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Old 01-30-2018, 07:12 AM   #1
Lani
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Exclamation Stealth 22% price rise on herceptin took place in July!

https://www.linkedin.com/pulse/fake-...iccio-rph-bcop


FAKE NEWS: Genentech raises price of Herceptin by 22.7%
Published on June 7, 2017

Lawrence Riccio RPh. BCOP
Lawrence Riccio RPh. BCOP

Oncology Pharmacist at SUNY Downstate Medical Center
Mr. Lawrence Riccio, RPH BCOP

Chloe Haber, PharmD candidate


The image of the woman in the banner above is not new to any of us, though we all call her by a different name. Ancient Greeks called her “Artemis”, and Romans “Diana”, but the newest generation calls her “Wonder Woman”. Some of us know that female warrior fighting breast cancer as “Mom”, “sister”, “or “daughter”. Genentech created the Herceptin symbol of female empowerment using an image of a woman in battle stance, poised to target her disease and wipe it out. When I look at this image, I hear the battle cry ring clear, I hear the manufacturer’s shouts of support, I hear the Little Engine that could screaming “YOU CAN DO IT!” But Genentech’s latest business move tells a different story.

In April of 2017, Genentech announced that starting on July 7th, they will only ship the 150mg single-dose vial of Herceptin, which will replace the 440mg multi-dose vial that is being discontinued. Herceptin is dosed based on weight, with doses of 2mg/kg for weekly regimens and 6mg/kg for thrice weekly dosing. Multi-dose vials are ideal for this type of dosing because you can open a vial for one patient then use the remaining drug for the next patient within 28 days. The new 150mg single-dose vial will ensure drug wastage. How much drug wastage? The quantity will depend on obesity (which is a risk factor for breast cancer) and surprisingly, race.

According to the Center for Disease Control and Prevention (CDC), the average white female in the United States weighs 75.0kg. The average black female weighs 85.2kg. In a dosing regimen of 2mg/kg, that means that one 150mg vial will be sufficient to treat the average white female, but the average black female will need 170.4mg, or two vials. Single dose vials cannot be reused, so 129.6mg (43.2% of the dose) will go to waste. That means that the average black woman will be paying for twice as much medication as the average white woman (even though she only needs 13.6% more drug), and in an institution that serves a largely black population, this will result in thousands of dollars wasted. With this in mind, I conducted an analysis of all the patients who received Herceptin over the last year in my institution. I tracked a total of 23,694mg of Herceptin administered over a twelve-month period. Switching to the single-dose vial would result in 5,386mg being wasted. This number denotes 22.7% wastage (23,694/51,167), and at $9.50/mg, this amounts to total of $51,167 lost. This number is the result of a single analysis conducted in a single institution, so it might not represent the national total, but this data is supported by a recent study published in the British Medical Journal which found that the total US revenue from cancer drugs in 2016 was $18 billion, with 10% or $1.8 billion from discarded drugs. One thing is certain: this switch will not benefit anyone but the Genentech executives and shareholders.

Herceptin had $2.5 billion in US sales in 2016, and a 22.7% increase will result in a $570 million bonus in the upcoming year. Genentech tried to assuage any worries, reassuring its buyers that the price per milligram will remain stable at $9.50. The official net price will not be increasing, hence the title “FAKE NEWS”, but in actuality, we, the US health-care consumer, the taxpaying citizen, will be paying about 20% more for this drug. It is up to us to take a stand against big pharma, to stand up for your mother, your sister, and your daughter. We are fighting a powerful adversary and I think we’ll need the help of Wonder Woman in this most important battle for equity in our health-care system.



References:

Bach Peter B, Conti Rena M, Muller Raymond J, Schnorr Geoffrey C, Saltz Leonard B. Overspending driven by oversized single dose vials of cancer drugs. BMJ 2016; 352 :i788

Fryar CD, Gu Q, Ogden CL. Anthropometric reference data for children and adults: United States, 2007–2010. National Center for Health Statistics. Vital Health Stat 11(252). 2012.

Klasa M. Drill Down: Herceptin Multi-dose Vial Waste Targeted by OIG and WellPoint. RACmonitor. https://www.racmonitor.com/drill-dow...-and-wellpoint. Published December 17, 2013. Accessed June 6, 2017.

Roche Annual Report 2016. Roche; 2017. http://www.roche.com/investors/ar16e...al-report-2016. Accessed June 6, 2017.




FollowLawrence Riccio RPh. BCOP
Lawrence Riccio RPh. BCOP
Lawrence Riccio RPh. BCOP
Oncology Pharmacist at SUNY Downstate Medical Center
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7mo
Lawrence Riccio RPh. BCOP
Oncology Pharmacist at SUNY Downstate Medical Center
Where's #WonderWoman when you need her?
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Old 01-30-2018, 10:50 AM   #2
jra40
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Re: Stealth 22% price rise on herceptin took place in July!

