When California’s aid-in-dying law takes effect this June, terminally ill patients who decide to end their lives could be faced with a hefty bill for the lethal medication. It retails for more than $3,000.

Valeant Pharmaceuticals, the company that makes the drug most commonly used in physician-assisted suicide, doubled the drug’s price last year, one month after California lawmakers proposed legalizing the practice.

“It’s just pharmaceutical company greed,” said David Grube, a family doctor in Oregon, where physician-assisted death has been legal for 20 years.

The drug is Seconal, or secobarbital, its generic name. Originally developed in the 1930s as a sleeping pill, it fell out of favor when people died from taking too much, or from taking it in combination with alcohol. But when intended as a lethal medication to hasten the death of someone suffering from a terminal disease, Seconal is the drug of choice.

“It works very quickly and very gently,” Grube says. “People fall asleep with no complications. It’s a very gentle passing.”

In 2009, Grube remembers the price of a lethal dose of Seconal — 100 capsules — was less than $200. Over the next six years, it shot up to $1,500, according to drug price databases Medi-Span and First Databank. Then Valeant bought Seconal last February and immediately doubled the price to $3,000.

Most drug companies justify such hikes by pointing to high research costs. But Grube says that’s not the case with Seconal. It’s been around for 80 years.

“It’s not a complicated thing to make, there’s no research being done on it, there’s no development,”  he says. “That to me is unconscionable.”

Valeant bought several other drugs at the same time it bought Seconal, raising some of those prices as much as 500 percent. That sparked a congressional investigation into its pricing practices. (The CEO resigned Monday amid an accounting controversy).

“Valeant sets prices for drugs based on a number of factors,” the company said in a statement, including the cost of developing or acquiring the drug, the availability of generics and the benefits of the drug compared with costly alternative treatments. “When possible, we offer patient assistance programs to mitigate the effects of price adjustments and keep out-of-pocket costs affordable for patients.”

The most likely explanation for raising the price of Seconal is the lack of generics, says Mick Kolassa, founding partner of Medical Marketing Economics, a firm that advises drug companies on how to price and market their drugs.

Seconal went off patent in the early ’90s. There were some generics for a while, but then demand shrank and manufacturers abandoned them.

“So that meant when the current company bought it, they didn’t have any generic competition, simply because the market got so small that it left,” Kolassa said. “So in situations like that, a company can acquire it and raise the price.”

Kolassa says it’s also possible that the demand for even the brand-name drug is so low that it’s hard to recoup the costs of making and selling it.

“Here’s a company that said, well, we can raise the price, keep it on the market and make some money with it,” he said. “Or we can walk away and the product goes away.”

Whatever the explanation, what cancer patients like Elizabeth Wallner see is a drug company taking advantage. She has one word to describe the pharmaceutical executive who decided to double the price of Seconal: “Scumbag.”

Wallner was diagnosed with Stage 4 colon cancer five years ago. It spread to her liver and lungs. She always thought that if her suffering became too unbearable, she would consider ending her life. But she never thought about the price tag of the lethal drug.

“You’re going to make money off my death,” she said.

She’s most worried about her son.

“You are literally, at that point, taking the money from children,” she said. “Everything I have, if I’m going to die tomorrow, everything I have will be left to my son who will be 20 years old and almost 100 percent on his own.”

Under the California aid-in-dying law, it is optional for health insurance companies to cover the costs of the practice. Most private insurers plan to do so, according to the California Association of Health Plans. So does the state’s Medicaid program.

But for patients who aren’t covered, there is a cheaper alternative: a three-part drug cocktail that can be mixed by a compounding pharmacy for about $400.

Grube says the cocktail works just as well, but doctors usually don’t prescribe it because of the hassle some patients have to go through to get it. Seconal, on the other hand, is a ready-made pill, routinely available at most retail drugstores.

He says advocacy groups like Compassion & Choices are working on campaigns to reduce drug costs and to educate doctors and patients about the law.

