Identification of Generic Cancer Medicines That Have Undergone Momentous Price Rises in The Nhs in England

OBJECTIVES: Over the last 40 years, the rising trend in cheaper generic medicines has enabled the national health service (NHS) to save billions of pounds which have been used to fund new and innovative medicines. However, recent incidents suggest new practices in the pricing of generic medicines may be underway, as evidenced by the recent opening of a formal investigation by the European Commission (May 2017) against a pharmaceutical company regarding alleged cases of unfair and significant price increases for generic cancer medicines. We seek to understand if similar pricing practices are taking place widely in generic cancer medicines and in other areas of high demand such as anti-hypertensives, statins and antacids. METHODS: Medicines of interest were categorised as generic cancer medicines and associated supportive care medicines. Price and formulation data was obtained from the British National Formulary (BNF).The timeframe of interest was from September 2010 to May 2017. Longitudinal price changes were compared and trends were identified for the different categories of medicines. RESULTS: Substantial price rises where seen in a number of generic cancer medicines, with some prices increasing between 100% and 1,314% between 2010 and 2017. The highest price increase observed was that of busulfan for the treatment of leukaemia, which rose from 21p per 2mg tablet in 2010 to £2.76 in 2017. CONCLUSIONS: Although substantial price rises were seen in a small group of cancer medicines, a similar pattern was not seen across all cancer medicines or treatment categories analysed. Our research suggests that there may exit small monopolistic situations within the generic market in England.