Wow, thank you Lani for this eye-opener!!
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11/17/10 - Diagnosed with 4.5cm tumor in right breast, IDC, Stage 2, Nuclear grade 2, ER+ PR+ HER2+
12/13/10 - Lymph node biopsy - negative
12/28/10 - Started neo-adjuvant treatment along with clinical trial with 4 rounds of AC chemo every 3 weeks
3/15/11 - Began weekly Taxol/Herceptin infusions along with 750mg of Tykerb taken by mouth daily
6/28/11 - Finished last cycle of Taxol
7/27/11 - Breast MRI shows tumor has dissolved, remarkable reaction to chemo
8/31/11 - Lumpectomy, Sentinel Node biopsy. Node negative, clear margins, 7mm of cancer left over from chemo.
10/05/11 - Started radiation, 5 days a week for 7 weeks.
11/8/11 - Finished radiation
3/21/12 - Last Herceptin!
3/26/12 - Port removed!
Tamoxifen for 5 years
8/4/15 - Hysterectomy & bilateral salpingo-oophorectomy. Due to large fibroids. No cancer!
8/8/15 - Started Arimidex
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Old 01-30-2018, 08:59 PM   #3
Catherine
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Re: Stealth 22% price rise on herceptin took place in July!

Geez! Do you think some people will be denied Herceptin because of the price increase?
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Catherine


Found my own lump in the shower
April 2006 at the age of 58
Stage IIB, ER- PR- HER2+++ multi focal tumors, largest 2.3cm
Chemo first: AC/Taxol over 16 weeks
Bilateral mastectomy Sep 06
33 rads after the surgery
1 year of Herceptin completed Dec 07
15 years and no recurrence as of April 2021
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Old 01-31-2018, 03:09 PM   #4
Colleen
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Re: Stealth 22% price rise on herceptin took place in July!

But the article is labeled as "fake news". However I did notice a slight increase for herceptin on my billing statements this past year, but it wasn't 22.7%.
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*October 2013 mammogram suspicious lump right breast
*Oct. 2013 Breast MRI reveals 2.5 cm tumor right breast 6-7 nodes positive
*Nov 2, 2013 PET/CT tumor right breast, 6-7 nodes include right axilla and one above clavicle, 3.5 cm lesion on dome of liver
*Nov 4, 2013 meet oncologist: schedule port placement
*Nov 5, 2013 baseline echo 65%
*Nov 13, 2013 start THP six cycles every 21 days
*Nov 20, 2013 blood counts now coming back quickly start neulasta following next treatment, no pain and it worked!
*Jan 19, 2014 syncope, ambulance ride to hospital, cracked a tooth and chipped three, six stitches in chin, CT scan shows brain is ok but am required to follow up with neurologist.
*Jan 28, 2014 PET/CT shows great response to THP
*Jan 28, 2013 echo, all is good 60-65%
*Feb 2014 brain MRI, no missing parts and no extra parts, all clear
*Feb 27, 2014 last treatment with taxotere
*Apr 22, 2014 PET/CT shows complete pathological response to THP amen!
*Apr 22, 2013 echo 60%
*continue vitamin H and P every 21 days until...eternity?
*May 2014 emotional melt down, demand port be removed.
*May 22 2014, biopsy of original tumor rt. breast, no cancer cells in 8 tissue samples, amen
*June 2, 2014 Port removed, happy dance! Just couldn't tolerate the port any longer; it never worked properly and was extremely uncomfortable
*July 24, 2014 echo 60%
*August 28, 2014 PET/CT all clear NED
*Oct 29, 2014 echo 65%
*Feb 4, 2015 PET/CT NED!!!
*Feb 4, 2015 Echo 65-70%
*May 19, 2015 mammogram all clear
*May 19, 2015 Brain MRI all clear!
*August 18, 2015 PET/CT NED!!! amen!
*March 8, 2016 CT w/contrast NED
*March 10, 2016 Echo normal
*June 2016 Echo normal
*September 7, 2016 CT scan w/contrast NED
*September 8, 2016 Echo normal
* still receiving infusions every 21 days of Perjeta and Herceptin with no end in sight......
*March 2017 CT scan NED and echo normal
*May 2017 mammogram all clear!
*November 2017 CT scan NED and echo normal
*May 2018 echo normal
*December 2018 ct scan with contrast and nasty drink-all clear!


"Better pass boldly into that other world, in the full glory of some passion, than fade and wither dismally with age."
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Old 02-01-2018, 02:11 AM   #5
Pamelamary
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Re: Stealth 22% price rise on herceptin took place in July!

Oh dear - fake news? Sorry for all you US women who have to consider this.
Best wishes... Pam
__________________
Diagnosed 2004: Lumpectomy - 2 tumours, both grade 1 infiltrating duct carcinoma, about 12mm. ER+,
C-erbB-2 status 3+.
Clear margins, no nodal involvement.
Radiotherapy, i year Tamoxifen, 4 years Arimidex.
Rediagnosed 2012: Multiple bone metastases.
3/12: began on Marianne trial - T-DM1 + Pertuzamab/Placebo.
5/12:Unexpected development of numerous bilateral liver mets. Came off trial.
Started Docetaxol/ Herceptin + Zometa.
8/12:Bones stable +major regression in liver (!)
9/12:Can't take any more Docetaxol! Start on Herceptin and Tamoxifen. Cross fingers!
Changed to Denosumab.
11/12: Scan shows stable - yay!
11/13: Still stable :-) !!!
1/16: All stable, but lowered calcium, so switched to Zometa 3 monthly.
2/19: Happily still stable on Herceptin, Letrozole and 3 monthly Zometa.
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