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Prices Raised on Older, Largely Ignored Drugs
Daraprim® (pyrimethamine), an antimalarial medication commonly used to treat Toxoplasma gondii parasitic infections in immunocompromised patients, recently made headlines when its list price increased to $750 per tablet from $13.50.
The increase, instituted by Turing Pharmaceuticals, which purchased the rights to pyrimethamine in August, is just one example of a business strategy whereby older, largely ignored drugs are bought and marketed as “specialty drugs,” according to a report in The New York Times.
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Turing’s move prompted Democratic presidential hopeful Hillary Rodham Clinton to use it as a launching pad for her health care proposal. "Price gouging like this in the specialty drug market is outrageous," said Mrs Clinton said via Twitter. She released a plan to take on price gouging the following day.
Turing’s steep increase is not the first in this drug’s history. At one point, pyrimethamine cost about $1 a tablet. CorePharma purchased rights to it from GlaxoSmithKline in 2010, and the price jumped to $13.50 per pill. Turing’s increase, says a report in The New York Times, brings the annual cost of treatment for some patients to hundreds of thousands of dollars.
In a separate report in Bloomberg Business, Turing’s CEO, Martin Shkreli, noted that references to the annual cost are not reflective of the true cost, since it takes about 6 weeks to treat most of the 2000 patients who take pyrimethamine every year. Mr Shkreli also noted in television interviews that most patients do not pay the full cost, and those who qualify can get it for free.
Medicaid will be able to get pyrimethamine inexpensively. Private insurers, Medicare, and hospitalized patients will likely pay an amount closer to the list price.
Clinicians and organized medicine are questioning the move. “What is it that they are doing differently that has led to this dramatic increase?” asked Dr Judith Aberg, chief of the division of infectious diseases, Icahn School of Medicine at Mount Sinai, in The New York Times.
On September 8, 2015, the Infectious Diseases Society of America and the HIV Medicine Association sent Turing Pharmaceuticals a joint letter. In the letter they state that the price increase for pyrimethamine is “unjustifiable for the medically vulnerable patient population” and “unsustainable for the health care system.”
Turing is not the only company implementing this strategy. Rodelis Therapeutics purchased the rights to cycloserine, a drug used for treatment of multi-drug resistant tuberculosis (TB), and announced a price hike to $10,800 for 30 pills from $500. Scott Spencer, Rodelis’ general manager, said the company needed to invest in order to ensure the supply drug remained reliable, according to The New York Times report.
A subsequent article in The New York Times noted that the price increase was rescinded and the rights were returned to Purdue Research Foundation, which instituted a hike of its own, to $1050 for 30 capsules. Multi-drug resistant TB affects 90 individuals each year; half of them are treated with cycloserine.
After much backlash, Mr Shkreli told NBC News, “I think it makes sense to lower the price in response to the anger that was felt by the people,” according to a later report in The New York Times. However, as of October 9, 2015 the price has not been lowered.—Alessia D’Anna
References
- Pollack A. Drug goes from $13.50 a tablet to $750, overnight. The New York Times. September 20, 2015.
- Calderwood SB, Adimora A. Letter to Turkin Pharmaceuticals. 8 September 2015. TS.
- Langreth R, Armstrong D. Clinton’s tweet on high drug prices sends biotech stocks down. Bloomberg Business. September 21, 2015.
- Pollack A. Big price increase for tuberculosis Drug is rescinded. The New York Times. September 21, 2015.
- Pollack A, Creswell J. Jump in price for an old drug will be rolled back, C.E.O Shkreli Says. The New York Times. September 22, 2015.
