Comes a new twist in the recent uproar about how pharmaceutical companies are spiking costs for variations of medicines that have been around for decades. Little children often have a difficult time swallowing pills or they run the risk of an adverse reaction to a pharmacist’s ad hoc compounded liquid version. So it figures that new pharmaceutical-company made liquid forms of older medications would find a market.
Unfortunately, insurers’ may have a difficult time swallowing the prices. Qbrelis is used for treating hypertension in children ages 6 and up, but the liquid form costs 775 times more than the 10-mg generic tablet. Epaned treats hypertension in babies one month or older. It is 21 times more costly than the 5-mg generic tablet.
Luke A. Probst, PharmD, and Thomas R. Welch, MD, of Upstate Golisano Children’s Hospital, Syracuse, N.Y., write in the New England Journal of Medicine that, “Once liquid preparations are available, pharmacies are precluded from dispensing ad hoc formulations. In many instances, instead of a month’s supply of an extemporaneously compounded preparation costing a pharmacy less than $20, the commercially marketed liquid will have a wholesale acquisition cost of $1,000 or more.”
Probst and Welch acknowledge that the development and marketing of a pediatric liquid drug can be costly. The complexity of the drug, preclinical and clinical testing, regulatory filings, the size of the market and the length of market exclusivity all add to the costs.
“Intuitively, though, the costs should be less than the costs to develop an entirely new drug,” write Probst and Welch. “Pricing models should take such a difference into consideration. Streamlining the regulatory requirements related to the development of pediatric drug formulations as well as responsible pricing models could preclude the call for legislative cost controls.”
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