Why Is Old Tranquilizer (Meprobamate) So Damn Expensive?

Meprobamate (Equanil, Miltown) has been around since the 1950s. It was one of the most successful drugs of that era. This blockbuster tranquilizer was considered far safer than the barbiturates it replaced. It has been available generically for decades and should be dirt cheap. What went wrong?

The Outrageous Price Increase for Meprobamate:

Relatively few people may remember meprobamate, but we heard recently from one reader who does:

“At the age of 27, I began having numerous panic attacks daily. As a teacher, I found it increasingly impossible to function in the classroom.

“I visited my doctor and he prescribed a drug called meprobamate that made it possible for me to do my job, get married and function normally. Fast forward to 2016. I am 65 years old and have continued to take 400 mg of meprobamate four times per day under my psychiatrist’s care. I have never needed more than that.

“Originally, he tried to get me to take other medicines for my condition and wean me off the meprobamate. I tried Paxil, Xanax and buspirone among others. None of them gave me the relief that meprobamate does. (Paxil actually gave me agoraphobia.) He now prescribes meprobamate for me because it’s the only thing that works.

“The problem is this generic drug that used to cost $20 a month is now hundreds. I am trying to wean myself off, but it is difficult even though I’m down to two a day.

“I have a wonderful psychiatrist who made sure I was covered because at 65 I was too ‘old’ to take it without special approval from my insurance company. The thought of trying to find something else to deal with my panic attacks at my age is causing me even more anxiety.

“I am now retired from 41 years of teaching. This was the last thing I contemplated dealing with in retirement. I exercise and do yoga, and I am in good health. What suggestions do you have for my dilemma?”

A Very Old Generic Tranquilizer Becomes Unaffordable:

Forty years ago the brand name Miltown cost $8.45 for 100 pills. The same amount today in its generic form could cost almost $350. We can think of no good explanation or justification for such a price hike.

Drug companies, including generic manufacturers, now believe they can charge whatever price they want and get away with it. Old fashioned competition and capitalism no longer seem to apply within the pharmaceutical industry.

Because the tranquilizer meprobamate can cause dependence, the drug can be hard to discontinue suddenly. Like most anti-anxiety agents, including popular benzodiazepines such as alprazolam (Xanax), diazepam (Valium) or lorazepam (Ativan), the dose of meprobamate must be tapered very gradually over a long period of time under medical supervision.

Sadly, neither the FDA nor most drug companies provide detailed guidelines for getting off a tranquilizer or anti-anxiety agent. As a result patients and health professionals have to make up a program on their own.

People also differ in the way their bodies react to these medications. As a result, some people can phase off a tranquilizer gradually over several weeks without too much distress while others may suffer terribly for months. Cognitive behavioral therapy may help overcome some of the challenges of panic and withdrawal.

You can read about symptoms of withdrawal at this link.

Please share your own experience with drugs like meprobamate, alprazolam, diazepam or lorazepam. How well did the medication work? Were you able to phase off it smoothly? Others may benefit from your story, so please share it in the comment section below.