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Lawrenceville, NJ (Dr Simone) – Big Pharma generally raise prices each year, or when a new indication is granted by the FDA, or by other ways (https://www.simonesuperenergy.com/big-pharma-and-feds-blocks-generic-cancer-drugs/).   

A new way of raising prices is the use of trickery.  Merck, maker of pembrolizumab (Keytruda) for lung cancer, established that 2 milligrams (mg) per kilogram of the patient’s weight was the treatment dose. The price was set per milligram. Most patients need 150 mg and 50 mg vials of the drug were manufactured.  Then Merck removed their 50 mg vial from the US (not Europe) and made only vials containing 100 mg of drug. The patient who only needed 150 mg at a cost of $7,050 was forced to receive two vials of a total of 200 mg at a cost of $9,400.  THE HIGHER DOSE PROVIDES NO ADDITIONAL BENEFIT.  And in addition, Medicare gives doctors $100 per patient if they prescribe the higher dose. Did Big Pharma lobbyists persuade Medicare?

The true excess cost to the U.S. health care system exceeds $1 billion for this single drug at the higher dose. (J Natl Cancer Inst (2017) 109 (11): djx125.   

(c) 2017 Charles B. Simone, M.MS., M.D.