Express Scripts covers $1 alternative to $750 AIDS pill Daraprim.

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The US's biggest manager of prescription drug benefits said it will cover a $1-a-capsule alternative to the anti-parasitic treatment Daraprim, which costs $750 a pill after Turing Pharmaceuticals AG raised the drug's price from $13.50 this year.

Express Scripts Holding Co. said in a statement that it's partnering with Imprimis Pharmaceuticals Inc., a San Diego-based company specializing in compounded drugs. In October, Imprimis started making a medicine for as little as $1 a capsule that includes the active ingredient in Daraprim, pyrimethamine, together with a vitamin called leucovorin that Daraprim is usually used with.

Turing's price increase for Daraprim, a decades-old drug that no longer enjoys patent protection, drew outrage from politicians, doctors and health insurers. By having a compounding pharmacy combine the two drugs, Express Scripts doesn't need to wait for an FDA-approved direct competitor to Daraprim to come to market at a lower cost.

The $750-a-pill price "wasn't acceptable," Steve Miller, chief medical officer for Express Scripts, said in an interview Monday. Using a compounded drug is "a simple, elegant solution that gets desperate patients the drugs they need at an affordable price." Miller said because Daraprim isn't needed in large quantities, Imprimis should not have a supply problem.

Safety Concern

Daraprim treats a condition called toxoplasmosis, which is caused by a parasite that can become active in people with weakened immune systems because of HIV, chemotherapy or other conditions or treatments.

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