Inhaled Pentamidine and Prevention of Pneumocystis Pneumonia

To the Editor: In the report of the recent European controlled trial of inhaled pentamidine for prophylaxis against Pneumocystis carinii pneumonia (PCP), Hirschel and colleagues (April 18 issue) 1 state that it appears that prophylaxis against PCP may be less expensive than treating this disease. On the basis of data from the United States, there are several reasons why inhaled pentamidine is unlikely to reduce costs in this country. First, its cost is $100 to $129 per 300-mg vial (the lowest wholesale cost to the hospital), four times the cost in Europe. 2 , 3 In addition, according to data from the Multi-center AIDS . . .