Ther Rx is Still Too Greedy

April 2nd, 2011

A follow-up to our earlier piece about KV Pharmaceutical and subsidiary Ther-Rx’s extortionate pricing for their premature birth drug Makena, inspired by Price of preterm labor drug slashed: At $690 a shot, some say manufacturer is still charging too much (Washington Post 4/02/11).

KV Pharmaceutical and its subsidiary Ther-Rx

Still haven’t fundamentally changed their Rx.

Their prescription for preemies is still extreme greed,

Shamelessly trying to exploit families who their medicine need.

I’m one of the “some” that thinks $690/dose is still much too much

And just shows how hopelessly KV and Ther-Rx are out of touch.

They keep on touting their investment in the drug of $200 million

Absurd, given that they could have made monopoly profits of over $100 billion.

Even at $25/dose, KV could have made that $200 mill back in just one year,

And then racked up monopoly profits that would have made any shareholder cheer.

Instead, KV attempted preemie families to shamelessly shake down

Until KV’s excessive greed led the FDA, KV’s monopoly to break down.

PS: Funny how Republicans claim to care about the unborn and preventing abortion,

But were conspicuously silent about KV’s extortion.


As reported in Price of preterm labor drug slashed: At $690 a shot, some say manufacturer is still charging too much (Washington Post 4/02/11), KV Pharmaceutical has “slashed” (a highly charitable term, given the initially and still absurd price) from $1500 to $690/dose, as opposed to the $10-20/dose that the drug used to cost (and still will for people who continue to get the drug from compounding pharmaceuticals, thanks to a highly unusual FDA exception triggered by KV’s extreme greed). KV keeps saying that they were justified in their pricing (first as justification for the $1500/dose, then as justification for the $690) because they invested $200 million in developing the drug.

As the calculations below show, even at a cost of $25/dose, KV could have recovered its initial $200 million investment in Makena in just one year, and then could have netted an additional $1.2 billion in profits over the remainder of the 7-year monopoly that FDA approval gives a drug manufacturer (that monopoly was what KV was banking on, and what the FDA exception negated). That’s gross profits of six times their alleged initial investment—a pretty sweet deal for a drug you didn’t even invent, and that you got approved through a taxpayer-subsidized study.

How do I figure that? The calculations are shown in the table below (or, download the spreadsheet). Since pharmacies were previously selling the compound at $10-20/dose, I assume that KV’s manufacturing cost would be $5/dose. That is an extremely charitable assumption, since KV’s large scale production would be much more efficient and less labor-intensive than the small-scale pharmacy batch production, which itself was probably at a cost of $5/dose (assuming a conservative 100% mark-up of raw material and labor costs). Based on 500,000 premature births/year, that’s a potential market of ten million doses, yielding potential profits of $200 million/year. Even assuming higher costs and lower market penetration, at $25/dose, KV would still be making hundreds of millions in profits.

That’s at a price of $25/dose, which neither the FDA nor a single preemie family in the country would have complained about, happily accepting that $5-15/dose mark-up in exchange for the higher quality and consistency that KV’s product would have represented. But instead, KV opted for the absurdly extortionate price of $1500/dose, which over the course of their planned monopoly could have yielded them over $100 billion, or gross profits of 522 times their initial investment. (NB: KV’s original price tag yielded a total cost to patients of $30K for each at-risk pregnancy, since 20 doses were required. KV and Ther-Rx justified that cost by portraying it as a “bargain” relative to the $51K to care for a premature infant in the first year of the infant’s life.)

Even KV’s modified plan to charge $690/dose and increase subsidies so that 85% of families pay no more than $20 yields gross profits of $7.7 billion and gross profits of almost 40 times KV’s initial “investment, since an unlucky 15% of clients are still paying the only slightly less extortionate $690. At that price, even lower levels of market penetration, KV and Ther-Rx would still recoup their initial investment in about seven months and net $2.25 billion in gross profit over their seven-year monopoly period.

How’s that sound to you? To me, it still sounds pretty darn greedy.

KV’s original plan

KV’s Plan B

Less greedy, but still enormous profits















premature births/year


course (doses)


demand (doses/year)


market share






share sold at cost






sales (doses/year)














Total profit for 7 year monopoly period






Profit ratio








Here’s Sen. Sherrod Brown (D-OH) speaking out against KV and Ther-RX’s extortionate price (strangely, Republicans didn’t seem as upset about it), and HHS Secretary Sebelius countering KV’s threats to pharmacies that they would be subject to penalties if they continued to compound the drug (read our earlier piece for more on that).

NB: It’s also interesting to note that KV has had more than its share of past problems, including another wholly-owned subsidiary’s criminal conviction for selling oversize morphine tablets and then concealing that from the FDA. So like I said before, KVarma’s a bitch.

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