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drug used to treat lead poisoning is causing a toxic reaction among hospitals and poison control centers after Valeant Pharmaceuticals jacked up the price more than 2,700 percent in a single year.

At issue is a decades-old, intravenous treatment for severe and life-threatening cases of lead poisoning, which occur infrequently, but generally require supplies to be on hand. Known as Calcium EDTA, Valeant acquired the drug in 2013 as part of a $2.6 billion deal to buy another company called Medicis.

After resolving manufacturing problems that caused shortages, Valeant pursued the hallmark strategy that made it infamous — taking sky-high price hikes. Before Valeant took control, the list price for a package of vials had been stable at $950. But in January 2014, Valeant boosted the price to $7,116. By December 2014, several more increases took the price to $26,927, according to Truven Health Analytics.

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Ever since, poison control specialists have been angry, especially since there are few viable options and a French company sells its version for less. Their reaction is a case study in the exasperation doctors and hospitals feel at the multitude of price hikes of all sizes that they see month after month, the vast majority of which never make headlines but create frustration and squeeze budgets behind the scenes.

“This is a drug that has long been a standard of care, and until recently it was widely accessible at an affordable price,” said Dr. Michael Kosnett, an associate clinical professor in the division of clinical pharmacology and toxicology at the University of Colorado’s School of Medicine and a consultant to the California Poison Control System, who has contacted Congress. “There’s no justification for the astronomical price increases by Valeant, which limit availability of the drug to children with life-threatening lead poisoning.”

If this sounds like a familiar complaint, it is.

For nearly two years, Valeant has been a poster child for pharmaceutical greed. Before a series of congressional hearings and an accounting scandal altered its playbook, the drug maker regularly bought companies and then boosted prices on some medicines to new heights. The plan, which largely eschewed investment in R&D, made the company a Wall Street darling.

More recently, however, Valeant suffered the proverbial reversal of fortunes. Its strategy has been discredited, its stock price plunged, government investigations are piling up and a new management team was hired. As a gesture toward the company’s many critics, the new Chief Executive, Joe Papa, promised to eschew the sort of price hikes that were taken in the past.

But skepticism remains. The drug maker committed to offer discounts on a pair of heart drugs, which are used by hospital emergency rooms, after raising prices tremendously last year. But some hospitals still grumble they have not seen the discounts. And wary of scrutiny over double-digit price hikes, Valeant last month tried flying under the radar by raising the cost of three drugs by 9.9 percent.

A Valeant spokesman maintains the current pricing is justified. “The list price increases over the past several years have enabled us to provide to the market consistent availability of a product with high carrying costs and very limited purchase volume of 200 to 300 units per year,” he wrote us. Each unit contains a pack of five vials.

He added that Valeant must purchase sufficient supplies of needed ingredients in advance and this can amount to three to five times more than recent annual sales, which were between $3 million and $5 million last year. “Given [the drug’s] relatively limited shelf life, the company takes substantial carrying cost risk and has written down at its own expense approximately half of purchased quantities in the past few years,” he wrote, adding that list price does not reflect any rebates or discounts that Valeant pays.

And so, poison control specialists fear they are stuck with the current pricing. Prior to a congressional hearing held earlier this year on drug pricing, the California Poison Control System and the American Association of Poison Control Centers wrote to the House Committee on Oversight and Government Reform to investigate the price hikes, but nothing came of their efforts.

Doctors acknowledge that the relatively few cases of severe lead poisoning each year means that only a small number of packages are stocked. There were about 50 serious cases reported in 2015, according to the American Association of Poison Control Centers. But even this small outlay can take a toll on hospital finances and, by extension public health, according to emergency room experts.

“Lead poisoning is often an inner city problem and many hospitals don’t have a lot of resources in those areas,” said Dr. Lewis Nelson, who chairs the department of emergency medicine at Rutgers New Jersey Medical School. “Hospital pharmacy budgets are not unlimited, and this is the kind of drug nobody wants to keep around because there isn’t a lot of use. So this can create a dilemma.”

