The great price debate: The skyrocketing cost of Acthar for sarcoidosis
March 10, 2016
By Dr. Deep Ramachandran
Dr. Mark Metersky is a smart guy. Winner of the Alfred Soffer Research Award, he’s served on numerous scientific advisory committees and is the Medical Director of the University of Connecticut’s Center for Bronchiectasis Care. So let’s just agree—this pulmonary and critical care doc has Master Jedi chops. So when Dr. Metersky opened up the October 2015 issue of CHEST and found an ad for a drug to treat sarcoidosis that he had never heard of, he recalled asking himself: “What am I missing?”
He noted with a mixture of curiosity and a fair degree of skepticism, the full-page advertisement for an injectable medication called Acthar. In the ad, the drug is promoted to treat sarcoidosis and prominently displays “FDA-approved Acthar for symptomatic sarcoidosis.” For a moment, even Dr. Metersky had to pause to wonder. “Why have I never heard of this?” he thought. It’s a question that doubtless had many pulmonary physicians scratching their heads.
So he dug a little deeper, “I looked on PubMed and found nothing to support its use over prednisone.” Acthar, it seemed, appeared to have little if any clinical evidence to support it. It appeared to be essentially similar to currently available steroid therapy with many of the same side effects. In fact, it was not a new drug at all but has actually been around for decades—and yet its prices have skyrocketed to a mind-boggling level of nearly $29,000 per 5 mL vial.
Dr. Metersky’s initial curiosity quickly turned into something else. “I’m a fairly apolitical guy, but this really set me off!” He wrote a letter to the editor, which is published in the March 2016 issue of CHEST. In it he openly asks the manufacturer for evidence that Acthar has greater efficacy compared with corticosteroids. It’s a question that is certainly timely, as we find ourselves entering into a national debate about skyrocketing drug prices. The issue of skyrocketing drug prices is even finding its way into the presidential race.
The accompanying editorial, is similarly a must read. It posits that market forces may weed out unjustifiable prices.
Is this the last time we’ll see situations like this? Probably not. But at least we have people who are willing to raise their voices about perceived wrongs, and that at least is cause for hope.
What are your thoughts? Sound off in the comments section below.
Deep Ramachandran, MD, is a pulmonary, critical care, and sleep medicine physician, and social media co-editor of CHEST. He blogs at CaduceusBlog, CHEST Thought Leaders Blog, and is on Twitter @Caduceusblogger