“My dream is that any Californian who will choose aid in dying would have few burdens or barriers to jump through,” Grube said.

Katie Orr contributed reporting from Sacramento. 

Pharmaceutical Companies Hiked Price on Aid in Dying Drug 23 March,2016April Dembosky

  • The exploitation of human suffering for extreme profit is older than snake oil. The only protection we have is the bright light of investigative journalism directed into the shadows with unwavering resolve. The “scumbags” that run Valeant and Turing Pharmaceuticals have made the job easier by clearly demonstrating their unprincipled greed without apology or shame. The responsibility for correcting the predictable behavior of such optimism can’t possibly depend on the ethics of profit intoxicated “scumbags” The responsibility is ours as a society to take control of how we wish to care for each other in our most vulnerable moments. http://www.ResolutionCare.com

  • john bruce beardsley

    the pharmaceutical industry needs a lot more regulation. Yeah I know regulation reduces efficiency and is a burden, but when the “free market” effs up this bad, there is no real choice.

  • rxdoc

    Why are you using a picture of cheap generic Prozac for your story? It is very commonly dispensed/widely used in the population, and is NOT the drug featured in your story. I think this is really irresponsible.

  • Bradley Williams

    If this upsets you consider that the entities that reap wind fall profits on legalizing assisted suicide are the insurance corporations and the promoters and facilitators of the premature deaths of vulnerable people.

    • Byard Pidgeon

      Give up, Bradley. The public has seen through your smokescreen, and there’s no there, there.

      • Bradley Williams

        It is your choice. Don’t ask, don’t tell or follow the money.

  • D . G.

    Valeant, Turing and other companies like them are finished they will be banned and regulated out of existence. The days of bigPharma ripping off everyone are numbered. The last thing I would do is pay some company graft for the pill I already know how to wipe myself out for less than 5 bucks if and when the time comes and it will be painless.

  • Roy Jordan

    How do you spell: G-R-E-E-D? If I needed to end my life the go-to affordable drug of choice would be: OPIATES, not over-rated/over-priced SECONAL!

  • Byard Pidgeon

    A few years ago, when my friend used Oregon’s Death With Dignity law, the drug was Pentobarbital, which we got at the local pharmacy. We got a laugh from the label: “No Refills”.
    It was reasonably priced…is it no longer available?

  • MLou Simpson

    When our president sought to provide healthcare coverage for the masses, he left out one important issue out of the equation…stop the charlatans and snake-oil salesmen from implementing obscenely high prices far above the reach of most patients. Profits over human life should NEVER be their creed or mantra, particularly for purposes of satisfying their shareholders, nor should our government continue to ignore this egregious and deliberate offense by big pharma against humanity.

    • Virginia Stanley

      They did that on purpose.Obama is not a progressive.Neither is HIllary.They wanted to maintain the for profit HC system. So that patched together mess they call the ACA was created.Ignoring the fact that PHarma greed must be regulated
      Just demanding bidding on Medicaid and Medicare drugs would save $100 billion per year.So that added profit is built in the system.

      • Ami

        Obviously YOU have forgotten that MANY of the provisions in the ACA/Obama Care were written by RepubliKlans in Congress who then turned around and voted against it.

        I watched the hearings on CSPAN.

        • Virginia Stanley

          No I didnt forget.I dont remember that being an issue at all with the ACA. It was just let go.Now BAPF Hillary says it should be changed.It must be changed.Its just more corporate welfare.

    • While the attempt was admirable, we didn’t get healthcare reform. We got Insurance reform. Insurance is not and never has been healthcare. We still have the same old disease management health care we’ve always had. Keep falling apart on schedule while making the pharmaceutical industry, pharmacies, and insurance companies billions. Now, take this pill.

