.8K $12.5K $10.9K $4.2K $11.3K $16.1K $11.1K $9.0K $13.6K $15.3K

PMPRB7 median $13.7K $18.8K $16.7K $5.8K $16.9K $28.5K $17.5K $15.6K $20.3K $20.2K

Canada $21.9K $19.7K $20.9K $8.8K $16.5K $22.9K $17.4K $18.3K $16.8K $18.9K

US $21.3K $66.3K $69.3K $16.4K $29.8K $53.0K $24.9K $46.4K $36.6K $57.2K

EU maximum $20.8K $26.9K $27.7K $8.6K $22.0K $31.9K $23.5K $22.2K $25.0K $26.8K

OECD median $12.9K $16.6K $15.3K $6.0K $14.1K $22.6K $15.1K $16.0K $16.8K $17.5K

Note: Annual doses are based on PMPRB Human Drug Advisory Panel (HDAP) recommendations.

*France, Germany, Italy, Sweden, Switzerland, the United Kingdom, and the United States. Data source: MIDAS™ Database, January–December 2017, IQVIA. All rights reserved.

Figure 4.3 Annual treatment costs for biologic DMARDs Canada versus PMPRB7* and OECD countries, 2017

$0K

$10K

$20K

$30K

$40K


PMPRB7 median OECD median CanadaEU maximumEU minimum


Annual doses per 1 million inhabitants

PM

PR

B7

EU minimum 33 6 3 139 3 1 3 1 22 16

PMPRB7 median 626 717 352 959 157 63 90 7 50 47

Canada 1,418 1,034 430 829 256 83 64 59 27

US 1,008 973 494 959 157 131 183 1 50 23

EU maximum 918 1,663 884 1,368 396 88 118 24 123 110

OECD median 350 652 289 687 145 31 60 5 39 41

0

200

400

600

800

1,000

1,200

1,400

1,600

1,800


PMPRB7 median OECD median CanadaEU maximumEU minimum

Figure 4.4 Rate of consumption* of biologic DMARDs Canada versus PMPRB7† and OECD countries, 2017

*Based on the annual maintenance dose determined by the PMPRB Human Drug Advisory Panel and reported per one million inhabitants per year. †France, Germany, Italy, Sweden, Switzerland, the United Kingdom, and the United States. Data source: MIDAS™ Database, January–December 2017, IQVIA. All rights reserved.


THE NPDUIS INITIATIVE

The National Prescription Drug Utilization Information System

(NPDUIS) is a research initiative established by federal,

provincial and territorial Ministers of Health in September 2001.

It is a partnership between the PMPRB and the Canadian

Institute for Health Information (CIHI).

Pursuant to section 90 of the Patent Act, the PMPRB has the

mandate to generate analysis that provides policy makers and

public drug plan managers with critical information and

intelligence on price, utilization and cost trends so that Canada’s

health care system has more comprehensive and accurate

information on how drugs are being used and on sources of cost

pressures.

The specific research priorities and methodologies for NPDUIS

are established with the guidance of the NPDUIS Advisory

Committee and reflect the priorities of the participating

jurisdictions. The Advisory Committee is composed of

representatives from public drug plans in British Columbia,

Alberta, Saskatchewan, Manitoba, Ontario, New Brunswick,

Nova Scotia, Prince Edward Island, Newfoundland and Labrador,

Yukon and Health Canada. It also includes observers from CIHI,

the Canadian Agency for Drugs and Technologies in Health

(CADTH), the Ministère de la Santé et des Services sociaux du

Quebec and the pan-Canadian Pharmaceutical Alliance (pCPA)

Office.

ABOUT THE PMPRB

The Patented Medicine Prices Review Board (PMPRB) is a

respected public agency that makes a unique and valued

contribution to sustainable spending on pharmaceuticals in

Canada by:

providing stakeholders with price, cost, and utilization

information to help them make timely and

knowledgeable pricing, purchasing, and reimbursement

decisions; and

acting as an effective check on the prices of patented

medicines through the responsible and efficient use of its

consumer protection powers.

ACKNOWLEDGEMENTS

The PMPRB would like to acknowledge the following staff for

their contributions to this supplement:

Tanya Potashnik – Director, Policy and Economic Analysis

Elena Lungu – Manager, NPDUIS

Karine Landry – A/Manager, Statistics and Data Management

Fatemeh Saberianranjbar – Economic Analyst

Jun Yu – Data Systems Analyst

Carol McKinley – Publications Advisor

Sarah Parker – Junior Communications Officer

supplement: 2017 · market intelligence report 2 supplement: 2017 biologic response modifier agents...

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