Perspective from Carlos del Rio, MD
September 14, 2018
4 min read
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‘Opportunistic greed’: ID groups criticize Nostrum for nitrofurantoin price spike

Perspective from Carlos del Rio, MD
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The Infectious Diseases Society of America and HIV Medicine Association strongly criticized Nostrum Laboratories Inc. today for quadrupling the price of the antibiotic nitrofurantoin from approximately $500 to more than $2,300 per bottle, saying it was unethical, irresponsible and unnecessary.

Nostrum is the only manufacturer of the liquid formulation of nitrofurantoin and “costs pennies to produce,” the groups said in a statement. They compared the price hike to raising the price of bottled water during a hurricane.

“To more than quadruple the price of an antibiotic drug developed more than 6 decades ago reflects opportunistic greed in its most indefensible form,” they said. “It is important to note that Nostrum Laboratories, which packages and markets the drug, had no role in its discovery, development, or production.”

Nitrofurantoin, which is available in pill and liquid form, is commonly used by ID physicians to treat urinary tract infections, and the liquid form is critical for patients who struggle taking pills, the groups noted. They said the price hike will limit access to an effective antibiotic, which could result in increased drug resistance, making treatment of infections even more challenging.

The IDSA and HIVMA compared the situation to the Daraprim price hike in 2015 and said it “reflects cynical opportunism rather than investment and innovation.”

“We believe that developers of new antibiotics should receive fair returns on their investments,” they said. “We advocate strongly for incentives that promote innovation and strengthen the pipeline of these critical medicines. Financial models for antibiotic reimbursement, however, should reward true innovation, promote stewardship, and protect appropriate patient access to needed therapies. This price hike fails on all three points.”

“As this price increase becomes news,” they concluded, “it is worth noting that laws exist to discourage exorbitant price hikes of necessary supplies such as bottled water that exploit emergencies including hurricanes. This act of price gouging should not be viewed differently.” – by Marley Ghizzone