    • awake108

      Bush already broke that when they passed medicare part D also unpaid for by an offset. Like with the Post Office poison pill also passed under Bush they break government then they blame government Those tricky cons

  • Rafer Singleton

    what do you want to bet the ceo is a trump republican.

    • Gus diZerega

      Certainly a Republican- that party’s sociopaths can be found supporting many different candidates.

  • Virginia Stanley

    So where is the GEneric version? Only in AMerica can the dying be gouged for the last $$$ they have. Its just incredible.The PHarma candidate is HIllary.

    • hytre64

      This IS the generic version. Only one company was interested in manufacturing/selling it.

  • Francis Fuselier

    America has the best healthcare system in the world. American has the best healthcare system in the world. America has the best healthcare system in the world. America has the best healthcare system in the world….

    • Ami

      So the RepubliKlans keep telling us.

    • awake108

      Plesse google this don’t believe everything you read on right wing web sites I believe the real number is 37th

    • Cheryl

      I already tried self hypnotism with that mantra – didn’t work. We are not even on the first page.

    • Haunani V. K. Kawananakoa

      Not the best, only the most expensive.

  • dzerres

    health care is not a free market competition subject to the rules of the market – it never will be. If you’re in dire need of something you don’t have time to “shop around”, to compare, to even forego something or wait for a better price. That’s why that market needs regulation.

  • pizanos

    Only in the America. Elsewhere drug company pricing is regulated.

  • Nookster Black

    Unregulated capitalism, lets make America great again. Snark!

    • awake108

      Capitalism Unchecked by socialism is fascism

  • scotty501

    i dont understand if its generic why other companies can’t make and sell it?

    • hytre64

      They can. The question is whether or not they are willing to sink the capital into creating the manufacturing facilities, documentation, FDA inspections, marketing, etc. Since this appears to be the “drug of choice” for suicide, there could also be a potential liability issue for accidental overdoses (even if the overdose was intentional).

  • Elizabeth Bacon

    Pharmaceutical companies are going to make a profit off of sick people. The whole business model is flawed. They make profit off of sick people. If you are going to cut off their profits by dying early they are going to force you to either continue to live taking treatment that insurance/Medicaid will cover or penalize you for opting out “early” (like a wireless provider).

    An example of this is antibiotics. We have many bacteria that are drug resistant but pharma won’t invest in news. To make a profit on a new drug (offset research costs) they would have sell lots of it and charge a high price. Doctors won’t prescribe an expensive antibiotic.

    Another would be that they control a lot of medical doctors by providing grant money. This way they can make a huge profit on medication for symptom management. For example, chronic pain, fibromyalgia, chronic fatigue syndrome. If money was put into research to find the root cause and treat it they would lose all the profit from sleep meds, pain meds, it’s meds, etc. it’s why they use direct marketing. It’s a lot to cheaper to run ads telling consumers that they can just ask their doctor for this “new” medication that will dramatically change your life. You go in and pressure your doctor. They don’t have to have their reps go into the docs office to get them to prescribe.

    Lyrica was a medication for diabetic neuropathy that was going out of patent but some doctors were prescribing it off label. So the pharma company did a small study showed it could be effective for Fibromyalgia. They were then able to relabel it for use in treating Fibromyalgia renewing the patent and keeping a profitable drug profitable. They direct marketed it to consumers. Problem is their marketing suggests that it will “cure” you when in fact it treats one symptom and does that poorly. The drug only works for about 30% of patients. For the rest, it either has no effect or the side effects are too severe,, but the marketing is so good people will take it anyway.

    The direct marketing for Lyrica & Fibromyalgia was so effective that docs stopped prescribing it for diabetic neuropathy. No problem. Add a marketing campaign for its use for diabetic neuropathy. Alternate the ads and additional profits.

    • awake108

      I might add many old time remedies work just as well and are safer.