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Moreover, hospitals and poison control centers apparently have few options.

A pill called DMSA may be used, but since people suffering from severe lead poisoning are unconscious or suffer seizures, it must be administered through a nasal tube into the stomach, which creates a risk of aspiration, Kosnett explained. And a hospital may be able to make a compounded version, but hospitals typically purchase intravenous medications and not all are equipped to make or sterilize such a drug.

“It’s not very viable or practical,” said Dr. Timur Durrani, an assistant clinical professor of medicine at the University of California, San Francisco and assistant medical director at the California Poison Control System. “It adds a level of complexity … Our hospital purchases the basic ingredients to compound the medication, but not all hospitals do … The price isn’t justified. Is Valeant doing something so magical that it takes thousands of dollars to make it sterile?”

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  • Speaking of drug price gouging, what about real estate price gouging. Housing affordability is just as important as drugs. Why not investigate the real estate price gouging and put a control real estate price escalation. The greedy real estate agents and landlords and sellers are just as guilty, if no more.

  • Speaking of drug price gouging, what about real estate price gouging. Housing affordability is just as important as drugs. Why not put a limit on housing prices. Greedy real estate agents are more guilty than drug company executives.

  • It does take tremendous efforts and expenses to make a drug. Just remember the years of study the scientist spent and their expenses, not to mention the invaluable talents which contribute to making a drug to safe life. Drug prices are well justified.

    • This drug had been the standard for decades, and it simply didn’t cost that much money to make the drug previously, so really I think you’re making excuses for people to make as much money as they can, no matter the context or morals, before they finally die. And then I guess leave it to their already spoiled children so the next generation of price gouging scum can live in comfort and provide a basis for the following generation. No, it’s not complicated. Human beings are like any other animal. Despite our large brains and ability to empathize and feel emotion and drive this planet towards its future, we will still look out for only our own. Because we’re awesome.

  • I had mercury poisoning years ago and underwent a series EDTA chelation treatments. With all the toxic substances in our environment and all the lead poisoning in many communities not just Flynt I would think EDTA chelation treatments would be in demand. It shouldn’t be reserved for just emergencies and a reasonable price would be in order.

  • As a pharmacy buyer in a hospital increased drug cost affects the state of the facility. Hospitals do make profits, but those profits are not coming from drug cost. Hospital pharmacies lose money. Many people believe Valeant is making smart business decisions when buying older drug patents. Drugs that have been on the market for 30+ years and are not all high demand, but are don’t have competition. Valeant has increased my budget by $190k in one year. Is that ethical? When talking about healthcare and why hospitals don’t make their own products by using powders to compound themselves in manner that suggests, ‘it’s easy. I figured that out already. Hospitals are dumb.’ culture, you’re wrong. Hospitals take sterility and stability very seriously and there are rules and regulations that need followed. To create sterile compounding facility is complex and very expensive. The next question is, if the compounding sterility lab existed within the hospital, how long is the bulk powder good for once opened to make the compound stable? These factors are why pharmacies rely on pharmaceutical manufactures to make sterile pharmaceuticals. Valeant knows these drugs are needed and that hospitals will buy them because they need them and they want to make money, I get that, but these pricing increases are out of control. A lot of these meds cost are being passed off the patients themselves that may or may not have insurance and I’ve always wondered how a drug company could feel right charging someone $17000 for 10mls of dye when that same dye cost $19 in 2013?

  • So what exactly is your beef. Your article admits its rare and very limited supplies are ever bought. Do you even know how much it costs to maintain the infrastructure needed to produce the drug? This is an old drug, there is no intellectual property involved. It’s become a generic drug by now, and if other companies think they can even break even at a lower price they’d already have done so. Companies are not in the business to lose money and forcing them to do so will only drive them to shutter production altogether, and then it wouldn’t matter what the price is because there will be zero supply. If the gov feels so strongly about it why doesn’t it manufacture the drug itself, there is no IP protection any longer, anyone can make it. I really cant believe the sort of communist junk that passes for journalism these days.

