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Express Scripts backs Imprimis' $1 pill over $750 Daraprim

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(Reuters) — Express Scripts Holding Co., the largest U.S. drug benefit manager, has improved access to a much cheaper competitor to Daraprim, an anti-infective medication that became a poster child for excessive drug pricing after its cost rose 5,000% overnight.

Express Scripts said it has added the drug's maker, compounding pharmacy Imprimis Pharmaceuticals, to its network of pharmacies and is working with doctors to make it easy for them to choose Imprimis' $1 pill instead of Daraprim at $750 a pill.

Imprimis combines pyrimethamine, the chemical name for the active ingredient in Daraprim, with a form of folic acid called leucovorin. The drug can be ordered to be delivered by mail and the pharmacy will submit the claim to Express Scripts, the company said.

The treatment is often used in patients who have the HIV virus and Express Scripts said it is working with both the Infectious Disease Society of America and the HIV Medicine Association on informing doctors about the competitor.

Daraprim is made by Turing Pharmaceuticals, which acquired the rights to make the 62-year-old Daraprim and then raised its price from $13.50 per pill to $750 per pill. Imprimis began compounding the drug in October in response to the price increase.

Last week, Turing said it would cut the price by about 50% for hospitals, which handle about 80% of cases of toxoplasmosis encephalitis, the dangerous infection that Daraprim treats.

Express Scripts Chief Medical Officer Steve Miller said the company has taken on makers of high-priced treatments for hepatitis C and cholesterol to try to lower prices.

"When there are these painpoints in health care that our patients and our clients identify, we want to be part of that solution," Mr. Miller said. He said doctors had reached out to Express Scripts about issues around the price increase in the niche product.

Express Scripts estimated that fewer than 2,000 of patients covered by its plans are prescribed the drug annually, making it a candidate for compounding on an individual basis.