Sticker Shock

Pre-packaged brand version of compounded medication to prevent preterm births costs 5,000 percent more
pregnant woman with stacks of $100 bills

Preventing a preterm birth could cost as little as $200 or as much as $20,000, depending on which one of two medications a doctor orders, according to a new analysis from Harvard Medical School.

The results, published Oct. 2 in JAMA Internal Medicine, are based on a comparison of medication costs and pregnancy outcomes among more than 3,800 women treated with either a compounded, made-to-order form of the synthetic hormone progestin known as 17P or with a brand-name prepackaged version of the same medication.

The two medications have the same active ingredients and are clinically interchangeable, the researchers say.

The analysis found no statistically significant difference in the rate of preterm births—23.9 percent among women who got the brand-name, prepackaged version, compared with 25.2 percent in women who received the compounded drug. However, the difference in cost was dramatic: $206 per pregnancy, on average, for the made-to-order drug, compared with an average of $10,917 per pregnancy for the brand, prepackaged medication.

For their comparison, the team led by DBMI's Andrew Beam and Inbar Fried (now an MD-PhD student at UNC Chapel Hill) analyzed insurance claims filed between 2008 and 2015 on behalf of more than 3,800 privately covered patients. More than 3,300 women received a generic version—compounded or made to order in local pharmacies—while 535 women got a prepackaged brand version.

Continue reading article in Harvard Medical School News


For additional background, see Pricing and the Orphan Drug Act: The Curious Case of 17P in the DBMI Blog.