Price of an OCD drug jumped 1,200%. State attorneys general blame price fixing

By Ben Elgin, Bloomberg

Her patient’s voice was panic-stricken, Emily Deans said, and her story was baffling.

“She said, ‘I can’t fill my prescription, it’s too expensive,’” said Deans, a psychiatrist near Boston, recalling a conversation from about five years ago. A patient who suffered from severe obsessive-compulsive disorder called, upset that she could no longer afford her medication, a drug called clomipramine. The price of a month’s supply had suddenly jumped from $16 to $348.

The increase appeared to defy logic. “This is crazy for a generic drug that’s been around for decades,” Deans said. Clomipramine was discovered 55 years ago; it was approved to treat OCD in 1989 and became available in cheap, generic form in 1996. Why the sudden price hike?

A possible answer finally came this year.

In May, attorneys general in more than 40 states accused three pharmaceutical companies that make clomipramine — Taro Pharmaceuticals Industries Ltd., Mylan Pharmaceuticals Inc. and Novartis AG’s generics arm, Sandoz — of conspiring to raise the drug’s price. The allegation is part of a sweeping lawsuit that names 20 generic drugmakers and subsidiaries in all, as well as 15 current and former industry executives. It says they communicated with one another to fix prices and divvy up customers for more than 100 drugs, treating a range of maladies, including HIV, high blood pressure and fungal infections.

The companies, including those that make clomipramine, have denied the states’ allegations. Nonetheless, the lawsuit, along with a similar one filed in 2016 and a federal investigation into price-fixing allegations, have rocked the generic drug industry, long regarded as consumers’ haven from the spiraling prices of name-brand medicines.
Decrying “one of the most egregious and damaging price-fixing conspiracies” in U.S. history, the lawsuit alleges that generic drugmakers illegally heaped billions of dollars of costs onto patients, employers and taxpayers. During the peak of the alleged conspiracy from 2013 to 2015, drug companies quadrupled the price of baclofen, which treats muscle spasms caused by conditions such as multiple sclerosis. They raised the price of a bladder-condition drug, oxybutynin chloride, by more than 1,000%. They took the price of an arthritis medication, etodolac, at least 200% higher.

Few drugs saw sharper price hikes than clomipramine, which weakens the powerful compulsions that cause OCD sufferers to spend hours each day stuck in rituals, like washing their hands or checking the locks and windows in their houses. It’s one of only five medications that U.S. regulators have approved for OCD, so clomipramine’s price hikes roiled patients’ treatment plans nationwide. (An estimated 1.2% of U.S. adults had OCD in the last year, and about half those cases were classified as “serious.”)

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