Slate: A Giant Pain in the Wallet


Slate: A Giant Pain in the Wallet

A drug called colchicine is all that keeps some 2 million American gout patients from suffering debilitating pain in their toes, elbows, wrists, and fingers. Doctors have prescribed the compound, derived from the seeds of the autumn crocus, for centuries. But patients who take colchicine woke up with a new symptom recently: a giant pain in the wallet.

Until January, colchicine was sold by many companies and cost as little as 10 cents a pill. Now it’s available only under the trade name Colcrys, sold by a Philadelphia company called URL Pharma–for five dollars per pill.* The colchicine story, and a few others like it, have provoked ire among some patients and doctors about an otherwise praiseworthy effort by the FDA to get rid of old, untested, potentially harmful drugs.

Take the case of 17 alpha-hydroxyprogesterone caproate (17OHP), a synthetic hormone designed to prevent preterm births in pregnant women. An unapproved form of the drug was previously formulated at specialized pharmacies. In February, after K-V Pharmaceutical Co. submitted its version of the drug to rigorous testing, FDA approved the new drug under the trade name Makena. Pharmacies that try to sell their own forms of 170HP now risk FDA enforcement action such as fines or raids.

The drug’s retail price jumped from $15 to $1,440 per treatment, a shock to obstetricians and their patients, as well as to those who write checks at insurance companies and Medicaid. The tens of thousands of women who receive the treatment each year typically require 20 injections during the course of their pregnancies.

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