Rasagiline Tabs 1mg 28 was launched onto the UK market as a new generic in August 2015 and since then has had three periods of shortage, during which prices have risen and concessions have been granted by the DHSC to improve supply and pharmacy profitability.
These price spikes are believed to be caused by the market price falling below the level at which manufacturers can make a profit, which results in the cancellation of manufacturing orders and the drying up of available dispensing stock.
In September 2022 a concession price of £9.56 was granted, followed by £6.45 in October, which tells us that shortages are biting again after two previous troubled periods in 2020 and 2017. The increase in the market cost which pharmacies have to pay to get stock during each price spike is very variable and probably relates to the amount of stock in circulation and the number of competing buyers and suppliers.
The length of time between each shortage was three years between the first and second shortage, and two years between the second and the third. We think this period is determined by the number of manufacturers and suppliers competing using price as a primary sales tool. When the price reaches a low point where the product is no longer profitable manufacturers withdraw.
The low trigger price which initiated the first shortage was £1.70; the second was £1.87 and the third £2.06. This suggests to us that manufacturing costs are increasing at about 10% between each shortage, and that if prices fall again in two or three years’ time the trigger price then will be about 10% higher than £2.06 which is about £2.27.
So our estimate is that the UK average market price will again fall to the vulnerable trigger level of £2.27 in mid-2024 and that this will start a new shortage. However like all our forecasts it depends on the intensity of market competition.