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Yet another showdown over the high cost of medicines is taking place in Ireland, where the government and the maker of a cystic fibrosis treatment are locked in a battle that has enraged and worried patients.

The struggle is over Orkambi, a drug sold by Vertex Pharmaeuticals that has a price tag of about $170,000 a year. But Ireland’s National Centre for Pharmacoeconomics determined the medicine would be cost effective only if it were priced at about $32,000 per patient and did not recommend reimbursement. Consequently, Ireland’s Health Service Executive has so far refrained from providing coverage.

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