Express Scripts Pushing $1 alternative To Turing's $750 Daraprim Pills

from the almost-competition dept

When last we checked in with the internet’s least-liked human being, the CEO of Turing Pharmaceuticals was backpeddaling on his promise to lower the cost of the AIDS and cancer fighting drug Daraprim, and hiding it ahead of the Thanksgiving holiday in the hopes that fewer people would notice (it worked relatively well). CEO Martin Shkreli, you’ll recall, increased the price for Daraprim from $13.50 per pill to $750 — a 5000% or so mark up for a sixty-two-year-old medication. Shkrelli brought renewed attention to the skyrocketing prices of generics thanks to (ab)using restricted distribution to deny samples to generics manufacturers.

But there may be a small ray of sunshine in what’s an otherwise dismal tale of greed. Prescription drug manager Express Scripts has indicated that the company will soon promote use of a compounded medicine that contains the same active ingredient as Daraprim, and offer it at a fraction of the price. Express Scripts manages prescriptions for tens of millions of Americans and will be pushing the compounded alternative made by Imprimis Pharmaceuticals. The new compounded alternative includes Daraprim?s active ingredient, pyrimethamine, as well as leucovorin, included to treat side effects.

The end result will be something that almost looks like competition:

“Compounded drugs are customized formulations made by pharmacies for particular, named patients. That requirement restricts how directly Imprimis can compete with Turing. For instance, hospitals cannot stock the compounded version to use for patients coming to the emergency room.

Imprimis, which is publicly traded, is not allowed to make a direct copy of Daraprim. So its capsule contains both pyrimethamine and leucovorin, a drug that is often prescribed with Daraprim to ease certain side effects. If a doctor writes a prescription for Daraprim, Express Scripts or pharmacies cannot substitute the compounded drug produced by Imprimis. So physicians will have to write a prescription specifically for the compounded drug and fax it to Imprimis.”

It’s a bit of a cumbersome tap dance (so glad we’re still using faxes in the age of gigabit fiber), but at least it’s an alternative. Impremis has stated it plans to offer the compounded drug for as low as 100 capsules for $99. Express Scripts in turn will help speed delivery of the cheaper option, working with the Infectious Diseases Society of America and the HIV Medicine Association to inform medical professionals about the alternative. Turing has so far responded by telling media outlets that “in addition to being potentially unsafe and ineffective, the compounded product is unnecessary.”

Granted, the actual impact may still be low; Express Scripts states it only had 350 patients who used Daraprim last year. Still, it’s the principle of the thing, and it’s nice to see the market — even if it has to jump through hoops to do so — giving Shkreli and Turing a few quick kicks to the shins.

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Companies: express scripts, imprimis, turing pharmaceuticals

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Comments on “Express Scripts Pushing $1 alternative To Turing's $750 Daraprim Pills”

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20 Comments
Mason Wheeler (profile) says:

Re: "...tale of greed."

This isn’t “good old capitalism.” Try reading Adam Smith sometime.

Free market principles only work when freedom exists in the marketplace, and that means strong, healthy competition. When there isn’t competition, everything breaks down and you end up under a system of monopoly economics, which looks more like extortion than capitalism, especially when the product being sold is necessary to prolong life.

Wendy Cockcroft says:

Re: Re: Re:3 Even proper Republicans don't call this capitalism.

You see that large simian creature in the middle of the room? The one scratching his armpits and beating his chest? Let’s talk about him, shall we?

The problem here is permitting intellectual monopoly maximalists to characterise their temporary privileges as property rights. They get away with it because property rights and the rent-seeking that goes with it is essential to a capitalist/market-led economy and anyone who opposes property rights is a librul soshalist commie pinko.

Limiting property rights and calling out BS over the definition of property will help to cage the beast but I fear I am alone in saying this.

Anonymous Coward says:

Good for patients to have a working alternative to Daraprim, so you won’t have to treat yourselves with horse medicine…
Practical question: are there any doctors/veterinarians who could legally prescribe horse medicine for humans? …

Still, this is just one drug, and not even the only one Shkreli is involved with. Before Daraprim, there was Thiola. And we’ll see what comes next.
http://blogs.sciencemag.org/pipeline/archives/2014/09/11/the_most_unconscionable_drug_price_hike_i_have_yet_seen

This will happen again… unless the loopholes are closed.
Quote from comments in the link above:

“If anyone can prevent other generics making from obtaining samples of compound for testing…” (for FDA approval)
Fix seems simple enough, mandate generic manufacturers file formulation info with the FDA who maintain it in an open source data base.
Does that make sense?

Jamie (profile) says:

Impact may still be low

Granted, the actual impact may still be low; Express Scripts states it only had 350 patients who used Daraprim last year.

If each of those patients was buying 1 pill per day for a year, they’d be paying Turing $273,750 each. That’s a total of $95.8 million, which is not exactly a small amount of money.

And that’s just 350 patients! Imagine the financial impact if Express Scripts manage to steal the majority of Turing’s customers… We could be talking billions of dollars a year.

That One Guy (profile) says:

"It's not my fault my greed resulted in the prices skyrocketing!"

Turing has so far responded by telling media outlets that “in addition to being potentially unsafe and ineffective, the compounded product is unnecessary.”

Blatantly incorrect, but given why he’s wrong, it’s not surprising he’d lie instead of admitting the truth.

When the drug was still affordable for the majority of patients, and they could get it without too much hassle, the ‘new’ drug would indeed have been unnecessary. However, by letting his greed get the best of him, and pricing it so insanely high, he created the need. It is entirely his fault that someone needed to step in and offer the drug at a more affordable rate.

nasch (profile) says:

Re: "It's not my fault my greed resulted in the prices skyrocketing!"

However, by letting his greed get the best of him, and pricing it so insanely high, he created the need.

There’s no need, those patients can either choose to pay his high price for the drug, or they can choose to die. I imagine Shkrelli would prefer the latter, rather than competition.

And is it just me or does Shkrelli sound like an alien species from Star Trek?

The Wanderer (profile) says:

Why no "direct copy"?

Imprimis, which is publicly traded, is not allowed to make a direct copy of Daraprim.

Why not?

Given that (per the article) it’s 62 years old, it must be long since out of patent. What is there which would forbid anyone who wants to do so from making a direct copy of it, using the information filed in the patent?

I was under the impression that the reason there isn’t / hasn’t been off-brand competition for Daraprim is that getting FDA approval for a generic alternative would require expensive studies, even if the generic is chemically identical to the brand-name drug. That’s ridiculous enough as it is, but if Imprimis is making a non-identical alternative, that should certainly have to go through at least as many studies to get approval – so how could the hoops to jump through for producing the identical generic be any more prohibitive?

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