$38,398 for just one shot of a very old cancer med. How can this happen?

November 9, 2022

Paul Hinds agreed to get a physical at the urging of his new girlfriend. It was a fortunate decision, as his blood test results showed alarmingly high levels of prostate-specific antigens, or PSA. A biopsy confirmed he had advanced prostate cancer.

After trying several treatments, doctors removed Hinds’ prostate gland in 2019. Still, as Kaiser Health News reports, his PSA levels rose again, and doctors assessed that the cancer had metastasized.

The only alternative then was to dramatically lower Hinds’ testosterone levels, either through surgery or drugs. In May 2021, Hinds got his first injection of Lupron Depot, a brand-name drug created to suppress his body’s release of testosterone for three months. He received a second shot in August.

The total bill for the two shots? $73,812. $35,414 for the first injection and $38,393 for the second.

Was the cost so high because Hinds received a drug that was new to the market?

Nope. Lupron Depot was invented in 1973. Its manufacturer got patent extensions in 1989 by offering a slow-release version. In doing so the drug maker retained its exclusive rights to sell the product.

That patent was extended again and again. And the price kept going up. As similar drugs came to market, physicians and their patients preferred Lupron, which was relatively easy to store and administer.

Meanwhile, the drug was sold in the United Kingdom under another name for about $260.

Here in the United States, the pharmaceutical company kept raising the price of Lupron, and doctors and hospitals marked up the price even further by adding fees for administering the medication.

The shots left Hinds feeling listless and sore. After the second shot, a pharmacist told him about a pill that would also block testosterone. He started taking the drug, Orgovyx in November. The drug’s list price is about $2,700 a month, with Hinds paying $216 for a three-month prescription and his health insurance plan covering about $6,000.

Baffled by the high charges for the injection, Hinds made numerous phone calls and sent numerous emails to the hospital to negotiate a payment plan. It wasn’t easy, but he’s thankful that his pharmacist helped him to find another, more affordable, treatment.

Have you or a loved one received an outrageously high bill for medication? Share your experience with Voices for Affordable Health.