Two antibiotics – Pyrimethamine (branded Daraprim) and Cycloserine (branded Seromycin) were in the news recently for the same reason. Both of them were subjected to price increases of astronomical proportions, in a feat of price gouging that seems to be the new modus operandi of drug companies.
Turing Pharmaceuticals recently acquired Daraprim from Impax pharmaceuticals. It then promptly increased the drug price from $13.50 to $750, an increase of about 5000%. Daraprim is an important drug that is used to treat Toxoplaxmosis, a parasitic disease of the brain that affects people with weakened immune systems. Around 3 billion people in the world are said to be carriers of the protozoan.
In a similar move, Rodelis Therapeutics acquired Cycloserine from the Chao Center (a Purdue Research Foundation affiliate) and increased to increase the price of the drug from about $500 dollars to an astronomical $10,800 for 30 pills. Rodelis later backtracked after protests by Chao, and now has returned the drug back to them.
Cycloserine is used as a second line therapy for the treatment of multidrug resistant TB. At the new prices, the price of cyclosercine alone required to treat MDR-TB for the 24 month course would have been an astronomical 500,000 dollars. Manufacturers in the developing world make generic Cycloserine for as little as $20 per 30 pills. Chao says it will increase the price of the drug to about $1,050 dollars. The manufacture of Cycloserine has been a loss making operation for Chao.
And these are not stand alone incidents. The price of Doxycyclne has been up to $1849 dollars per bottle from about $20 dollars in 2013. Some cardiovascular drugs, that have been around for a long time, have seen price increases as well.
The script for the story seems eerily prototypical. Take a relatively rare or neglected disease drug that is off patent, has no local manufacturing competition, and market it as a specialty drug with a hefty price tag. Althuough these drugs may be manufactured for much cheaper outside of the OECD countries, they can’t really be imported to the rich world because these manufacturers have not been approved by the regulatory bodies. Chao for example is the only FDA approved manufacturer of Cycloserine in the world. Furthermore, some of these drugs could find indications that are currently not in use for. D-Cycloserine has a putative role in increasing neuroplasticity, thereby potentially lending itself to use in schizophrenia and tinnitus treatment. This would mean a huge increase in the market for a drug that has already been available for more than 50 years.
The general public has always been a little ambivalent about its opinion of the pharmaceutical industry. On the one hand drug companies bring valuable skill and expertise to the drug discovery, manufacture and marketing process. On the other, they seem to leverage thier valuable role in healthcare by running, what appears to many as an extractive inudustry bent on maximizing profits at the cost of everyone else. Incidents like these will only work to reinforce the latter notion.