While generic imatinib was approved in the United States in 2016 and reduced average retail prices by 30%, pharmaceutical manufacturers’ patient assistance programs declined in response to generic availability, according to Ozawa and his colleagues. This increased out-of-pocket payments for some US patients taking generic imatinib; many pay up to $700 a month at brick-and-mortar pharmacies.
As a result, more and more CML patients are turning to online pharmacies. The authors of this study claim that the vast majority (96%) of online pharmacies have failed to meet US legal standards, according to the author.
“Online access to CML treatment is a significant concern if drugs are dispensed without a prescription or without proper clinical oversight,” Ozawa wrote. “With imatinib, contact with a medical team is essential as patients need to be frequently monitored for response to treatment and should receive medication adjustments if necessary.”
Gleevec requires a compliance rate greater than 85% to 90% to achieve optimal clinical results, but patients with higher copayments have been shown to be more likely to discontinue or not adhere to class of drugs. tyrosine kinase inhibitors.
In their survey of online pharmacies that sell imatinib, only 3 of 44 identified English-language sites that ship to the United States were certified by the online pharmacy monitoring service LegitScript, according to a press release on this study. Half (52%) were classified as “rogue” pharmacies that might operate without a license, sell counterfeit or expired products, steal payment information, or dismiss important safety precautions, such as requiring a prescription for potentially dangerous drugs, found the researchers.
Notably, 13 of the online pharmacies sold Gleevec without a prescription, and more than three-quarters did not offer patients the option to speak with a pharmacist, according to Ozawa.
“This is a significant patient safety concern,” Ozawa said. “We were struck by how easy it is to buy an oral chemotherapy drug online, because imatinib is not a benign drug.”
“Taking imatinib requires monitoring and frequent dosage adjustments. Even if an online pharmacy supplies the drug as ordered, “patients who bypass interactions with the supplier are likely to face much greater risks of non-adherence, discontinuation, failures treatment and adverse events,” Ozawa added.
Additionally, dishonest or unclassified pharmacies may not provide patients with the real drugs and could steal patients’ medical or payment information, according to the authors.
Unfortunately, rogue sites are difficult to regulate, as they often come from overseas. “We also found it misleading how some illegitimate websites mimic legitimate sites,” Ozawa said.
“The exorbitant price of oncology drugs is a major obstacle to the optimal treatment of many malignancies, including CML,” said Bernard Marini, Pharm.D., BCOP, clinical pharmacist specialist at Michigan Medicine who treats patients with leukemias. and other hematological malignancies, but did not participate in the research. “…The problem has become so serious that there is a large illegitimate online market for generic oral oncology drugs. Healthcare providers should be aware that many of these rogue and unapproved pharmacies do not even require a prescription or have access to pharmacist consultations, putting patients at high risk of drug abuse. adverse drug events.
The study reminds healthcare professionals “of the need to fully recognize the dangers of illegitimate online pharmacies and to ensure our patients have adequate financial support when prescribing expensive drugs,” Marini added.
Patients should be encouraged to speak with their pharmacist, financial advisor or other members of their healthcare team if they cannot afford their medications, added study co-author Benyam Muluneh, Pharm .D., BCOP, assistant professor at the University of North Carolina’s Eshelman School of Pharmacy.
“Cancer drugs are very expensive; however, some resources such as grants from third-party foundations may be helpful. If a drug is not affordable through regular channels, patients could also discuss other drug options with their suppliers rather than looking for discounts online,” Muluneh said.