Portman said the subcommittee “will continue its efforts to protect taxpayers from drug manufacturers that are exploiting loopholes in the Medicare and Medicaid system in order to profit from a national opioid crisis.”
The Path Forward: Addiction in Dayton
The synthetic opioid drug fentanyl killed 3,431 people in Ohio last year.
The report charges that to boost “sluggish sales” of EVZIO at its price of $575, the company “implemented a new distribution model proposed” by a consultant “that increased the price by more than 600 percent by 2016.”
In addition, the report accuses Kaleo’s sales force of trying to make sure doctors’ offices signed necessary paperwork indicating that EVZIO “was medically necessary, which ensured the overdose reversal drug would be covered by government programs like Medicare and Medicaid.”
The price markup by Kaleo was reported earlier this year by Bloomberg News. Any drugs covered on drug lists called formularies are approved for coverage by pharmacy benefit managers or PBMs.
Those PBMs are hired by health care companies with the promise they keep drug costs low. But PBMs receive rebates from drug manufacturers for putting drugs on the formularies.
In a statement, a Kaleo spokesperson said “we are disappointed with the way in which some of the facts are being presented and believe there is much more to this very complex story.”
“We believe two facts are critical to the EVZIO story,” the company said. “First, we have received voluntary reports from recipients of donated product that EVZIO has saved more than 5,500 lives since we launched the product in 2014. Second, we have never turned an annual profit on the sale of EVZIO. Patients, not profits, have driven our actions.”
(Lucas Sullivan of the Columbus Dispatch contributed to this story.)