UK re-in­ves­ti­gates Pfiz­er's eye-pop­ping price goug­ing on an epilep­sy drug

When a drug­mak­er rais­es the price of a drug in the US by more than 2,000% overnight, and with­out any par­tic­u­lar rea­son for that in­crease, noth­ing typ­i­cal­ly hap­pens to the com­pa­ny. No fines, no court or­ders, just busi­ness as usu­al.

Mar­tin Shkre­li’s decades-old an­ti-par­a­sitic drug Dara­prim was the per­fect ex­am­ple — mas­sive price spike on an old drug, lots of me­dia at­ten­tion, pub­lic out­cry, con­gres­sion­al com­mit­tees drag­ging his for­mer com­pa­ny through mul­ti­ple hear­ings, and at the end of it? Noth­ing hap­pened to the price or the com­pa­ny (un­til gener­ic com­pe­ti­tion came).

But when this type of be­hav­ior oc­curs in the UK, as we’re now see­ing in this case with Pfiz­er, reg­u­la­tors are pre­pared for ret­ri­bu­tion, and they aren’t afraid to re-open an in­ves­ti­ga­tion ei­ther.

In this in­stance, the UK’s Com­pe­ti­tion and Mar­kets Au­thor­i­ty has al­ready, in 2016, im­posed a record £84.2 mil­lion ($117 mil­lion) fine on Pfiz­er, find­ing that the com­pa­ny broke com­pe­ti­tion law by in­creas­ing the price of its epilep­sy drug pheny­toin sodi­um by 2,600% overnight af­ter the drug was de­lib­er­ate­ly de-brand­ed in Sep­tem­ber 2012.

The change meant that the price the UK’s Na­tion­al Health Ser­vice was charged for 100mg packs of the drug sky­rock­et­ed from £2.83 ($3.94) to £67.50 ($94), re­sult­ing in in­creased ex­pen­di­tures from about £2 mil­lion ($2.8 mil­lion) in 2012 to about £50 mil­lion ($70 mil­lion) in 2013.

In 2018, the UK’s Com­pe­ti­tion Ap­peal Tri­bunal (CAT) up­held the CMA’s find­ings on mar­ket de­f­i­n­i­tion and dom­i­nance, but set aside the CMA’s find­ing that the com­pa­nies’ prices were an un­law­ful “abuse” of dom­i­nance.

This lat­est re-in­ves­ti­ga­tion by the CMA, an­nounced Thurs­day, will wade back in­to that find­ing that the CAT set aside.

The CMA has now pro­vi­sion­al­ly found that Pfiz­er and Fly­nn Phar­ma, the com­pa­ny that sold the Pfiz­er drug to NHS and pre­vi­ous­ly was fined £5.2 mil­lion ($7.2 mil­lion), ex­ploit­ed a loop­hole and de-brand­ed the drug – known as Epanutin pri­or to Sep­tem­ber 2012 – so that it was not sub­ject to price reg­u­la­tion in the way brand­ed drugs are. As Pfiz­er and Fly­nn were the dom­i­nant sup­pli­ers of pheny­toin sodi­um in the UK, the NHS had no choice but to pay the high prices.

Pfiz­er and Fly­nn now have a chance to re­spond to the CMA’s ac­cu­sa­tions, and the au­thor­i­ty said it will care­ful­ly con­sid­er their rep­re­sen­ta­tions be­fore de­cid­ing whether they broke the law.

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Albert Bourla, Pfizer CEO (John Thys, Pool via AP Images)

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