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KV Pharmaceutical Company (KV) was an American
drug company The pharmaceutical industry discovers, develops, produces, and markets drugs or pharmaceutical drugs for use as medications to be administered to patients (or self-administered), with the aim to cure them, vaccinate them, or alleviate symptoms. ...
that brought generic and non-branded pharmaceutical products to the market. Headquartered in
St. Louis, Missouri St. Louis () is the second-largest city in Missouri, United States. It sits near the confluence of the Mississippi and the Missouri Rivers. In 2020, the city proper had a population of 301,578, while the bi-state metropolitan area, which e ...
, it had research and manufacturing facilities, as well as marketing and sales operations, the latter activities conducted through its subsidiaries, Ther-Rx Corporation and Nesher Pharmaceuticals Inc.


Background

KV was founded by Bob Keith & Victor Hermelin in 1942 who ran the company until 1975, when he was replaced by his son Marc. Marc Hermelin was ousted in 2008 when an FDA inspection took place. The following year KV convicted of felony charges for the "making, marketing, and distribution of adulterated and unapproved drugs" was shut down by the
Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is respon ...
(FDA). After a proxy fight, M. Hermelin returned to the company's board. Between 2008 and 2010, KV lost three-quarters of its workforce, down to 350. KV was reapproved for manufacturing drugs in 2010, while its ''Ethex'' manufacturing subsidiary was sold. Rather than developing new molecular entities, KV researches different modes of
drug delivery Drug delivery refers to approaches, formulations, manufacturing techniques, storage systems, and technologies involved in transporting a pharmaceutical compound to its target site to achieve a desired therapeutic effect. Principles related to dr ...
. It developed bioadhesive drug delivery where molecules adhere to wet sites such as a mucosa (example Clindesse), and is investigating quick-dissolving and controlled-release drug venues.


Makena pricing controversy

In February 2011, U.S.
Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is respon ...
(FDA) granted approval to KV for "Makena" (
hydroxyprogesterone caproate Hydroxyprogesterone caproate (OHPC), sold under the brand names Proluton and Makena among others, is a progestin medication which is used to prevent preterm birth in pregnant women with a history of the condition and to treat gynecological diso ...
or OHPC) for the prevention of
premature birth Preterm birth, also known as premature birth, is the birth of a baby at fewer than 37 weeks gestational age, as opposed to full-term delivery at approximately 40 weeks. Extreme preterm is less than 28 weeks, very early preterm birth is between 2 ...
in women with a single fetus of less than 37 weeks gestation who had at least one previous
preterm birth Preterm birth, also known as premature birth, is the birth of a baby at fewer than 37 weeks gestational age, as opposed to full-term delivery at approximately 40 weeks. Extreme preterm is less than 28 weeks, very early preterm birth is between 2 ...
. For many years, however, OHPC had been available and used by obstetricians "off label". Prior to the release of Makena, the drug was made available by pharmacies that compounded the agent for $15 or less per injection (typically 15 to 20 injections are given over a treatment course). With the FDA approval of Makena as an orphan drug, KV received the exclusive right to sell the drug for seven years. KV boosted its price by a factor of 100, to $1,500 per injection, or about $25,000 per treatment. The pricing policy of KV was heavily criticized as it substantially increased medication cost and removed less expensive alternatives. KV indicated that the cost of taking care of a premature birth is about $51,000 justifying the cost of the medication, further, a system would be in place to enable patients without means to obtain the medication. Thus, expenses would essentially fall on the public sector and insurance carriers. A number of physician organizations have opposed the pricing policy of the company as did the March of Dimes that supported the arrival of Makena. The FDA commissioner Margaret Hamburg stated that the agency was not in a position to influence pricing. Concerned about
price gouging Price gouging is a pejorative term used to describe the situation when a seller increases the prices of goods, services, or commodities to a level much higher than is considered reasonable or fair. Usually, this event occurs after a demand or ...
, two Senators, Amy Klobuchar (D-Minn.) and
Sherrod Brown Sherrod Campbell Brown (; born November 9, 1952) is an American politician serving as the senior United States senator from Ohio, a seat which he has held since 2007. A member of the Democratic Party, he was the U.S. representative for Ohio's ...
(D-Ohio) indicated that they plan to initiate hearings with the Federal Trade Commission about KV's conduct. The controversy spawned protests like the "Shame on You KV Pharmaceutical and CEO Greg Divis" Facebook page. By the end of March the FDA announced that pharmacies compounding the drug independently will not face legal reprisal, thus enabling the price of the drug to remain in the $10–20 range. After this announcement, K-V's stock dropped by more than 60% on March 30, 2011, and the company cut the price of Makena to $690 per dose.


