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Yet another flare-up over the cost of medicines is playing out in the Netherlands, where the government is angry at Novartis (NVS) for boosting the price of a cancer treatment more than six times — to roughly $26,000 for an infusion — in a convoluted case that has spurred debate about orphan drug status and the ability of local hospitals to make their own lower-cost alternatives.

At issue is a medication called lutetium octreotate that is used to combat neuroendocrine tumors and was originally developed two decades ago by physicians who were affiliated with the Erasmus Medical Center in Rotterdam. Although they formed a company to secure the rights, the hospital became well known for treating patients with the medicine, including former Apple chief executive Steve Jobs.

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So where does Novartis fit in this picture?

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