News Stories

The $23,000 Foot Cream


Meet Al Noto. Al is a 72-year-old retired educator from New Jersey.

When he visited his podiatrist for a routine foot examination. Al found himself caught up in the world big pharma, hedge funds and crazy expensive drugs all because he told his doctor he had dry feet.

Like the sagas of the EPI Pen by Mylan Pharmaceuticals and Martin “The Pharma Bro” Shkrali, Al found himself on the wrong side of big pharma. Shkrali received widespread criticism when his company bought the license for the antiparasitic drug Daraprim and raised its price by a factor of 56 from $13.5 to $750 per pill. The media called him “the most hated man in America.” Al was the latest example of how big pharma can find its to big profits.


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Al went to his podiatrist Dr. Chapman at the Naples Foot and Leg Clinic on East Naples. Al is a diabetic and so he plays close attention to his feet. “I get regular examines and Dr. Chapman thought my feet were dry so he suggested I get a foot cream. So Dr. Chapman ordered e a prescription for me through Express Scripts (Al’s Medicare drug insurer).
When Al’s foot cream arrived – called ALCIORTIN A Gel – Al thought nothing of it. He used and his feet felt fine. It was on the arrival of the third tube that Al made for him what was a shocking discovery that his simple foot cream cost more than four times its weight in gold. The company that owns the patent on Al’s cream is not one of the big pharma companies. Instead it is a Chicago based firm that started in 2015 by buying another companies prescription creams that had no generic competition and by making minor changes to the drugs they could claim they had a drug that had no generic competition. In the case of Al’s cream, Novum added aloe, a herbal ingredient already approved by the FDA. The fact that drugs were already accepted by Medicare and other insurance plans is where Novum found big profits. The company then set out a pricing plan that raised the prices on the creams to stratospheric levels. Without generic competion the Novum sales force was able to convince doctors like Dr. Chapman to prescribe a drug that was only “possibly effective” according to the FDA.

If they keep doing this these companies are going to bankrupt Medicare.

Al is incensed at how much the cream costs in light of the fact that over the counter diabetic foot creams sell for about $9 at Walmart.

Neither Dr. Chapman, or Dr. Lam, who owns the Naples Foot and Leg Center responded to our repeated phone calls and emails asking to interview them. Instead we received this Halloween greeting card. Al did say Dr. Chapman had no idea what he was prescribing was so expensive.

For the last three weeks we reached out to the spokesmen for Medicare and though we were promised a response the government, like Novum in Chicago never got back to us.

A former Senate Investigator on drug isssues said the reason drug companies can unleash such price increases is because Gorge W. Bush’s prescription drug benefit for Medicare could only get through Congress “if there were no cost controls. Now we are living with the result.”

For Al Noto the price abuse is not acceptable. “If they keep doing this these companies are going to bankrupt Medicare.”

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