KV Pharmaceutical
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KV Pharmaceutical Company (KV) was an American
drug company The pharmaceutical industry is a medical industry that discovers, develops, produces, and markets pharmaceutical goods such as medications and medical devices. Medications are then administered to (or self-administered by) patients for curing o ...
that brought generic and non-branded pharmaceutical products to the market. Headquartered in
St. Louis, Missouri St. Louis ( , sometimes referred to as St. Louis City, Saint Louis or STL) is an Independent city (United States), independent city in the U.S. state of Missouri. It lies near the confluence of the Mississippi River, Mississippi and the Miss ...
, 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 and 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 a
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 respo ...
(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 FDA. After a proxy fight, Marc 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 focused on unusual modes of
drug delivery Drug delivery involves various methods and technologies designed to transport pharmaceutical compounds to their target sites helping therapeutic effect. It involves principles related to drug preparation, route of administration, site-specif ...
.


Makena pricing controversy

In February 2011, the FDA granted approval to KV for "Makena" (
hydroxyprogesterone caproate Hydroxyprogesterone caproate, sold under the brand name Delalutin among others, is a medication used to reduce the risk of preterm birth in women pregnant with one baby who have a history of spontaneous preterm birth. In March 2023, the manuf ...
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 betwee ...
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 Childbirth, birth of a baby at fewer than 37 weeks Gestational age (obstetrics), gestational age, as opposed to full-term delivery at approximately 40 weeks. Extreme preterm is less than 28 ...
. For many years, however, OHPC had been available and used by obstetricians "off label". Before the release of Makena, the drug was compounded by pharmacies for $15, or less, per injection. Typically 15 to 20 injections are given over a treatment course, costing a total of $225 to $300. With the FDA approval of Makena as an
orphan drug An orphan drug is a medication, pharmaceutical agent that is developed to treat certain rare medical conditions. An orphan drug would not be profitable to produce without government assistance, due to the small population of patients affected by th ...
, 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 at about $51,000 justified the cost of the medication, and that a system would be in place to enable patients without means to obtain it. 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 March of Dimes is a United States nonprofit organization that works to improve the health of mothers and babies. The organization was founded by US President Franklin D. Roosevelt in 1938, as the National Foundation for Infantile Paralysis, to co ...
that supported the arrival of Makena. The FDA commissioner,
Margaret Hamburg Margaret Ann "Peggy" Hamburg (born July 12, 1955, Chicago, Illinois) is an American physician and public health administrator, who is serving as the chair of the board of the American Association for the Advancement of Science (AAAS) and co-chair ...
, said that the agency was not in a position to influence pricing. Concerned about
price gouging Price gouging is the practice of increasing the prices of goods, services, or commodities to a level much higher than is considered reasonable or fair by some. This commonly applies to price increases of basic necessities after natural disaste ...
, two sSenators,
Amy Klobuchar Amy Jean Klobuchar ( ; born May 25, 1960) is an American politician and lawyer serving as the Seniority in the United States Senate, senior United States Senate, United States senator from Minnesota, a seat she has held since 2007. A member o ...
(D-Minn.) and
Sherrod Brown Sherrod Campbell Brown ( ; born November 9, 1952) is an American politician who served from 2007 to 2025 as a United States senator from Ohio. A member of the Democratic Party, he was the U.S. representative for from 1993 to 2007 and the 47t ...
(D-Ohio), indicated that they planned to initiate hearings with the
Federal Trade Commission The Federal Trade Commission (FTC) is an independent agency of the United States government whose principal mission is the enforcement of civil (non-criminal) United States antitrust law, antitrust law and the promotion of consumer protection. It ...
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 2011, the FDA announced that pharmacies compounding the drug independently would 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, w ...
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 the 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. Hologic, Inc. is an American medical technology company primarily focused on women's health; it sells medical devices for diagnostics, surgery, and medical imaging. History In late November 2013, activist investor Carl Icahn disclosed a 12.5% st ...
, 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.
AMAG Pharmaceuticals AMAG Pharmaceuticals, Inc. is an American pharmaceutical company developing products that treat iron deficiency anemia (IDA) in adult patients. The company was a publicly traded company listed on NASDAQ under the symbol "AMAG" until November 2020 ...
, based in Waltham, Massachusetts, acquired Lumara Health for $675 million in cash and stock, and, in a separate transaction, Perrigo Co. of Dublin, Ireland, 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 Gynaecology or gynecology (see American and British English spelling differences) is the area of medicine concerned with conditions affecting the ...
nitrate vaginal cream, 2%) * Clindesse (
clindamycin Clindamycin is a lincosamide antibiotic medication used for the treatment of a number of bacterial infections, including osteomyelitis (bone) or joint infections, pelvic inflammatory disease, strep throat, pneumonia, acute otitis media (mi ...
phosphate vaginal cream, 2%) * Evamist (
estradiol Estradiol (E2), also called oestrogen, oestradiol, is an estrogen steroid hormone and the major female sex hormone. It is involved in the regulation of female reproductive cycles such as estrous and menstrual cycles. Estradiol is responsible ...
transdermal spray) * Makena (
Hydroxyprogesterone caproate Hydroxyprogesterone caproate, sold under the brand name Delalutin among others, is a medication used to reduce the risk of preterm birth in women pregnant with one baby who have a history of spontaneous preterm birth. In March 2023, the manuf ...
) (after March 14, 2011)


Nesher Pharmaceuticals

*
Potassium Chloride Potassium chloride (KCl, or potassium salt) is a metal halide salt composed of potassium and chlorine. It is odorless and has a white or colorless vitreous crystal appearance. The solid dissolves readily in water, and its solutions have a sa ...
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 Companies that filed for Chapter 11 bankruptcy in 2012 Defunct pharmaceutical companies of the United States