Dey slashes price of DuoNeb

NAPA, Calif - As respiratory pharmacists continue to find ways around the distribution of the DuoNeb compound of albuterol sulfate and ipratropium bromide, Dey, the drug's manufacturer, has slashed prices in a bid to win more customers. DuoNeb, which had been selling for about $1.65 a dose, is now selling to some of the smaller respiratory pharmacies for $1.18 a dose. Reports say Dey is offering the drug to larger respiratory pharmacies for about 83 cents a dose. But even at 83 cents a dose, DuoNeb is still a far more costly alternative than albuterol and ipratropium, which costs pharmacies about 47 cents. Medicare reimburses providers about $1.52 per dose for the compound. Despite the deep price cuts, respiratory providers and distributors say that companies like Apria are still not likely to bite. (Apria did not return calls for this story.) While the FDA prohibits pharmacies from dispensing a compounded mix if a premix is commercially available, pharmacists who receive prescriptions for DuoNeb routinely ask physicians to change the prescription so that they may legally dispense DuoNeb. And physicians routinely comply. "A physician provides duties and services that he doesn't make money on," said Mickey Letson, president of Letco Medical in Decatur, Ala. "He understands [the pharmacist's] predicament." Increasingly, however, pharmacists are seeing more and more prescriptions for DuoNeb. Letson said Dey is detailing the medicine to physicians very well. He estimates that nearly one out of every five prescriptions for albuterol and ipratropium is coming in for DuoNeb. That's partly why Rainsville, Ala.-based ABC Plus has begun "to say yes to DuoNeb," said John Durkee, the company's national sales manager. "From a business standpoint, we will take a significantly reduced profit on this med, but our DME companies should be able to use it as a marketing advantage with pulmonologists who are insisting on this," said Durkee. "Everyone is saying no to them. Now we are saying yes." HME