Like atorvastatin, the cancer medicine Gleevec (imatinib) is a small molecule. But unlike atorvastatin, its path to becoming an inexpensive generic was convoluted…
Gleevec is a kinase inhibitor first approved in 2001 as an oral pill to treat chronic myelogenous leukemia (CML). (To learn about the cool science behind its early development, check out this [OPTIONAL] piece in Nature Education.) Gleevec’s developer, the large drug company Novartis, subsequently tested the drug in a variety of cancer indications, eventually winning approvals in acute lymphoblastic leukemia, gastrointestinal stromal tumors, and several other indications. Almost all CML patients respond to Gleevec, and according to the American Cancer Society, most responses last for many years. If you’d like to geek out further on this topic, we invite you to check out this [OPTIONAL] article: Targeted Therapies for Chronic Myeloid Leukemia.
For many cancer patients, Gleevec is nothing short of a wonder drug. It was a wonder for Novartis too; it brought in more than $4.6 billion as the company’s top-seller in 2015, the last full year it was patented, costing society upwards of $10,000 a month/person. But when Gleevec went generic in 2016, its price didn’t immediately fall like Lipitor’s did, because of the convoluted machinations of the players in the specialty drug supply chain between a doctor prescribing a drug and the patient picking it up at the pharmacy.
Today, a 30-day supply of a common dose of imatinib is available for $13.40 at Mark Cuban’s Cost-Plus Drugs, the discount online pharmacy. The story of how this miracle pill went from highly-profitable branded drug, to still-very-expensive generic, to less than a dollar-a-day commodity has been explored at length by journalists and analysts who investigate the drug supply chain, which is ripe for reform and has recently attracted the attention of Congress.
If you want to better understand why, take a look at this [OPTIONAL] recent article in the Wall Street Journal: