WB: Colchicine Price Increase Tied to Poorer Gout Control Over a Decade

A sharp increase in colchicine prices in 2010 was associated with a sustained decrease in colchicine use and poorer disease control over a decade, according to a study published online May 8 in JAMA Internal Medicine.

Dan P. Ly, M.D., Ph.D., from University of California, Los Angeles, and colleagues examined the association between the large 2010 price increase in colchicine and long-term changes in colchicine use, substitution with other drugs, and health care use. The analysis included patients with gout with employer-sponsored insurance from 2007 through 2019.

The researchers found a 15.9-fold price increase, with the mean out-of-pocket price increasing from $7.37 to $39.49. Concurrently, colchicine use declined from 35.0 to 27.3 pills per patient in year 1 and to 22.6 pills per patient in 2019. Adjusted allopurinol use rose by 7.8 pills per patient in year 1, a 7.6 percent increase from baseline, and by 33.1 pills per patient through 2019, a 32.0 percent increase from baseline over the decade. In year 1, there was no significant change in adjusted oral corticosteroid use, but there was an increase by 1.5 pills per patient through 2019, an 8.3 percent increase from baseline over the decade. Adjusted emergency department visits for gout rose by 0.02 per patient in year 1, a 21.5 percent increase, and by 0.05 per patient through 2019, a 39.8 percent increase over the decade. Over the decade, there was a 10.5 percent increase in adjusted rheumatology visits for gout.

“Increased emergency department and rheumatology visits for gout over the same period suggest poorer disease control,” the authors write.