Family owned and run Jacobus Pharmaceutical has priced its rare disease treatment for pediatric patients with Lambert-Eaton myasthenic syndrome, or LEMS, at less than half what Catalyst Pharmaceuticals charges for its similar treatment for adults, according to a story by STAT.

In LEMS, the immune system attacks the areas where the nerves and muscles connect, affecting the way they communicate and making it difficult to move the muscles normally. It can occur at any age but more commonly occurs in patients with cancer, where its onset precedes or coincides with the diagnosis of cancer. Prevalence of LEMS is estimated to be there per million individuals worldwide.

According to the report, Jacobus has priced its drug Ruzurgi at $80 per 10mg pill, a number it attributes to Truven Health Analytics. A 10mg pill of Catalyst’s Firdapse costs $178.84, according to drug.com. Dosage varies depending on patient size, with the approved maximum dosage at 80mg per day.

Jabobus’ pricing is likely to introduce fresh competition to an issue that has already been very controversial. Jacobus had offered its LEMS treatment for free for many years under an FDA-approved compassionate use program. The U.S. Food and Drug Administration approved Catalyst Pharmaceuticals’ Firdapse for the treatment of adults with LEMS in late 2018 giving it seven years of market exclusivity and effectively ending the compassionate use program.

Catalyst announced that Firdapse would have an annual list price of $375,000 and created an uproar. While Catalyst instituted a patient assistance program to help pay for the drug at government and insurer expense, Senator Bernie Sanders (D-VT) called the price egregious and an “immoral exploitation of patients who need this medication.”

In early May, the FDA granted approval for Jacobus to market its drug Ruzurgi for pediatric LEMS patients, and while Jacobus didn’t immediately price its treatment, there was speculation that the FDA may have dampened the controversy with the approval of the competing treatment as there would be nothing to stop doctors from prescribing the pediatric drug to adult patients. In fact, the approval was based on data from studies in adults.

According to STAT, some analysts on Wall Street see physicians and payers as wary of prescribing pediatric drugs to adults, but the price difference may change their perspective. A patient needing more than the recommended dosage could face out-of-pocket costs of $5,000 per month.

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