Destroy Them: One Way to Up Price of Generic Cancer Drugs

Nick Mulcahy

April 17, 2017

In a now-leaked email, a senior executive at a large  pharmaceutical company discussed destroying supplies of generic cancer drugs as part of a pricing battle with health authorities in Spain, according to a report in the British newspaper The Times,.

The idea was floated in 2014 in an exchange with another staff member at Aspen Pharmacare, which has a market valuation of $10 billion and sells products globally, including in the United States, according to the company website.

At the time, Aspen was in negotiations with the Spanish health service about the price of five generic cancer drugs. Aspen was reportedly attempting to increase prices by up to 4000% after having acquired the drugs from GlaxoSmithKline.

Aspen also threatened to stop selling the cancer treatments in Spain unless the country agreed to the price increases, according to The Independent, another British newspaper.

The increases in Spain were part of the company's scheme to raise prices for the drugs throughout Europe, according to the news reports.

The five drugs included busulfan (marketed under the Aspen brand name Myleran), which is used in the treatment of chronic myelogenous leukemia, brain malignancies, and stem cell transplantation. In England and Wales, the price of busulfan increased in 2013 from £5.20 to £65.22 per pack of tablets, a spike of more than 1100%, after Aspen took control of the product.

Another drug, chlorambucil (marketed under the Aspen brand name Leukeran), which is used to treat chronic lymphocytic leukemia and Hodgkin's lymphoma, rose from £8.36 to £40.51 per pack of tablets in the same year in these two  countries.

The drugs also included mercaptopurine (marketed under the Aspen brand name Puri-Nethol) for acute lymphocytic leukemia. Overall, the Aspen drugs are generic but have had no significant competition from other manufacturers, said the reports.

In Spain, the situation deteriorated so far that Aspen stopped direct supplies of the five drugs starting in May 2014. About half a year later, in October, a staff member in Aspen's Dublin office, which serves as the European headquarters for the company, asked about what to do with the leftover cancer drugs that were created and packaged for the Spanish market. A senior executive replied that the drugs could not be sold because of the pricing dispute and that if the Spanish health ministry did not agree to higher prices, "the only options will be to donate or destroy this stock."

Aspen also used a strategy of creating shortages of their drugs or threatening to stop supplying the drugs to force health authorities in Italy to accept its increased pricing demands, according to the reports.

The cost of generic cancer drugs is a global issue. In January, Medscape Medical News reported that various generic cancer drugs have increased in price by 1000% in recent years in the United Kingdom.

Andrew Hill, PhD, senior research fellow from the Department of Pharmacology and Therapeutics at the University of Liverpool, United Kingdom, called some of the price increases outrageous. He explained that companies are getting away with the price spikes because they have a monopoly with a certain product. Cited in the report was Aspen's busulfan, which is made in India, where it costs £0.03 per tablet.

Aspen has not commented publicly on the reports of drug destruction. In The Times, Dennis Dencher, chief executive of Aspen Pharma Europe, said the company's price increases were designed "to promote long-term sustainable supply to patients" and had been increased from "a very low and unsustainable base." Shortages of the Aspen cancer drugs were not deliberate, he said.

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