A medication for pregnant women that prevents premature birth that currently costs $10 to $20 per dose will soon cost $1,500 per dose. Why and how did this happen? In a move that was intended to make the drug Makena more available and of a more consistent quality, its manufacturer, KV Pharmaceutical, was granted a retroactive monopoly, making it the only pharmaceutical company to sell the drug and, therefore, charge whatever they want according to their own labor, research, and manufacturing costs. So, if you had any doubts whose side the pharmaceutical industry was on …
The most frustrating part about all of this is how vocal and adamant organizations such as the March of Dimes were about this move. Obviously, women with a history of high-risk pregnancies and premature births deserve a solution that has been proven to help other women in similar situations. The costs of caring for a premature baby can be astronomical and the long-term effects on the baby are devastating, but this is preventable with a drug like Makena. In fact, Makena can save about 10,000 high-risk pregnancies from spontaneously ending every year. And to produce that drug uniformly, meeting the high standards of one manufacturer rather than several manufacturers with varying standards, makes sense. In theory.
But clearly, they were not anticipating the price hike that came with the monopoly, which will render Makena out of financial reach for just low-income women as well as uninsured, middle-class women. Because Makena is not a one-time medication — it’s a weekly shot of a form of progesterone, administered about 20 times throughout a woman’s pregnancy. That means that the total cost to the women will go from about $200 to a staggering $30,000. And insurance providers will be forced to raise their premiums if they still want to cover their patients who take Makena. Aetna, for example, still plans to include Makena as part of its coverage, but it will cost them an additional $30 million a year.
Previously, Makena was a generic, custom compound mixed in a pharmacy that wasn’t FDA-approved. Now that it has received that approval, it will no longer be a generic drug, and state Medicaid programs will find it hard to pay for. The company expected to market the drug, Ther-Rx Corp., says that it is planning a patient assistance program to help low-income women and the uninsured get the drug “at little to no cost.” But someone is going to have to pay for it.
I think the question we’re all wondering is how the cost of such an important drug did not come up in the conversation, and if it did, what was said about it? Did someone forget to mention the 150-fold increase? How do you neglect to mention that? Is this something that normally goes undiscussed? Did no one take a look at the current economic climate? Because I’m no business person, nor am I a pharmaceutical expert, but when unemployment is at just under 9 percent and there are about 50 million people without health insurance, the first thing I’m asking is “How much is this going to cost out of pocket??”
And then the cynical side of me says they probably discussed it and someone either lied or witheld the truth, which is just as bad. Let’s hope they keep their promises on the assistance.
