Cornering the Market on Essential Drugs

Cornering the Market on Essential Drugs

In this June 14, 2011, file photo, bottles of prescription drugs: Lipitor, TriCor, Plavix, Singulair, Lexapro and Avapro are displayed at Medco Health Solutions Inc., in Willingboro, N.J. Express Scripts Holding Co. said Tuesday, March 10, 2015, that prescription drugs spending rose 13 percent last year, the largest annual increase since 2003. (AP Photo/Matt Rourke, File)
(AP Photo/Matt Rourke, File)

(Slate) – A few months ago, I treated a patient for a case of pinworm, a parasitic infestation that affects roughly 400 million people worldwide, with 40 million of those cases occurring within the United States. Though pinworms can be found in middle-class suburbs, the parasite is common in settings of urban poverty, including the low-rise public housing complexes across the street from my East Baltimore clinic, where far too many people struggle to survive on less than $2 a day.

The diagnosis itself was relatively easy to make, and though my patient had no insurance, I sent her to the pharmacy confident that the right drug for her disease, albendazole, should only cost a few dollars to fill. After all, the drug had been introduced in 1971, and by the 1980s its cost was so low and its use so broadly validated that it was added to the essential drugs list of the World Health Organization: a powerful medicine widely available for pennies a pill. When she returned an hour later saying that she could not afford the medication, I pressed for more detail. Sometimes even a few dollars can be too much for patients scraping to make rent or buy food for their families, and our staff has a limited ability to offer vouchers to help cover drug costs in times of need. Yet I was not prepared for the figure she showed me: The two pills of albendazole I had prescribed would cost her an untenable $330. As I soon discovered, the U.S. market for the once-generic drug albendazole had been cornered by a small pharmaceutical company called Amedra and retrofitted into a newly exclusive brand, Albenza, at more than $150 a pill.

This week’s revelation that another small pharmaceutical company, Turing Pharmaceuticals, acquired the sole U.S. distribution rights to another antiparasitic drug on the WHO essential drugs list and boosted its price by more than 5,000 percent, suggests that the price jacking of albendazole was no fluke. After it came out that Turing, having acquired the 62-year-old drug pyrimethamine, suddenly raised its price of a single pill from $13.50 to $750, the topic went viral, prompting calls from Democratic presidential candidates Bernie Sanders and Hillary Clinton to control escalating drug prices. Turing’s brash and unapologetic CEO, Martin Shkreli, did little to diminish the story after confidently asserting in a CNBC interview that the new price of the drug should simply be borne on the backs of existing patients and calling one journalist a “moron” for contesting the ability of the drugmaker to set whatever price he wanted to.