Blog | Thursday, September 24, 2015

'The scandal isn't what's illegal; the scandal is what's legal'


This quote, attributed to Michael Kinsley, is applicable to a very disturbing trend that is having an increasing impact on antimicrobial availability: the acquisition of exclusive marketing rights (usually by small private firms) to inexpensive generic drugs in order to jack up their prices astronomically. The antimicrobials pyrimethamine, albendazole, cycloserine, flucytosine, and doxycycline have all experienced price increases of up to 5,000%, and there have been several recent posts on the Emerging Infections Network about how this is limiting availability of these agents for those who desperately need them.

I hope this New York Times story about the pyrimethamine saga draws more attention to this trend, and leads to some regulatory reforms to prevent this obvious price gouging. Because, you guessed it, there is nothing illegal about this under U.S. law.

Fortunately, because it engenders bad press when people suffer and/or die due to unavailability of an essential drug, some of these “pharmaceutical companies” (I put that term in quotes, because the company that owns marketing rights to pyrimethamine is founded and run by a hedge fund manager) will immediately send out the drug at a reduced price (or even without charge) if contacted by the treating physician.

Such saints, these folks are.

Daniel J. Diekema, MD, FACP, practices infectious diseases, clinical microbiology, and hospital epidemiology in Iowa City, Iowa, splitting time between seeing patients with infectious diseases, diagnosing infections in the microbiology laboratory, and trying to prevent infections in the hospital. This post originally appeared at the blog Controversies in Hospital Infection Prevention.