There’s no good reason for a drug to go from $10 to $1,500

If ever there were a perfect snap- shot of dysfunction in modern American medicine, it would appear in the pharmaceutical dictionary beside the word Makena.

That is the trade name for a drug whose rights are now owned by KV Pharmaceuticals, a St. Louis-based company that didn’t invent the drug; it bought exclusive rights to it, named it and got Food and Drug Administration approval for a monopoly in marketing it.

The drug is a synthetic form of the hormone progesterone, which has been prescribed by obstetricians for years to forestall premature births among high-risk pregnant women. Weekly doses were $10 to $20 from a variety of pharmaceutical labs, but when KV announced the introduction of Makena, the cost shot up to $1,500. The cost of stabilizing a high-risk pregnancy would have gone from $200 or $300 to $20,000 or $30,000 depending on the number of injections a woman needed. The company originally tried to maintain its product was still a bargain, because the average cost of treatment of a premature infant is $51,000.

Under withering criticism from, among others, U.S. Sen. Sherrod Brown, D-Ohio, a threat by the FDA to allow other pharmacies to continue to market their progesterone and an announcement by the March of Dimes that it was severing ties with KV, the company relented.

It dropped the price to $690 and announced patient-assistance programs the would provide heavy discounts to uninsured women and caps for state Medicaid agencies and health insurance plans.

Entitled to profit, but ...

Certainly drug companies are entitled to a profit, and to be compensated for the extraordinary investments they make in developing and testing new drugs.

But this was not such a case. This was a case of profiteering, and doing so in a way that not only endangered the health of premature babies and the mental health of their mothers, but represented a potential enormous cost to individuals, insurance companies and state Medicaid funds. It also threatened to increase the number of premature births, placing a strain on the medical facilities available to those infants.

The word entitlement is bandied about these days — generally in a derogatory context regarding people of lower economic stature who presumably go through life thinking the world owes them a living. But the Makena story defines a corporate sense of entitlement to profit without even producing something new that transcends the wildest dreams of any working stiff or retiree, or of anyone on Medicaid, Medicare or Social Security.

The scourge of entitlement can be found at many levels. An indignation with those who exhibit it shouldn’t be confined to any one segment of society.