Preemie message boards are all fired up by KV Pharmaceutical’s pricing of 17 Alpha-hydroxy progesterone caproate (17P, a hormone than can help prevent premature delivery for some women who have previously delivered prematurely). Once KV was awarded the patent, the price metastasized from $10 to $1500 a shot. More expensive per ounce than gold.
The March of Dimes supported KV Pharmaceutical’s application to the FDA, apparently over concern about product consistency in compounding pharmacies. However, I can’t find one article in PubMed to support this claim. I suspect some compounding pharmacies make inferior products, just like some doctors give bad advice, and some non-profits make bad choices.
The FDA has long had an issue with compounding pharmacies, so I wonder who actually got this whole process underway. Personally, I think a lot of compounding (such as tailoring “bioidentical hormones,” is nothing but snake oil, but that doesn’t mean the drugs are not mixed up correctly, just that the superiority of such preparations compared to standard commercial preparations has never been tested. I’m all about the evidenced based medicine).
Once the backlash began, the March of Dimes quickly released the following statement:
The FDA’s decision to approve Makena will help ensure that a consistent drug will be more widely available to prevent premature births. We played no role in the pricing of products. We have discussed the price with manufacturer Ther-Rx and have received their assurance that no medically eligible women will be denied the drug due to inability to pay. Financial assistance is available through Makena Cares Connection.
I have no doubt that the March of Dimes had no role in the price point, but the result can only mean one of two things:
The March of Dimes were incredibly stupid/naive thinking KV Pharmaceuticals (who barely escaped bankruptcy last year) would have a reasonable price point. I was interviewed by Matthew Herper, a reporter from Forbes magazine yesterday and he was not shocked at all by the price of $1500 per shot. In fact, he felt that price was pretty easy to predict based on how Big Pharma prices drugs. But he actually studies the business of health care. I dunno, maybe the March of Dimes could have thought of the implications before supporting the application. Maybe they could have, you know, asked around, done some research.
The other option is that The March of Dimes thinks it is justifiable to charge $30,000 per treatment, which would mean they all flunked grade 5 math. A premature baby costs $50,000 to get home from the hospital (this is average, some kids like mine are $250,000 babies and others cost $20,000). You need to treat at least 5 pregnant women with 17P to prevent one premature delivery, so it will cost $150,000 (5 X $30,000) to prevent one premature delivery. At this price point, 17P becomes cost ineffective.
Of course 17P should be used regardless of price, but the reality is the price will make it harder for some women to get the treatment and the added price tag to 50,000 or so pregnancies a year will have a ripple effect that we will undoubtedly all feel in higher premiums.
If the March of Dimes wants to win back my support or the support of the majority of preemie moms (check out all the nasty comments on the March of Dimes Facebook page), they’re gonna have to do better than their tepid statement. Perhaps they should start by proving, you know, with scientific evidence, that this whole process was even needed in the first place.