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Southwest Life Health And the West is History Community Travel

Generic drugs increase in price rapidly

The first sign of trouble came when Dr. Barry Lindenberg, a cardiologist, received a three-page insurance form in January, demanding he get preapproval to prescribe one of the oldest known heart medicines.

His patient had been on the drug, digoxin, for many years. A mainstay of treating older patients with rapid rhythm disturbances, it was first described in the medical literature in 1785. Millions of Americans still use it every day, and many had long paid just pennies a pill.

“I wrote on the form: ‘ARE YOU KIDDING ME?’” said Lindenberg, who practices in Schenectady, New York.

What the cardiologist did not know then was that the price of generic digoxin was rapidly rising. The three companies selling the drug in the United States had increased the price they charge pharmacies, at least nearly doubling it since late last year, according to EvaluatePharma, a London-based consulting firm.

For patients, that meant the prices at pharmacies often tripled from last October to this June, according Doug Hirsch, chief executive of Goodrx.com, a website that tracks drug pricing to help consumers find good deals. And while the average price tag at the pharmacy for a month of digoxin this year is still relatively cheap, about $50, he said, some patients are now encountering costs of more than $1,000. That can translate into copays of hundreds of dollars.

No wonder, Lindenberg said, that he began hearing from patients requesting a drug change because they could not afford digoxin.

In recent years, generics have curbed the rise of drug prices, saving the U.S. health-care system billions of dollars. After the patents for Lipitor, the cholesterol drug, and Ambien, the sleeping pill, expired in the last few years, for example, generics entered the market and prices plummeted.

But increasingly, experts say, the costs of some generic drugs are going the other way. In January, the National Community Pharmacists Association called for a congressional hearing on generic drug prices, complaining that those for many essential medicines grew as much as “600, 1,000 percent or more” in recent years.

Digoxin provides a telling case study. There was no drug shortage, according to the Food and Drug Administration, that might explain the increase. There was no new patent or new formulation. Digoxin is not hard to make. What had changed most were the financial rewards of selling an ancient, lifesaving drug, and company strategies intended to reap the benefits.



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