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People’s Pharmacy: Medicine costs millions per gallon

Q. My niece Cindy has multiple sclerosis. She takes one 20-milligram injection of Copaxone each day. The cost for a one-month prescription is $4,600. Fortunately, I have the wherewithal to pay for her medicine after her insurance benefits stopped paying for it for the remainder of this year.

I have done some mathematics on the cost of Copaxone. This is how it breaks down:

1,000 mg/20 mg injection dosage = 50 doses per gram

$4,600/30 doses = $153.33 per dose

50 doses x $153.33 = $7,666.50 for 1 gram of medicine.

$7,666.50 x 28 (grams in an ounce) = $214,662 for 1 ounce of this medication.

$214,662 x 128 (ounces in a gallon) = $27,476,736 per gallon.

How can any medicine be this unconscionably expensive?

A. Thank you for this eye-opening price analysis. Copaxone and other similar MS drugs cost anywhere from $50,000 to $60,000 a year, more than the median family income in the U.S.

Drug companies can charge whatever they want. That’s why many new cancer drugs cost anywhere from $50,000 to $100,000 for a full course of treatment.

A lifesaving medication to treat a rare genetic condition called Gaucher’s disease can cost more than $200,000 a year and has to be taken for life.


Q. I have to get up three or four times a night to pee. My doctor tells me that it is a benign prostate problem, but there is nothing benign about it because I often have a hard time getting back to sleep.

I was prescribed terazosin, but it has not helped enough to make a difference. My doctor doesn’t know what else to suggest. Any ideas?

A. Several other medications might work, including finasteride (Proscar) or tadalafil (Cialis). Unfortunately, finasteride has been linked to long-lasting negative sexual side effects. Some men report low libido, erectile problems or less satisfying orgasms (Journal of Sexual Medicine, November 2012).

Cialis has been approved for prostate symptoms as well as erectile dysfunction. Unless your insurance pays for it, however, this drug is pricey when you take it every day.

Another surprising option is vitamin D (Canadian Journal of Urology, August 2013). Preliminary studies suggest that taking at least 600 IU daily may help shrink the prostate gland and reduce inflammation.

To learn more about this crucial nutrient and whether your levels are adequate, you may want to consult our Guide to Vitamin D Deficiency. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (66 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. D-23, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our website:


Q. My son has been using lip balms for years and has developed an addiction to them. He is frustrated and hasn’t been able to find a substitute to heal his lips. Is there help out there for him?

A. Dermatologists frequently blame dry lips on the habit of lip licking. If your son can overcome the urge to moisten his lips with his tongue, he may not need lip balm so often.

If he has a fungal infection of the lips, however, he may need an antifungal cream. A trip to the dermatologist might reveal the root cause of the lip balm dependency.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them via their website: Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”