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2010 Colchicine Price Hikes Adversely Affected Gout Care

May 10, 2023 1:18 pm

Researchers from Harvard have reported their analysis showing that the large increase in colchicine cost in 2010 was associated with an immediate decrease in colchicine prescription use, with a 10 year increase in emergency department and rheumatology gout visits suggesting poorer gout control.

In 2010, the US Food and Drug Administration’s discontinued lower-priced (generic) versions of colchicine in favor of new research on an old drug with the advantage of patent protection. 

This was a retrospective cohort study using commercial claims (MarketScan data) analysis of gout patients followed longitudinally from 2007 through 2019.

A total of 2.7 million patient-year observations of gout patients were examined from 2007 through 2019. This cohort had a mean age of 57 years and 21% were women.

In 2010 mean price of colchicine increased sharply from $11.25 (2009) to $190.49 (by 2011); a 16-fold increase. This resulted in a patient out-of-pocket costs increase of  4.4-fold ($7.37 to a mean of $39.49). At the same time, colchicine use declined from 35 pills per patient-year (2009) to 22.6 colchicine pills per patient-year (2019). Thus a 16.7% reduction was noted in the first year, with a 27% reduction over the decade (P < .001).

Over the same era, allopurinol use rose by 7.6% in the first year and 32.0% over the ensuing decade (P < .001).  While there was no immediate increase in oral corticosteroid use, this increased 8.3% over the decade.

This resulted in a significant rise in gout care visits (at both year 1 and year 10) to the ED and rheumatologist (a 39.8% and 10.5% increase respectively; P < .001).

The FDA sanctioned patent protected and higher priced newer colchicine came with a less colchicine, more allopurinol and steroid use and increased healthcare utilization by gout patients in the USA, suggesting poorer disease control.


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The author has no conflicts of interest to disclose related to this subject