Greed hampers treatment of lead poisoning in children

Despite the enormous scientific advances in our understanding of the adverse impact of lead on children’s healthy development, lead poisoning remains a serious health concern for parents and children in poor urban centers such as Hartford. Exposure to even low levels of lead causes long-term intellectual deficits, academic failure, and  adverse social and economic consequences, which perpetuates the cycle of poverty among affected children and their families.

While preventing children’s exposure to lead through abatement of old houses is a key prevention strategy, treatment of children with lead poisoning is imperative to minimize harm.  Despite the availability of drugs to treat such poisoning since the 1950’s, pharmaceutical price gouging is currently placing children’s lives and healthy development at risk.

In 2016, Valeant Pharmaceuticals, now known as Bausch Health Companies, sharply increased the price of Calcium Disodium EDTA (EDTA) when it became the sole producer of this medication in the United States. The formulation of EDTA has not changed since its introduction almost seven decades ago. No expense has recently gone into research, development, and marketing. Yet, Valeant Pharmaceuticals sharply increased the price of this medication by 1,600 percent in the past several years. As of April 2019, the price for a single treatment regimen (five ampules) of EDTA is reported to be $26,927. In 2008, EDTA was sold for about $355 dollars per ampule. In 2014, after Valeant started producing EDTA, the price soared to $5,300 per ampule.

Hospitals in Connecticut and across the country now face the difficult decision of whether to maintain a supply of this medication, which only has a shelf life of  18 months. The infrequent use of EDTA and, as a consequence, the expiration of medication ampules, result in a significant financial burden.

After reading a Forbes article on the issue, I wondered about the impact on local Connecticut hospitals. The Connecticut Department of Public Health’s most recent lead surveillance report estimates that more than 2,000 children in Connecticut suffer from lead poisoning, necessitating that hospitals treating children continue to stock this medication.  My survey of  25 local hospitals revealed that only three maintain a supply .

Connecticut Children’sis committed to keeping EDTA in stock. However, the cost to the hospital is high. Connecticut Children’s lost more than $100,000 from 19 expired doses of the medication in one year, in comparison to losses of approximately $6,745 based on the original retail price.

EDTA is one of only 400 medications on the World Health Organization’s Model List of Essential Medicines. Yet, in one of the wealthiest states in one of the wealthiest countries in the world, many of our hospitals are unable stock it.

A young child suffering from lead intoxication leading to complications such as brain damage requires immediate treatment and drug availability. Our lawmakers must advocate for lowering the market price of EDTA to allow for universal access to this life-saving medication and decrease the burden on local hospitals.

Amritha Patel MD is a resident physician at the Connecticut Children’s Medical Center and University of Connecticut School of Graduate Medical Education.

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