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Revlimid: A cancer drug that costs 25c to make - they charge 900$/pill [1]
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Date: 2025-05-08
This is based on more fantastic reporting from Pro Publica:
www.propublica.org/…
A diagnosis of multiple myeloma is one of those things that used to almost be a death sentence. Back in the late 1990’s, researchers discovered that a variant of the drug thalidomide can work to starve the cancer, and result in remission.
Thalidomide itself got a very bad name back in the 1950’s and 1960’s when it was found to cause severe birth defects when taken by pregnant women. It was sold over the counter in Europe, but the FDA put the brakes on in the U.S., so there weren’t many in the U.S. who suffered from those birth defects. It was the very properties that caused the birth defects that also help it to starve the cancer cells of a supply of new blood vessels.
By 2005 it was approved for use in treating cancer, and it was on the market and named Revlimid.
When Celgene launched Revlimid in December of 2005, it set the initial price at $55,000 a year, or $218 a pill, which was about double what analysts expected.
Now since this is based on thalidomide, the cost to manufacture is pennies — they estimated 25 cents per pill. The original patents for thalidomide have long since expired. The company didn’t do any of the research that discovered that it could be used to treat cancer. And they have jacked the price 26 times since then — it currently stands at 892$/pill, or $19,660/month. The reporting from Pro Publica reveals that the price increases are largely driven by the need to maintain corporate profits along with increases in executive pay and bonuses that are based on sales figures.
Celgene had kept the price of Thalomid low when it was initially intended for AIDS patients, CEO John Jackson told investors in 2004, as the company “didn’t want huge numbers of people demonstrating in front” of its office. That wasn’t a problem with cancer patients. There was “plenty of room for very substantial increases” in the price of the drug now, Jackson told investors. Just two days earlier, Celgene had hiked the price of Thalomid to $47 a pill. “There was a common internal theme at Celgene that cancer patients were willing to pay almost any amount Celgene charged,” wrote David Schmidt, a former national account manager at the company, in a whistleblower lawsuit he filed after his employment was terminated in 2008. The lawsuit was voluntarily dismissed by Schmidt. (Jackson didn’t respond to requests for comment; Schmidt declined to talk to me.)
The article itself also describes the manufacturer’s efforts to prevent generics from coming onto the market. They essentially insisted that safety studies be performed by anyone wanting to make a generic, but they refused to sell the pills to any such companies, which prevented anyone from making any generics. That being said, apparently a generic does now exist, but the generic costs $17,349 a month — not much of a savings at all.
Outside of the U.S., the price of the drug is far more reasonable.
Note: Celgene got bought out by Bristol Myers Squibb at some point in the story, but the price increases have continued.
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