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Rising drug prices hit Cortland hospital

Todd R. McAdam/contributing photographer

Pharmacist Michelle Tucker prepares medicines Wednesday used in cancer treatment at Cortland Regional Medical Center. The pharmaceuticals are mixed in a sterile, vented hood; in a sterile room; itself separated from other parts of the hospital by a pressurized transition space.

Cortland Regional Medical Center expects to spend $4.7 million this year on the medications that keep its patients healthy, a 30 percent increase from 2016.

That’s money the hospital can’t spend on raises for its 700-odd employees, equipment and education, said hospital President Mark Webster.

“We can only spend a dollar once,” Webster said.

Matthew Denniston, the hospital’s pharmacy director, says rising prices are as much a concern as drug shortages and the hospital always looks for ways to mitigate the impacts.

“This means being diligent about seeking opportunities for lower cost alternatives within a class of drugs and constantly finding the most cost effective means of treatment,” Denniston said.

Denniston cited a variety of reasons why prices have gone up, including companies’ price strategies, drug shortages and regulations.

“In some cases, cost is tied to the dose and in other cases varying doses may have the same price,” Denniston said. “This can be due to manufacturing processes or to the cost of raw materials needed to make the drugs.”

The increases can be extreme:

* In 2014, 10 vials of injectable hydralazine, a blood pressure drug, cost the hospital $118. The same package cost $1,008 in 2015 and $2,476 in 2017, a more than 20-fold increase.

* EpiPens, injections that reverse severe allergic reactions, cost $100 in 2007, but now cost $500 a decade later after it was bought by pharmaceutical company Mylan.

* Prices of nivolumab, used to treat melanoma, went up 258 percent; apixaban, used to treat blood clots, went up 98 percent and lispro insulin increased 31 percent between 2015 and 2016, the American Journal for Health-System Pharmacists reports.

“It’s understandable that pharmaceutical companies need to offset expensive research and development costs, but EpiPen was available for many years before Mylan purchased the drug and raised prices 400 percent,” Webster said.

Drug shortages have forced the hospital to buy more-expensive options, Denniston said, adding that complex pricing schemes and prices that show up only as negotiated insurance payments mask the true cost of drugs.

“We continue to be diligent about mitigating the impact of rising drug costs by putting a lot of focus on finding cost-effective options for treating patients, when options are available,” Denniston said.

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