[Ip-health] FT: US charges 200 times UK price for common worm pill

Thiru Balasubramaniam thiru at keionline.org
Sun Dec 18 23:20:31 PST 2016


Drug prices

US charges 200 times UK price for common worm pill

Impax sells childhood infection treatment course for $880, against £3.50 in

by: David Crow in London

A US drugmaker has put a price tag of more than $800 on a pinworm treatment
— 200 times more expensive than the equivalent medicine on British pharmacy
shelves, in the latest example of “price gouging” in the world’s largest
healthcare market.

Impax Laboratories started selling mebendazole this year at an average
wholesale price of $442 per pill, according to figures seen by the
Financial Times, which were checked with several US pharmacy chains
including Walgreens and CVS.

Most cases of pinworm, a parasitic infection also known as threadworm,
require two pills, meaning a course of treatment costs about $884. The drug
is available prescription-only in the US but can be bought over the counter
in the UK, where Boots, a British chemist chain, charges £6.99 for a pack
of four pills, or £1.75 each.

The pinworm parasite, which is common in children, affects 200m people a
year worldwide and up to 40m in the US. It is recommended that family
members are treated for the highly contagious infection at the same time,
meaning a household of five’s treatment costs more than $4,400.

Mebendazole was first used to treat pinworm and other parasitic infections
in the 1970s and is on the World Health Organisation’s list of essential
medicines. In the developing world it can be bought for less than 1 cent
per pill.

The drug was available as a cheaper generic version priced at around $1.60
per pill until 2011, when it was removed from the market by Teva, the
manufacturer, without explanation.

Impax reintroduced a branded version of the pill, Emverm, in April, and is
the only provider of mebendazole tablets in the US. It is also the only
purveyor of albendazole pills, which treat other parasitic infections, and
which doctors sometimes prescribe for pinworm.

“In my opinion, this is the latest example of a pharma bad actor cornering
the US market and taking advantage of payers and consumers,” said Michael
Rea, chief executive of Rx Savings, which makes software to help reduce the
cost of medicines.

Impax declined to comment.

Impax is not a household name, but the group briefly gained notoriety in
2015 after it sold Daraprim, a life-saving drug for Aids and cancer
sufferers, to a company controlled by Martin Shkreli, the disgraced pharma

Mr Shkreli swiftly raised the price of Daraprim from $13.50 to $750 a pill,
prompting an international outcry. Like mebendazole, Daraprim was first
discovered decades ago, appears on the WHO’s essential medicines list, and
is available in developing countries for just a few cents.

Critics say the reintroduction of mebendazole at such a high price more
than 40 years after it was first used by doctors — and decades after its
patents expired — shows how drugmakers are able to charge huge sums for old
medicines that cost them little to develop.

“We’ve been seeing isolated examples of generic price gouging — individual
products that become essentially single source, which are able to take
enormous price increases,” said Steve Miller, chief medical officer of
Express Scripts, a US pharmacy benefits manager that negotiates drug prices
on behalf of employers and insurers.

Impax has not released sales figures for the medicine since it went on sale
eight months ago, but David Amsellem, analyst at Piper Jaffray, estimates
the market could be worth nearly $300m per year.

In its third-quarter earnings, Impax said it would be “building awareness
that mebendazole is back” and told investors that Emverm was the “only
prescription therapy for pinworm” approved by the US Food and Drug

For families with good healthcare coverage, their insurer would pick up
most of the cost. But a growing number of Americans on cheaper insurance
plans contribute up to 50 per cent of the price.

Families unable to afford the medicine must use a powder formulation,
pyrantel pamoate, which has not been approved by the FDA. The formula is
less effective than mebendazole and can cause side effects such as toxicity
in the central nervous system, according to Stanford University.

More information about the Ip-health mailing list