Why so much?

The NYT covers drug pricing issues related to addiction:

But there was one question that Evzio’s manufacturer has so far declined to answer and that the F.D.A. does not consider in its approval deliberations: How much is it going to cost?

It’s a simple question that goes unuttered throughout the American health care system. It’s a taboo subject. But our failure to ask it costs us dearly, experts say. We approve drugs and devices without considering cost-effectiveness, or even having a clue about price. We don’t ask for estimates and then are surprised when the nation is stuck with a $2.7 trillion annual health care bill.

In the case of the naloxone device, the question is germane because the drug itself is very old, and long off patent. A simple syringe filled with a dose of naloxone should cost about $3, said Dan Bigg, director of the Chicago Recovery Alliance, which has long deployed the drug in communities to reverse overdoses. He says giving the shot is “no more complicated than basting a turkey. It’s a no-brainer: You pull up this liquid and inject it into the muscle.”

But experts expect that Evzio could well be priced close to $500.

They also discuss a Hepatitis C breakthrough:

The price,” he concluded, “is whatever the market will bear.”

For many doctors and health economists that conclusion was affirmed in December with the approval of Sovaldi, the first drug to cure hepatitis C. Breathlessly awaited by patients and doctors as a medical revolution for a deadly disease, most were agog when its maker, Gilead Sciences, affixed its price: $86,000, or $1,000 a pill, for a six-week course. Last week Gilead announced first-quarter earnings of $2.3 billion, driven by record sales of Sovaldi.