New Dosages of Old Drugs Are Used to Raise Their Prices

Doctors have long prescribed a muscle relaxant called cyclobenzaprine to treat injuries like back strains, using five- or 10-milligram pills.

But doctors who also dispense the drugs they prescribe directly to patients have recently embraced a new pill that contains 7.5 milligrams of the muscle relaxant. There is no evidence to suggest that the pill works any better except, perhaps, for doctors and the middlemen supplying them. They can charge $3.45, or about five times as much as a five- or 10-milligram pill.

Over the last two years, states nationwide have moved to crack down on so-called physician dispensing of prescription drugs, a practice largely limited to doctors who treat injured workers. But doctors and companies have responded by exploiting loopholes in those rules and adopting new strategies to stay one step ahead, recent studies suggest.

One tactic has been to create novel dosages of old drugs to get around cost controls on traditional ones, according to a report issued in January by the Workers Compensation Research Institute, a group in Cambridge, Mass. Along with the 7.5-milligram version of cyclobenzaprine, the muscle relaxant, new dosages of two older painkillers, tramadol and hydrocodone, that carry far higher prices than the standard versions, have also appeared, the study found.

more