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In a blow to Alexion Pharmaceuticals (ALXN), a Canadian government agency ordered the drug maker to lower the price of a rare disease medicine and reimburse the government for “excessive” pricing.

The ruling by the Patented Medicine Prices Review Board follows a long-running struggle that began after the drug maker three years ago refused to lower its price for Soliris, which, depending upon the disease, costs either US$383,000 or $585,000 per patient. The government agency also asked Alexion to repay sales generated by the drug from 2012 through the first half of 2014.

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