Express Scripts Pushing $1 alternative To Turing's $750 Daraprim Pills

When last we checked in with the internet's least-liked human being, the CEO of Turing Pharmaceuticals was backpeddaling on his promise to lower the cost of the AIDS and cancer fighting drug Daraprim, and hiding it ahead of the Thanksgiving holiday in the hopes that fewer people would notice (it worked relatively well). CEO Martin Shkreli, you'll recall, increased the price for Daraprim from $13.50 per pill to $750 -- a 5000% or so mark up for a sixty-two-year-old medication. Shkrelli brought renewed attention to the skyrocketing prices of generics thanks to (ab)using restricted distribution to deny samples to generics manufacturers.

But there may be a small ray of sunshine in what's an otherwise dismal tale of greed. Prescription drug manager Express Scripts has indicated that the company will soon promote use of a compounded medicine that contains the same active ingredient as Daraprim, and offer it at a fraction of the price. Express Scripts manages prescriptions for tens of millions of Americans and will be pushing the compounded alternative made by Imprimis Pharmaceuticals. The new compounded alternative includes Daraprim’s active ingredient, pyrimethamine, as well as leucovorin, included to treat side effects.

The end result will be something that almost looks like competition:

"Compounded drugs are customized formulations made by pharmacies for particular, named patients. That requirement restricts how directly Imprimis can compete with Turing. For instance, hospitals cannot stock the compounded version to use for patients coming to the emergency room.

Imprimis, which is publicly traded, is not allowed to make a direct copy of Daraprim. So its capsule contains both pyrimethamine and leucovorin, a drug that is often prescribed with Daraprim to ease certain side effects. If a doctor writes a prescription for Daraprim, Express Scripts or pharmacies cannot substitute the compounded drug produced by Imprimis. So physicians will have to write a prescription specifically for the compounded drug and fax it to Imprimis."

It's a bit of a cumbersome tap dance (so glad we're still using faxes in the age of gigabit fiber), but at least it's an alternative. Impremis has stated it plans to offer the compounded drug for as low as 100 capsules for $99. Express Scripts in turn will help speed delivery of the cheaper option, working with the Infectious Diseases Society of America and the HIV Medicine Association to inform medical professionals about the alternative. Turing has so far responded by telling media outlets that "in addition to being potentially unsafe and ineffective, the compounded product is unnecessary."

Granted, the actual impact may still be low; Express Scripts states it only had 350 patients who used Daraprim last year. Still, it's the principle of the thing, and it's nice to see the market -- even if it has to jump through hoops to do so -- giving Shkreli and Turing a few quick kicks to the shins.

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