    • Dear Sidney,

      Thanks for your note – apologies for the belated reply. In any event, I don’t have a ‘beef,’ as you put it. I reported that others are upset about the price and I chose to do so because this sort of pricing pattern displayed by Valeant, and others, is an issue in the debate over the cost of medicines.

      Hope this helps,
      ed

  • I will vote for candidates who will work to place tighter restrictions on Big Pharma. The fact that pharma companies do not have to meet transparency criteria to supply drugs to the general population is mind boggling. In my lifetime I have watched this industry profit off of human suffering without shame or humanity. How much money is it going to take, to fill that never ending hole of greed? How many golden parachutes and bonuses are being handed out this year ? What a racket, insurance, pharma and the U.S. Government. Come on! Find some humanity. And not just in the marketing department.

    • It’s always someone else’s fault, or greed or whatever. You don’t seem to remember history too well, remember the soviet bread lines? Now why did that happen? Cuz you know, they had to restrict all those greedy bakers and farmers…and pretty soon there is no grain and no bread and people start starving.

      I can predict with 100% certainty what will happen if you try to cap this particular drug. Valeant will shrug say ok and stop production altogether because who wants to lose money making 300 units of a drug that requires an FDA approved manufacturing facility and all the other billion regulations that you have to pass just to sell drugs in this country. I read it takes a billion dollars and 10 years to get a drug to market. You guys aren’t asking the right question, if hospitals say they can compound it themselves, why don’t they instead of paying the market price for this drug?

  • Ironically all the heroic research to develop life saving drugs has been undone by a small group of greedy capitalist. They are moving us back to the middle ages, and they eschew themselves as the new heroes. They have proved there is no future for the human race.

    • When I took econ 101, I recall it’s all about supply and demand in a free market system. Greed doesn’t matter does it, it is an assumed fact of life. There really is no such thing as price gouging….because if you charge too high, no body will buy it, if you charge too low (price cap), everyone will buy it and you end up with lines like in the former communist block countries. Why is it a good thing for prices to go up when supplies are very low (as is the case here and during a natural disaster)? Because that signals to the market that more supply is needed there, the high prices provide incentive to bring in new supply, get it? Why is everyone blaming industry for doing nothing more than their job? The main reason for high drug prices is because the FDA takes 10 years to allow a new drug to market. So go blame the government if you’re that angry about it. The drug is Valeant’s property, if you think the price is too high don’t buy it, or compound it yourself as the hospitals say they are able to do (why then not do it themselves? maybe because it is still cheaper to buy the drug from Valeant than to do it yourself hmmm? hypocrites)

  • You should check the GoodRx App or GoodRx for the best prices on drugs around you. I’ve been savings $100s each month on Diabetes drugs, maybe they can help with lead poisoning too.

    • I did a spot check around the internet, about USD 15 for 250 grams appears to be a regular price. Maybe there are issues of purity and quality control and yadda yadda, but the crystals last forever and in the olden days the corner pharmacist could have whipped up a USP IV drip in two shakes of a lamb’s tail.

      So, USD 27K sounds like piracy and a blatant abuse of the US intellectual property laws. I would prefer that we resolve these issues amicably, today, than tomorrow with torches and pitchforks.

    • I buy EDTA buy the pound to make my own fertilizers. I add it to micronutrients along with other chelators like DTPA. It’s dirt cheap. Even using pharmaceutical grade EDTA, to complex it with some calcium and package it for an IV…… the prices they even used to charge before the increase was RIDICULOUS for what they are actually supplying.

    • @Robert This is an old generic drug, there is no IP protection. Sounds like you have a great business opportunity then, why don’t you ‘whip’ some up and sell them yourself…i’m surprised that given drug company’s ‘greed’ other drug companies aren’t already whipping some up…hell I’m surprised that despite all the complaints by hospitals (the greediest bunch in my own experience) that they don’t compound the drugs themselves…hey in the article they say it’s easy, so why don’t they? I agree, maybe they buy because it’s still less expensive than making it yourself huh?

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