Cheap Generic Drug Challenges Big Nitroprusside Price Hike

Hospitals wait for promised Valeant discounts

As hospitals wait for the discounts that Valeant Pharmaceuticals promised on its price-hiked blood pressure therapy Nitropress (nitroprusside), relief has arrived in the form of a cheap generic competitor, according to an article posted on the FiercePharma website. Last week, the FDA approved generic sodium nitroprusside, marketed by Namigen LLC.

In August 2015, lawmakers began grilling Valeant after it hiked the price of Nitropress by 212%––from $258 to $806 per vial––after buying the product from Marathon Pharmaceuticals. In April 2016, Valeant execs vowed before Congress to offer discounts to hospitals of up to 30% on the product––but hospitals are still waiting.

In September, Bloomberg contacted 23 hospital systems and purchasing groups to find out how the discount program was doing. In some cases, the hospitals said Valeant’s contract offers were undesirable. In others, they were unable to get a response from the drug maker. Others appeared not to know that they might need to negotiate with Valeant for discounts, rather than get them automatically.

Erin Fox, director of the drug information service at University of Utah Health Care, told Bloomberg that her organization had spent $540,000 on Nitropress in 2016––more than 20 times more than in 2013.

“Valeant is being very consistent about not returning calls, and providing zero information on accessing potential discounts,” she said.

John Lewin, director of the critical care and surgery pharmacy division at Johns Hopkins Hospital, reported that a day’s therapy of Nitropress cost almost $10,000 on average––up from approximately $440 a day in 2013.

The new approval of generic nitropruside is another warning to drug makers that price increases won’t necessarily be a viable strategy going forward, according to the FiercePharma article. Valeant has already seen some of its peers—including Turing and EpiPen-maker Mylan—pilloried for their controversial pricing strategies.

But in addition to reputation issues, competition is another reason monster price hikes won’t necessarily work, the article says. Last October, for example, compounding pharmacy Imprimis challenged Turing Pharmaceuticals’ overpriced Daraprim (pyrimethamine) with a $1-per-pill version.

EpiPen, an epinephrine auto-injector, is also coming under siege by less-costly rivals. Imprimis has announced that it is working on another solution, and former EpiPen nemesis Auvi-Q—pulled from the U.S. market after manufacturing issues spurred a recall—could soon be back on the scene. Moreover, Impax Laboratories—maker of its own approved epinephrine auto-injector, Adrenaclick—is working on significantly expanding its manufacturing capacity.

Sources: FiercePharma; December 12, 2016; FDA; December 8, 2016; FiercePharma; August 14, 2015; and Bloomberg; September 16, 2016.