Additional thoughts from Dr. Goldman:
This is an important article found in the Business Day section of the New York Times, June 4 edition. It talks about the startling rise in the cost of pharmaceutical drugs — this time focusing on products helping replenish vaginal moisture in menopausal women.
It is a good article, as it points out the back channel deals involving drug companies, pharmacy benefit managers and insurers — they are ALL making extra money while increasing the costs to insurance payers and patients.
The lead off product in the discussion is Vagifem. Over the last five years costs have steadily risen and is currently over $200/month. Vagifem is a very low dose, 10mcg/vaginal tablet made of bioidentical estradiol. They are taken twice a week, totaling eight tablets monthly. Patches (also replaced twice a week), range from 25mcg/day up to 100mcg/day. This dose, although quite effective in improving vaginal moisture, is too low to significantly raise the blood levels of estradiol. I know because I have many patients on Vagifem and I measure their blood levels.
The point of the article discusses the huge increase in the cost of estrogen products (just in the last few years). Estradiol is a body part and cannot be patented. It is only the delivery system that can hold a patent. Recently, Vagifem’s patent ran out (it has been on the market for well over a decade). Now there are generic competitors, but despite that, the price just keeps going up.
This story is not just about Vagifem. Estrace vaginal cream has been around for decades. In the last few years the price doubled, then redoubled and is now approximately $372 per tube. An exorbitant price, despite the fact that it is now also off patent — yet the generics are similarly priced. A compounding pharmacy could produce similar products for around $60/tube. Unfortunately, the Times article does not discuss what a compounding pharmacy could supply.
Nothing is going to stop this outrageous robbery until the American public holds businesses and Congress accountable. This is almost exclusively an American problem. The same medications are much less costly in other parts of the world. It is illegal for medications to be purchased from other countries and brought into the USA. That law could be changed.
This is an important article found in the Business Day section of the New York Times, June 4 edition. It talks about the startling rise in the cost of pharmaceutical drugs — this time focusing on products helping replenish vaginal moisture in menopausal women.
It is a good article, as it points out the back channel deals involving drug companies, pharmacy benefit managers and insurers — they are ALL making extra money while increasing the costs to insurance payers and patients.
The lead off product in the discussion is Vagifem. Over the last five years costs have steadily risen and is currently over $200/month. Vagifem is a very low dose, 10mcg/vaginal tablet made of bioidentical estradiol. They are taken twice a week, totaling eight tablets monthly. Patches (also replaced twice a week), range from 25mcg/day up to 100mcg/day. This dose, although quite effective in improving vaginal moisture, is too low to significantly raise the blood levels of estradiol. I know because I have many patients on Vagifem and I measure their blood levels.
The point of the article discusses the huge increase in the cost of estrogen products (just in the last few years). Estradiol is a body part and cannot be patented. It is only the delivery system that can hold a patent. Recently, Vagifem’s patent ran out (it has been on the market for well over a decade). Now there are generic competitors, but despite that, the price just keeps going up.
This story is not just about Vagifem. Estrace vaginal cream has been around for decades. In the last few years the price doubled, then redoubled and is now approximately $372 per tube. An exorbitant price, despite the fact that it is now also off patent — yet the generics are similarly priced. A compounding pharmacy could produce similar products for around $60/tube. Unfortunately, the Times article does not discuss what a compounding pharmacy could supply.
Nothing is going to stop this outrageous robbery until the American public holds businesses and Congress accountable. This is almost exclusively an American problem. The same medications are much less costly in other parts of the world. It is illegal for medications to be purchased from other countries and brought into the USA. That law could be changed.
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