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Canadian authorities are reviewing whether Horizon Pharma (HZNP) violated pricing and advertising laws in connection with its efforts to boost sales of a newly approved rare disease drug that costs about $230,000 and replaced an older, similar medicine — which cost a fraction of the price.

At issue is a medicine called Procysbi, which Health Canada endorsed last August for treating cystinosis, a disorder that causes poor growth and kidney damage, and afflicts about one in every 100,000 to 200,000 newborns worldwide. But the approval has ushered in a controversy, raising questions about the trade-off between encouraging innovation and maintaining accessibility.

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