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Costly Drug to Be Offered in $1 Version

12/01/2015 | 12:45am US/Eastern

Drug-benefit manager Express Scripts Holding Co. said it is making arrangements with a drug compounder for patients to receive a lower-priced alternative to the expensive anti-parasitic pill Daraprim, whose price jumped more than 50-fold earlier this year.

Turing Pharmaceuticals AG raised the price of Daraprim after buying the U.S. rights to $750 a pill, up from $13.50. Since then, the company and its chief executive, Martin Shkreli, have come under fire from patient advocates and Democratic politicians criticizing dramatic price hikes for some medicines.

Express Scripts said Tuesday it has arranged for patients to get the drug for $1 a capsule from San Diego-based drug compounder Imprimis Pharmaceuticals Inc., which makes customized medicines by mixing pharmaceutical ingredients.

Among the steps Express Scripts took is adding Imprimis to its network of approved pharmacies and giving Imprimis's compounded drug a reimbursement code.

"We've made it very simple for doctors and patients to access this lifesaving medicine at a reduced cost," Steven Miller, chief medical officer at Express Scripts, said in an interview. He said St. Louis-based Express Scripts could start processing prescriptions as early as this week.

Dr. Miller said the move could save millions of dollars a year in spending on Daraprim, even though just 350 of Express Scripts's 85 million covered members took the drug last year, because patients can take the pills for months.

Daraprim is a half-century-old drug that treats a parasitic infection, called toxoplasmosis, that can threaten the lives of HIV patients, pregnant women and others with weakened immune systems.

After facing criticism, Turing said last week that it was taking its own steps to cut the cost of Daraprim, including providing hospitals with discounts of as much as 50% off the list price and giving doctors free samples.

Unlike Turing's product, Imprimis's tablets aren't approved by the Food and Drug Administration. Rather, they consist of the same main ingredient in Daraprim as well as another ingredient that treats the folic acid deficiency that is a common side effect of taking the drug, Dr. Miller said. He said Express Scripts members often use compounded drugs.

Turing raised the lack of FDA approval as an issue, and noted how it has made several moves to cut Daraprim's cost or provide it at a substantial discount.

"In addition to being potentially unsafe and ineffective, the compounded product is unnecessary. Turing is committed to ensuring access to patients who need Daraprim and has implemented a number of patient assistance programs that can limit a patient's out-of-pocket payment for Darapim to $10 per prescription," said Nancy Retzlaff, Turing's chief commercial officer.

Imprimis will buy the main ingredient, pyrimethamine, from FDA-registered and -inspected manufacturers, and make the drug in FDA-inspected facilities, Imprimis Chief Executive Mark Baum said in an interview.

"We'd like to be a part of driving down" the costs of drugs, Mr. Baum said.

Imprimis, a publicly traded company based in San Diego that Mr. Baum said he started about three years ago, reported $1.7 million in total revenue last year. The company's top-selling product has been a compounded drug for patients who underwent cataract surgery.

Express Scripts members would still get Daraprim if their doctors write a general prescription for the drug, Dr. Miller said. If a doctor sends a prescription to Imprimis, the company will then make and ship the drug, and Express Scripts will provide reimbursement.

Groups such as the Infectious Diseases Society of America and HIV Medicine Association said they would try to raise awareness among doctors about the option of sending prescriptions to Imprimis.

"We are optimistic that this arrangement will help address the serious cost and access barriers that have prevented or delayed pregnant women, infants, and patients with HIV infection or following transplantation from accessing this lifesaving treatment," the two groups said in a statement.

Write to Jonathan D. Rockoff at Jonathan.Rockoff@wsj.com

Access Investor Kit for "Imprimis Pharmaceuticals, Inc."

Visit http://www.companyspotlight.com/partner?cp_code=P479&isin=US45323A2015

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