Michael Hiltzik: The government could force a price cut for this prostate cancer drug by as much as 80%. Why hasn't it acted?

Xtandi, a wonder drug for prostate cancer, was developed at UCLA with substantial funding from the taxpayers through the Pentagon and the National Institutes of Health.

UCLA has profited handsomely from the drug, to the tune of more than $520 million in royalties. The drug companies that acquired the manufacturing license, including Pfizer and the Tokyo firm Astellas Pharma, have also raked in billions in sales.

American taxpayers and prostate cancer patients haven't done as well. Xtandi's average wholesale price in the U.S. comes to $189,800 a year.

Prostate cancer is disproportionately a disease of older men, so much of the cost falls on Medicare, which has become the largest single customer for the drug; Medicare spent more than $5.8 billion on Xtandi from its introduction in 2012 through 2019, the last year for which the figure is available. In some years, the drug has been among the top 10 costliest drugs for Medicare.

Deductibles and co-pays can bring the out-of-pocket cost of Xtandi even for