Hospitals cut use of Valeant heart drugs after price hikes

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Nitroprusside and isoproterenol, a pair of heart medicines, have been prescribed less since their prices skyrocketed between 2012 and 2015, according to a new research article.

Umesh N. Khot, a cardiologist at the Cleveland Clinic, and two colleagues studied the use of the drugs at 47 hospitals and published their findings Aug. 10 in a research letter in the New England Journal of Medicine.

Nitroprusside, which is given intravenously to combat dangerously high blood pressure, decreased 53 percent in use from 2012 to 2015. Over that same span, its price per 50 milligrams jumped from $27.46 to $880.88—a thirtyfold increase.

Isoproterenol, which treats heart rhythm problems during surgery, was given to 35 percent fewer patients as the price per milligram skyrocketed from $26.20 to $1,790.11.

“These findings refute the claim that price increases do not reduce patients’ access to these medications,” Khot and colleagues wrote.

The researchers used a pair of comparative drugs—nitroglycerin and dobutamine—as a control group. Those products remained relatively stable in price from 2012 to 2015 and increased in use by 118 percent and 7 percent, respectively.

Khot told Kaiser Health News those drugs couldn’t always be used as substitutes for their pricier counterparts, but used the differences in their usage trends as further evidence the cost increases of nitroprusside and isoproterenol affected prescription numbers.

“Clearly, physicians have decreased their rate of prescribing the drugs even though in the hospital setting both they and patients are typically insulated from the cost increases,” Khot and colleagues wrote. “Understanding exactly how pharmacists, physicians and hospitals have decreased utilization of the drugs is an area for future investigation.”