BiDil, The First Racially Targeted Medication For BP Has A Controversial Pricing

The new BP medication made up of isosorbide dinitrate and hydralazine has been approved for use in black patients. The brand will sell for 6-10 dollars per daily dose, but cost less then a dime.

NitroMed officials on Thursday announced that they have set the price for the heart failure medication BiDil at $1.80 per pill — a higher price than analysts expected and almost twice the price of rival treatments — and that the company will establish an "unusually generous" assistance program for the estimated 75,000 patients without prescription drug coverage who could benefit from the medication. The FDA in June approved BiDil for use in black patients based on the results of a study that found the medication reduced their risk for heart disease. BiDil marks the first medication approved by FDA for use in a specific racial group. Based on the dosage, treatment with BiDil will cost between $5.40 and $10.80 daily. However, under the assistance program, NitroMed will offer BiDil at no cost to patients with annual incomes of less than 300% of the federal poverty level, according to B.J Jones, marketing director for the company. In addition, patients without prescription drug coverage can purchase BiDil for $25 monthly, regardless of annual income. The program will benefit those who "unfortunately, so often, fall through the cracks, the quote, unquote working poor, with enough to keep food on the table but not enough to get the appropriate insurance," Jones said.

Steven Nissen and Jonathan Sackner-Bernstein, cardiologists who served on the FDA advisory committee that recommended approval for BiDil, raised concerns that not all the eligible patients will participate in the assistance program. "I’m skeptical about these plans," Sackner-Bernstein said, adding, "Since they require doctors to send in forms, they don’t work as well as they are supposed to. NitroMed "runs another risk by pricing the drug high" because some physicians might attempt to prescribe the generic ingredients of BiDil — isosorbide dinitrate and hydralazine — to patients who cannot afford the medication. The "generics are not available in the exact doses contained in the BiDil pill," but "some doctors are willing to experiment … to achieve similar results.