Express Scripts will offer a $1 alternative to the $750 dollar pill. 

In September, we wrote about Daraprim, which originally cost $13.50 per pill, and skyrocketed to $750 overnight. Last week, Express Scripts announced that they would offer a cheaper alternative. Express Scripts is the largest pharmacy benefits manager in the country.

What is the new drug?

The company partnered with Imprimis Pharmaceuticals to create a slightly different pill- not a generic version, which would require approval by the FDA. Theirs has pyrimethamine, the main drug in Daraprim, and leucovorin, which is commonly prescribed with Daraprim to control its’ side effects. It will cost $99 for a bottle of 100 pills- less than $1 each.

What is the old drug?

Daraprim is a decades-old drug that is used to treat toxoplasmosis, a rare infection that typically affects those with decreased immune systems. Since the disease is so uncommon, there was never a push for a generic version of the medication that treats it. The drug Express Scripts offers is cheaper than Daraprim’s price, even before Turing Pharmaceuticals raised it from $13.50 to $750. After public outrage at the price hike, the CEO of Turing Pharmaceuticals, Martin Shrkeli, said that hospitals would be offered discounts of up to 50%.


Express Scripts was motivated to help patients and the doctors treating them. After hearing from many infectious disease doctors, the Chief Medical Officer at Express Scripts, Dr. Steve Miller, began looking for a solution.

Now, “the use of this compounded medication could theoretically reduce a hospital’s cost of treating a patient with Daraprim from as much as $40,000 to less than $60,” Ron Shinkman wrote on Fierce Health Finance.

See more about Express Scripts, Imprimis and their drug on

Will Express Scripts’ decision impact healthcare and pharmaceutical prices? Read more here.

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