Turing Daraprim Price Hike Follows a Precedent

Old drugs with new price hikes add another dimension to the national drug pricing debate.

Sometimes, drug price increases can be attributed to raw material shortages, but other times, the hikes are just a business strategy executed under claims that the drugs were undervalued to begin with.

Whatever the reason, the public has taken notice of the trend, especially in the wake of Turing Pharmaceuticals increasing the price of the 62-year-old drug Daraprim 5000% overnight under the latter motive.

At 10:56 a.m. yesterday, Democratic presidential hopeful Hillary Clinton tweeted, “Price gouging like this in the specialty drug market is outrageous. Tomorrow I’ll lay out a plan to take it on.”

Clinton’s proposal aims to lower drug costs by reducing pharmaceutical industry tax breaks and mandating certain levels of research spending, Bloomberg reported today.

Specific provisions of her plan include:

• Enacting a $250 per month ($3000 per year) cap on patients’ out-of-pocket spending for prescription drugs.
• Reducing the sales exclusivity period for biotech drugs to 7 years from the current 12 years.
• Banning pharmaceutical companies from writing off drug advertising spending as a business expense.
• Allowing Medicare to negotiate drug prices with manufacturers—a right already afforded to both Medicaid and the US Department of Veterans Affairs.

In the meantime, Daraprim joins the following list of steep price hikes seen after drug acquisitions:

1. Pyrimethamine (Daraprim)

In August, Turing Pharma purchased the rights to Daraprim, the decades-old standard of care drug for life-threatening toxoplasmosis that is also a co-treatment for HIV and malaria.

Following the drug acquisition, the price per tablet of Daraprim promptly leaped from $13.50 one day to $750 the next.

The Infectious Diseases Society of America and the HIV Medicine Association sent a joint letter to Turing calling this price increase “unjustifiable for the medically vulnerable patient population” and “unsustainable for the health care system.”

Turing CEO Martin Shkreli told CBS News that the Daraprim price hike was “not excessive at all.”

“…The drug was unprofitable at the former price, so any company selling it would be losing money. And at this price, it's a reasonable profit,” Shkreli claimed.

2. Nitroprusside (Nitropress) and isoprotenerol (Isuprel)

Valeant Pharmaceuticals raised these 2 life-saving heart medications’ prices by 525% and 212%, respectively, after buying the rights to them in February.

Because both drugs are mainstays in cardiovascular treatment, payers and health systems have lamented that the price hikes had an immediate effect on their ability to absorb the cost of treating heart patients.

Valeant’s price hikes play a role in the ongoing joint effort by US Sen. Bernie Sanders and US Rep. Elijah Cummings to push the Medicaid Generic Drug Price Fairness Act through Congress.

3. Cycloserine (Seromycin)

The price of this tuberculosis drug increased from $500 for 30 capsules to $10,800 for 30 capsules after Rodelis Therapeutics acquired it from The Chao Center in August.

Interestingly, Rodelis announced Monday that it was returning the drug to the Chao Center, following the media frenzy over the Daraprim price increase.

The drug will still cost $1050 for 30 capsules, which is double the original price, but far below Rodelis’ initial cost hike.

4. Intravenous acetaminophen (Ofirmev)

When Mallinckrodt acquired Ofirmev in 2014, it immediately increased the price of the pain drug from $350.40 for 24 vials to $1020 for the same amount.

This represented a nearly 2.5-fold increase far above the 37% price increase that the original manufacturer Cadence Pharmaceuticals implemented during the 3 years prior to Mallinckrodt’s acquisition.

5. Naproxen and esomeprazole magnesium (Vimovo)

Horizon Pharma acquired Vimovo from AstraZeneca at the end of 2013. On its first day selling the pain drug, Horizon hiked the list price for 60 tablets to $959.04—a 597% increase.

The manufacturer increased the price again at the beginning of 2015 to $1678.32 for 60 tablets.