RT Journal Article
SR Electronic
T1 Target prices for mass production of tyrosine kinase inhibitors for global cancer treatment
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e009586
DO 10.1136/bmjopen-2015-009586
VO 6
IS 1
A1 Andrew Hill
A1 Dzintars Gotham
A1 Joseph Fortunak
A1 Jonathan Meldrum
A1 Isabelle Erbacher
A1 Manuel Martin
A1 Haitham Shoman
A1 Jacob Levi
A1 William G Powderly
A1 Mark Bower
YR 2016
UL http://bmjopen.bmj.com/content/6/1/e009586.abstract
AB Objective To calculate sustainable generic prices for 4 tyrosine kinase inhibitors (TKIs).Background TKIs have proven survival benefits in the treatment of several cancers, including chronic myeloid leukaemia, breast, liver, renal and lung cancer. However, current high prices are a barrier to treatment. Mass production of low-cost generic antiretrovirals has led to over 13 million people being on HIV/AIDS treatment worldwide. This analysis estimates target prices for generic TKIs, assuming similar methods of mass production.Methods Four TKIs with patent expiry dates in the next 5 years were selected for analysis: imatinib, erlotinib, lapatinib and sorafenib. Chemistry, dosing, published data on per-kilogram pricing for commercial transactions of active pharmaceutical ingredient (API), and quotes from manufacturers were used to estimate costs of production. Analysis included costs of excipients, formulation, packaging, shipping and a 50% profit margin. Target prices were compared with current prices. Global numbers of patients eligible for treatment with each TKI were estimated.Results API costs per kg were $347–$746 for imatinib, $2470 for erlotinib, $4671 for lapatinib, and $3000 for sorafenib. Basing on annual dose requirements, costs of formulation/packaging and a 50% profit margin, target generic prices per person-year were $128–$216 for imatinib, $240 for erlotinib, $1450 for sorafenib, and $4020 for lapatinib. Over 1 million people would be newly eligible to start treatment with these TKIs annually.Conclusions Mass generic production of several TKIs could achieve treatment prices in the range of $128–$4020 per person-year, versus current US prices of $75161–$139 138. Generic TKIs could allow significant savings and scaling-up of treatment globally, for over 1 million eligible patients.