    • Haunani V. K. Kawananakoa

      You are quite right about their business model. 80% of a person’s healthcare costs are spent in the last 6 months of life, and those bitches (hospitals, nursing homes, etc.) mean to collect, one way or another! If you cut your misery short, they lose money and your suffering be damned. Likewise for the suffering of your family and friends watching you die a slow, painful, but profitable death. They will of course phrase their opposition to self-deliverance in sanctimonious moral terms about the sanctity of life rather than publicly own their naked greed.

  • Ben Jet

    Why not just give him heroin, LSD, Cocaine, Marijuana and let nature take its course. If someone with terminal ill is going to die let him die naturally. I am afraid that if you choose to die on you chosen time it will amount to suicide. And don’t let the greedy pharmaceutical companies profited from the miseries of people. These companies and their heads (CEO & Board of Directors) are evils.

  • ByHorse

    Just opt out of the pharma money machine – no need to pay the greedy bastards…hoard pills, get online, enlist your friends & family to procure, or DIY…many options

  • Jerry Frye

    My end of life pill is free, recognizable and easy to find. It’s called, Traaiin.

    • hytre64

      As the grandson of a RR Engineer, I can tell you that it is not free to the poor engineer who has to live through it.

  • Tina Moody

    Any politician who takes big pharma money has this tainting them. Birdie doesn’t.

  • awake108

    failure of capitalism and for profit health care It wasn’t always for profit Time is get singlepayer an get rid of the Oligarches and their money in politics taking away the people power

  • Striptaway

    Wall Street and Pharma companies have found their normal operating procedures include sh ting all over the public, Between the widespread fraud and executives with the most extreme cases of Narcissistic personality disorder these are just two of the most extreme cases of capitalism run amok.
    No Wallstreeters in jail for almost destroying the world economy and the Pharma industry supplying varying degrees of poison in their maintainence drugs.

  • magoos

    Perhaps these vultures consider that anyone looking to check out no longer needs their money so they wil grab as much as possible before the checks can no longer be signed by the dying.. Our system places profit high above the value of human life and dignity, even in the dying process.

  • Cheryl

    The people are taking down Monsanto – these huge greedy drug companies need to pay attention to that – the people can take them down too. And will.

  • pastor john

    This has happened many times before..Meprobamate went from very cheap to very very expensive..same with seconal it was a very cheap drug when it was used regularly.. and don’t fall for the research BS.. the USA government pays for a whole lot of the research then the companies get the patent.. crazy I think.. Most of the money spent now is for the advertising..

  • ziggypop

    How is our fascism working for you America?

  • kenrubenstein

    One word. Boycott. (All Valeant products).

    • hytre64

      That’s it – boycott the medication you want.

      • kenrubenstein

        There are many generic drug companies in the world, and no doubt someone will step in to take up the slack.

  • Haunani V. K. Kawananakoa

    It seems like many of the folks who would need this medication would be older, so why does Medicare Part D refuse to pay for barbiturates except for phenobarbital?

  • Let me guess, the media will not cover this the same way they covered Martin Shkreli.

Author

April Dembosky

April Dembosky is the health reporter for The California Report and KQED News. She covers health policy and public health, and has reported extensively on the economics of health care, the roll-out of the Affordable Care Act in California, mental health and end-of-life issues.

Her work is regularly rebroadcast on NPR and has been recognized with awards from the Society for Professional Journalists (for sports reporting), and the Association of Health Care Journalists (for a story about pediatric hospice). Her hour-long radio documentary about home funerals won the Best New Artist award from the Third Coast International Audio Festival in 2009.

April occasionally moonlights on the arts beat, covering music and dance. Her story about the first symphony orchestra at Burning Man won the award for Best Use of Sound from the Public Radio News Directors Inc.

Before joining KQED in 2013, April covered technology and Silicon Valley for The Financial Times, and freelanced for Marketplace and The New York Times. She is a graduate of the University of California at Berkeley Graduate School of Journalism and Smith College.

State of Health Sponsored by

Become a KQED sponsor