Bankruptcy and acquisition

KV Pharmaceutical filed a petition for protection under
Chapter 11 Chapter 11 of the United States Bankruptcy Code (Title 11 of the United States Code) permits reorganization under the bankruptcy laws of the United States. Such reorganization, known as Chapter 11 bankruptcy, is available to every business, wheth ...
of the
Bankruptcy Act Bankruptcy Act (with its variations) is a stock short title used for legislation in Australia, Hong Kong, Malaysia, the Republic of Ireland, the United Kingdom and the United States relating to bankruptcy. The Bill for an Act with this short title ...
on August 4, 2012 in U.S. Bankruptcy Court for the Southern District of New York in Manhattan. The petition listed the company’s assets as $237 million and its debts as $728 million. The filing came on the same day that the company failed to make a $95 million payment it owed to Hologic Inc., KV’s partner in developing Makena. The bankruptcy followed a long string of troubles for KV involving oversize morphine tablets, a criminal prosecution, and the barring of KV’s former chairman, Marc Hermelin, from doing business with federal health programs. The company emerged from bankruptcy in 2013 with less debt and a $375 million recapitalization, including cancellation of its previous preferred and common stock. Senior secured notes were paid in cash, and general unsecured creditors received a pro rata share of $10.25 million. Convertible subordinated noteholders received 7 percent of KV’s new common shares in addition to shares purchased through the rights offering or direct purchase of shares. The company changed its name to Lumara Health, Inc. in May, 2014 and in September, 2014 announced that it was being acquired by two different buyers in deals valued at $757 million. Waltham, Massachusetts-based AMAG Pharmaceuticals acquired Lumara Health for $675 million in cash and stock, and in a separate transaction, Dublin, Ireland-based Perrigo Co. acquired Lumara Health’s women’s health care business, including the Clindesse Vaginal Cream, Gynazole-1 and Evamist products, for $82 million. The AMAG Pharmaceuticals acquisition included the Makena product. Lumara Health now operates as a division of AMAG Pharmaceuticals.


Products


Ther-Rx Corporation

* Gynazole-1 (
butoconazole Butoconazole (trade names Gynazole-1, Mycelex-3) is an imidazole antifungal used in gynecology. It is administered as a vaginal cream.Butoconazole Synthesis Reaction of epichlorohydrin with 4-Chlorobenzyl magnesium bromide leads to 1-chloro-4 ...
nitrate vaginal cream, 2%) * Clindesse ( clindamycin phosphate vaginal cream, 2%) * Evamist (
estradiol Estradiol (E2), also spelled oestradiol, is an estrogen steroid hormone and the major female sex hormone. It is involved in the regulation of the estrous and menstrual female reproductive cycles. Estradiol is responsible for the development o ...
transdermal spray) * Makena ( Hydroxyprogesterone caproate) (after 3/14/2011)


Nesher Pharmaceuticals

* Potassium Chloride Extended-Release Capsules, USP


References

{{Pharmaceutical companies of the United States Pharmaceutical companies disestablished in 2014 Companies formerly listed on the New York Stock Exchange Defunct pharmaceutical companies of the United States