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The pain reliever Duexis is a combination of two old drugs, the generic equivalents of Motrin and Pepcid. If prescribed separately, the two drugs together would cost no more than $20 or $40 a month. By contrast, Duexis, which contains both in a single pill, costs about $1,500 a month. ... Horizon Pharma, has figured out a way to circumvent efforts of insurers and pharmacists to switch patients to the generic components .... Instead of sending their patients to the drugstore with a prescription, doctors are urged by Horizon to submit prescriptions directly to a mail-order specialty pharmacy affiliated with the drug company. The pharmacy mails the drug to the patient and deals with the insurance companies .... Horizon is not alone. Use of specialty pharmacies seems to have become a new way of trying to keep the health system paying for high-priced drugs. (Pollack, 10/19)

There is a new price surge in the pharmaceutical industry—for a limited number of government-issued vouchers that drug makers including AbbVie Inc. and Sanofi SA are buying to speed products to market. Legal provisions enacted in 2007 and 2012 require the U.S. Food and Drug Administration to issue “priority review vouchers” as rewards to developers of drugs for rare pediatric conditions or tropical diseases like malaria. Congress intended the vouchers to encourage more research into underfunded diseases. Companies receive them when the FDA approves their drug for sale, and can redeem them to speed FDA consideration of a subsequent drug for any disease. (Loftus, 10/20)

In the latest indication that government spending on costly new specialty drugs is soaring, a new analysis by ProPublica finds that Medicare has already spent $4.6 billion this year on two breakthrough drugs for treating the deadly hepatitis-C virus – or almost as much as the hepatitis treatment program spent during all of last year. ... Those two drugs, Sovaldi and Harvoni, manufactured by Gilead Sciences, are in hot demand for treating the serious liver disease thanks to a success rates of well over 90 percent. The new specialty drugs are far superior to older drug treatments and in many cases obviate the need for costly and dangerous liver transplants. But the pills can cost as much as $1,000 a day – or $84,000 for a 12-week course of treatment, before rebates. (Pianin, 10/19)

The most important trade deal of Barack Obama’s presidency could hinge on a single provision that’s reigniting a years-old debate on monopoly rights for drugmakers. The exact details of the pharmaceutical provision, which involves a class of drugs called biologics, won’t be made public until later this month. Still, it’s already threatening to drag out — and possibly derail — the approval process for a deal reached by a dozen nations that together make up 40 percent of the world’s gross domestic product. (Ferris, 10/20)

U.S. Senator Marco Rubio (R-Fla.) became the latest presidential candidate to speak out on prescription drug prices, saying that some pharmaceutical companies are engaging in “pure profiteering” and that high prices threaten to “bankrupt our system.” At a campaign event in New Hampshire last week, a member of the audience asked Sen. Rubio to characterize his “free-market solution” to bringing down the high-cost of lifesaving medicines, according to a video of the event posted online. A spokesman for Sen. Rubio said the exchange occurred at a campaign house party on October 14. (Walker and Haddon, 10/19)