Â鶹´«Ã½

Women who take the hormone replacement therapy drug Premarin are getting a big case of sticker shock when they renew their prescriptions these days.

That's because as of April 1, a month's supply of the medication has risen an astonishing 800 per cent, from about 14 cents a pill to about $1.24 a pill.

The price hike isn't due to any changes in the drug's formulation or packaging; it's simply a matter of supply and demand, says its manufacturer, Wyeth Canada.

With a number of studies linking long-term hormone replacement use to increased risks of breast cancer, many women have gone off the drug. But some women who have debilitating menopause symptoms weighed the risks along with their doctor and decided to take hormone replacement medications.

But the drop-in demand has left Wyeth with few options but to raise prices, it says.

"Wyeth Canada is increasing the price of Premarin to more appropriately reflect the costs and value of the product today," the company said in an email to Â鶹´«Ã½.

"The new price is reflective of current costs, including higher manufacturing and ingredient costs and a long-term, steady reduction in the consumption of the product, increasing the per-dose and per-patient cost significantly.

"We believe this adjustment is fair and reasonable and it reflects the tremendous value of Premarin to Canadian women, while remaining competitive to other products in its category," the company said, noting that the current price remains below the average cost of prescriptions in Canada.

Rositta Buracas is one of the Canadian women who take Premarin. She says it helps her sleep better, feel better, and ward off osteoporosis. When she noticed the price increase last month, she was shocked. Her three-month bill went from about $25 -- including dispensing fee -- to more than $125. Prices vary slightly depending on pharmacy.

"When they showed me the bill I said, 'You've got to be joking, right?'"

A reader of the CTV MedNews Express health blog wrote in to say that she, too, was stunned with the price hike.

"I'm very upset at the company," Emily told CTV. "Companies shouldn't do this to their patients."

There is no generic version of Premarin, meaning there are no easy alternatives for patients. While generic conjugated estrogen can be used instead, many may find that the price is not much lower than Premarin.

Premarin's pricing based on market demand

There is little the federal government can do. That's because Premarin is no longer a patented medication, its pricing doesn't come under the jurisdiction of the federal government's Patented Medicine Review Board and companies are free to set pricing based on market demand.

Rositta has her own demand and that's that women write in to Wyeth and demand a more reasonable price increase.

"I want the company to sit up and take notice. They'd better do something because there will be lots of bitchy hormonal women out there!" she says.

Dr. Jim Wright of the University of British Columbia's Therapeutics Initiative, which analyzes prescription medication independently of pharmaceutical companies, says when there are no patents, companies can price a drug at whatever the market can handle.

He says at its new price, Premarin is not good value. He says women should reconsider whether they should talk with their doctors and assess whether they'd be better off with another kind of estrogen medication.

"I would also recommend all provincial drug plans, when they become aware of this, to no longer fund it, and private insurance should not fund it because it's not good value," he says.

Wyeth Pharmaceuticals says its decision "was based on extensive research, including discussions with stakeholders, physicians and patients, and reflects the value Premarin brings to Canadian women. Key inputs from that research showed that Canadian physicians and women wanted us to continue to offer the product."

"While we understand this is undesirable for some patients, the only other option was to remove the product from the market, and many Canadian women continue to rely on this unique product."

The company says that if women can't afford it, their doctors can apply for it on compassionate release and get a 100-day supply for free, while patients "consider options for payment or transitioning to an alternate product."

With a report from CTV medical specialist Avis Favaro and producer Elizabeth St. Philip