Injectable Oncology Therapies: Benchmarking Gross and Net Price Differentials in Europe vs US

OBJECTIVES: Compare gross ex-factory and net prices of injectable oncology therapies in Europe (EU4/UK) vs US

METHODS: Reviewed all currently available injectable oncology therapies approved by the FDA and EMA between 2020 and 2022. Only therapies with visible ex-factory prices available in US and at least three European countries were included in the final analysis. Evaluated gross ex-factory prices (per mg) in all 6 countries and conducted a further deep dive to examine relative net price differences between US average sales price (ASP) and Federal Supply Schedule (FSS) Germany and Italy post-completion of P&R negotiations. Prices were gathered in May 2024 using various national and local sources.

RESULTS: On average, the visible ex-factory price at launch in the EU4/UK is 0.69 relative to the US wholesale acquisition cost (WAC) at launch. Italy (0.76) and Germany (0.64) are at the higher end of the visible ex-factory price. However, while average discounts for injectable oncology therapies are 1.4% (ASP) and 12% (FSS) in the US, the average in Germany is 32% and in Italy is 55%. Indexing WAC of $100 in the US at launch translates into a visible ex-factory price of $76 in Italy and $64 in Germany. Post negotiations, however the net in the US is $88 (FSS) to $98 (ASP), whereas it is $34 in Italy and $44 in Germany.

CONCLUSIONS: The gap in injectable oncology drug prices between the US and key European countries is an example of the present market realities. With the ongoing speculation that IRA will shift R&D focus to biologic therapies, understanding these dynamics and how they impact the commercialization of bio/pharmaceuticals across countries and therapy areas both currently, and in the future, is critical. Further examination is warranted.