Drug cost increase creating concerns

THE province will be forced to fork out an additional $400,000 to pay for a popular hormone replacement drug this year after the price quadrupled last month.Pharmaceutical giant Wyeth Canada jacked up the price of the popular estrogen therapy Premarin in April from less than 25 cents a tablet to more than $1 amid declining sales and increased cost of production. Wyeth extracts estrogen from pregnant mares' urine (PMU) to manufacture the hormone replacement therapy.

Manitoba was considered a hot spot for PMU production, but the drug company has slashed manufacturing contracts in recent years. Currently, 50 Manitoba PMU producers extract urine from 4,000 mares.

In an email statement, Wyeth spokeswoman Lisa Ross said the new price of Premarin is "more realistic and reflective of current costs."

The unexpected jump will cost Manitoba Pharmacare an extra $400,000, and thousands of Manitoba women could have to pay more out out-of-pocket for the popular drug. Last year, more than 39,000 prescriptions for Premarin were dispensed in Manitoba.

"It's a big jump," said Kim Sharman, assistant deputy minister of Manitoba Health and Healthy Living.

"We tried to see whether they would hold off on the increase but the manufacturer chose to go ahead."

In the last decade, the rising cost of drugs has caused the provincial drug budget to balloon by 220 per cent.

Pharmacare deductibles increased by $5 this year to offset the $282 million the province will spend on drugs between 2009 and 2010.

Sharman said the spike in the price of Premarin to $1.08 a tablet is a perfect example of the challenge of balancing drug budgets and why the province now signs special agreements with drug manufacturers before Manitoba agrees to pay for a product under Pharmacare.

Sharman said the idea is to reduce costs and put the onus on the drug company to keep their cost projections in check.

"When we have price increases like this it's certainly a challenge," she said.

Dr. Warren Bell, a B.C. based critic of over-reliance on pharmaceuticals, said drug costs will continue to rise unless physicians start to shift their focus to preventative medicine and other alternatives. Bell said pharmaceutical companies sell products for diseases like metabolic syndrome that could be treated with a prescription for a better diet and exercise instead of a pill.

He said doctors need to take a step back from overmedicating and look for other options that could save patients and provinces money.

"The shift in focus has to come from medical professionals because we're fixed on the notion there's a pill for every ill," Bell said. "There's a huge opportunity for simplifying what we do and focusing on prevention."

jen.skerritt@freepress.mb.ca

Republished from the Winnipeg Free Press print edition June 5, 2009 A6