Authorities will probe whether the drug’s price was fixed or if the companies violated state antitrust laws by dividing customers or territories for digoxin sales.

The news followed a report that described the drug’s steep price increase since October 2013. One 85-year-old patient was shocked when her co-payment for digoxin reportedly jumped from US$1.15 for a three-month supply to US$30 a month.

Digoxin, which is related to digitoxin, was first isolated from the Foxglove plant (Digitalis) in the 18th Century, and has long been used to treat heart disorders such as atrial fibrillation. Although digoxin has largely been replaced by newer more effective drugs, it is still best for some patients, so two companies – Lannet and Global Pharmaceuticals (a division of Impax) – still make it.

In 2013, a third company, Covis Pharmaceuticals, began making a so-called ‘authorized version’. Authorized versions are generally more expensive because they are made using the original patent of the brand-name product (GlaxoSmithKline holds this).

Shortly after the arrival of Covis, the price of digoxin began to climb. It is not clear which company started this, however, the price doubled in six months. At the time of the price increases, the US Food and Drug Administration had reported no drug shortages, there was no new patent or new formulation and digoxin is not difficult to make. The companies have not yet provided an explanation for the price rise.

Not surprisingly, some patients have begun to question whether they can afford the drugs that have kept them healthy for many years. The only apparent winners in this have been the manufacturers of the drugs, whose share prices have soared since prices began to rise. How this proceeds in light of the investigation by the Connecticut Attorney General’s office remains to be seen.

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