Thursday, March 17, 2011

Pat on the Back

I caught snippets of a discussion the other day on self-pity and self-compassion. 'Twas interesting, and made me think not only of Japan, but all of us. Me. This community. And that maybe this woman had a point about self-compassion and not feeling quite so alone. I have a post up on Glow in the Woods.

Thursday, March 10, 2011

Makena: Or, How to Make-na Some Bucks from Women Who Have Already Paid the Highest Price

So I'm putting today's soggy, largely unread newspaper (Good Lord, this suspended priest issue is upsetting) in the recycling bin this evening when a headline catches my eye:

"Cost of Drug Preventing Preterm Labor to Soar."

Oh, like I needed that kick in the crotch.

Here's the situation as I understand it having surfed around and found a few more articles:

Apparently there's a synthetic-progesterone-based injection that doctors have prescribed for years in order to prevent pre-term labor. It's generally given from about week 16 through the end of the pregnancy, and has shown to be quite effective. Generally, a pharmacy can mix up this concoction and charges somewhere in the neighborhood of $15-20 per dose. In sum, people know how to make it, it works, it's very cheap. Yay babies not being born early!

Then Big Pharm company KV Pharmaceutical comes along and requests FDA approval of this drug they're calling Makena. It's the same fucking thing as before, but now probably in fancy packaging. (I'm guessing a lovely gender neutral purple.) Zero dollars were spent doing R&D because everybody and their mother already knew about it and how to make it, but I'm sure some bucks went into marketing. The FDA approved it, which means KV has a lock on it for the next number of years, they're going to make pharmacies cease and desist making it, and they're going to charge . . . .

$1,500 per dose. Which comes out to about $30,000 per pregnancy.


Obviously the doctors and insurance companies are beyond alarmed. One doctor in the article is outraged, another "breathless." Everyone is worried sick that women who lack insurance, or whose insurance refuses to pay it (pre-existing condition anyone? Because obviously you need to experience a pre-labor catastrophe in order to conclude that you have a problem, and may need this drug), or who get government-assistance (the government is a bit cash strapped of late, in case you've been preoccupied) will not get it. (The company claims it will offer assistance. I'm not sure where that leaves people who are independently insured but whose insurance companies don't cover pregnancy. Like mine.) Insurance companies are dry-heaving because of course they want to cover this, but now they'll have to (big surprise) raise rates across the board in order to cover this. One Aetna rep in one of the articles I perused claimed that she knows of 1,000 people or so who get this drug per year in her system.

The drug company? They defend the outrageous price hike with the following statement:

KV Pharmaceutical chief executive Gregory J. Divis Jr. said the cost was justified to avoid the mental and physical disabilities that can come with very premature births. The cost of care for a preemie is estimated at $51,000 in the first year alone.

"Makena can help offset some of those costs," Divis said. "These moms deserve the opportunity to have the benefits of an FDA-approved Makena."

Let me get this straight. You're going to charge mothers $30,000 to offset a potential $51,000, thus saving the health care system $21,000 per child.

Aren't you so fucking sweet. Because until you came along, the cost of the drug per pregnancy was $400, making the savings $50,700.

And those are the "lucky" ones (not) (not remotely) whose children are born outrageously early who live. Who suffer some really awful consequences and life-long disabilities.

I guess the ones who die, since they don't cost $51,000 the first year, aren't costing the system anything. Which means KV is making $30,000 in pure profit, essentially putting a price on a live child (because we? were all wondering).

To employ new math: It's not about the OFFSET you asshole, it's about taking a child to term. It's about HAVING A CHILD WHO LIVES. These moms don't deserve some fancy-ass package that your marketing team spent precious power point time dreaming up, they deserve a chance at a full-term pregnancy. THEY DESERVE A BABY WHO LIVES. Regardless of their income, or their insurance situation.

And that's not factoring in what I anticipate to be a rise in premature labor in lower income groups and those with government or private insurance because they won't be able to afford the same-old-drug in your fancy ass box. You aren't offsetting, you're going to cost. You're going to cost a lot. According to the March of Dimes,

Preterm birth is the leading cause of death in the first month of life in the United States. The preterm birth rate has increased about 20 percent since 1990, and costs the nation more than $26 billion a year, according to the Institute of Medicine report issued in July 2006.

I'm honestly apoplectic and don't know where to dump this other than here. You can read more about this decision to screw pregnant women over on NPR and numerous blogs, such as Bizmology and Contentenique.

Reaching KV is more difficult; if you feel this is an "investor Relations" issue, you can email them at I'd be more inclined to see this as "an adverse event or side effect" in which case you can email them at

Show some outrage, if you have a few moments. Women who have gone into labor prematurely and lost children -- or are living with the consequences of a child born way, way too early -- have already paid enough, a few lifetimes over. They don't owe big pharm jack squat.