This graphic is from www.wsj.com. Double click to enlarge
The Wall Street Journal has a good article showing how colchicine, a generic medication used to treat gout since the sixth century, and available for pennies a pill until a few months ago, now costs big, brand-name bucks.
This isn't the only time an old drug has been 'rebranded' and made devastatingly expensive. Thalidomide, which caused birth defects in the early 1960s, was discovered to be a good treatment for leprosy and as an "orphan drug" was reintroduced to the market priced ~$6 per pill. When thalidomide was shown to be useful for multiple myeloma, the price jumped to $30 per pill. Cost of manufacture is under a dime a pill. The manufacturer of Thalidomide, Celgene, performed a substantially more valuable service than URL- it rehabilitated an old drug that was no longer manufactured and identified new ways it could benefit patients. There is some value to the clinical trials that URL did - which established that a slightly lower dose of colchicine increased safety. It's hard to argue that the value added by this pharmaceutical company is worth almost $5 per pill for a drug in wide use and used with awfully good safety for decades.
In the US, we have a huge 'cost per unit' issue - and this is one more example of how this happens. Patent or other regulatory protection of intellectual property grants a monopoly - which requires careful regulatory oversight. In this instance, a well-meaning regulatory move to learn about the real safety of an old drug will bleed the health care system of many millions of dollars for relatively little value.
