A simple suppository can avert a potentially life-threatening disorder. It’s an old anti-inflammatory medicine called indomethacin (a cousin of Advil). It prevents dangerous inflammation in the pancreas among people who receive an ERCP (endoscopic retrograde cholangiopancreatography) – a test where gastroenterologists (GI doctors) insert an endoscope into the ducts of a person’s pancreas or liver.
With more than a half million ERCPs performed in the US, this little pill does a lot of good. Even better, it’s been off patent for decades, meaning it should be inexpensive.
In fact, it was inexpensive in the recent past, just $2 per suppository in 2005. But in recent years, the price has climbed, no…it has leaped to more than $300.
Here’s a picture of the outrageous trajectory of this version of highway robbery from a study in JAMA Internal Medicine, showing a doubling in price when Zyla Life Sciences (now Asserto Co) bought rights to the drug:
Escalating Price of Indomethacin Suppositories
Escalation in price of indomethacin suppository
More recent reports list the price at more than $400. For an old (!), previously inexpensive (!) little suppository.
What is a sensible healthcare system to do, in light of this obvious profit mongering? There’s no alternative medication available for this use in America today. And the market appears to be too small to invite competitors. Spend tens of millions of dollars bringing an alternative product to market, and the manufacturer will lower its price and make you pay for daring to compete.
I guess insurance companies could play hardball, and tell the company they won’t pay for the drug at that price. But then the cost will just get passed along to patients, with little chance they’ll learn about their out of pocket cost before they receive the bill.
If you’re not already angry enough, here’s another infuriating fact explained in the JAMA essay: many hospitals jack the price up two-fold, five-fold, even ten-fold before sending bills to their patients. In other words, they buy the overly priced drug and then charge patients and insurers an even higher price for it.
To greedy pharmaceutical companies and greedy hospitals: Enjoy the money you’re making now. Because you’re inviting a revolution. You’re creating an upswell in the number of people who won’t take it anymore, and who will demand that their elected representatives put an end to those unjustified and unjustifiable prices.