fentanyl transdermal system
fentanyl transdermal system. The increasing availability and use of intermediate strength patches has exposed providers to potential moral, social and efficacy concerns. The Centers for Medicare and Medicaid Services (CMS) estimates that the average cost per patient per month after insurance coverage is $312.2 This daily out-of-pocket cost exponentially increases with patch size, but remains low compared to other long acting opioids.
For example, the cost increase difference between one milligram (mg) increments for 10 mcg/hr transdermal fentanyl patches ranges from 45% to 90%.4 Practice-based data show significant variability between prices at pharmacies across the U.S., suggesting variability in pricing practices. In addition, Mylan’s implementation of five price tiers for lower strength patches (20 mcg/hr, 25 mcg/hr, 50 mcg/hr, 75 mcg/hr and 100 mcg/hr) reflects market segmentation that may be related to perceived therapeutic difference among varying strengths in treatment outcomes or complexity of supply chain management.
Drug Price Increase
Rising drug prices have become an issue nationwide, with the U.S. Centers for Disease Control and Prevention data showing that price increases occurred in half of all indicators tracked by the CDC between 2008 and 2013. ADW has played a key role in generating awareness of these prices and promoting greater patient involvement in health care decision making through “Ask Your Doctor” campaigns.
We have also worked with payers and pharmaceutical manufacturers to address the cost of brand drugs, including rapidly growing fentanyl patch strengths. In this complimentary commentary, we discuss how changes in patch strengths may impact clinical practice and policy considerations, particularly for those patients who are on high dose buprenorphine or methadone maintenance therapy receiving sublingual transmucosal tablet (SM-t) doses of strong opioids for chronic pain.