[ceterum_censeo]

If you're going to pull prices off Sigma, at the very least you should quote the USP grade.

The cost of a pharmaceutical is not the raw material cost for the API, which is frequently a small fraction of the total cost. The majority of the cost is in meeting regulatory requirements (e.g. GMP production, traceable testing). In the case of this product, a volume of 200–300 units per year is so tiny I would expect the setup/teardown costs for batch manufacture to also play a role.

$27k sounds outrageously high, but the original $950 sounds equally outrageously low in light of the volume.

[andmon2]

The Sigma price was purely to give an indication and show that its a relatively cheap and common chemical not something esoteric.

IMO, whether its $950 or $27k in the US, that is still outrageously high, considering that in the UK the same drug used to be sold to the NHS for under £8 a dose.

In fact, as its out of patent, I'm surprised people don't just point to the price in other countries right away before making excuses for the manufacturer.

[ceterum_censeo]

Even for expensive APIs, the cost of the compound is a small portion of the overall cost.

Directly comparing the advertised price between the US market and the formulary price for the UK isn't informative. It would be more informative to compare the ASP in the US to the UK price, but part of the problem with costs in the US is that those prices are not transparent.

That the compound is off patent doesn't affect the price if it is single source for this market. It takes something like 4 generic manufacturers to see fairer pricing emerge.