The Research Letter by McCormick and colleagues1 clearly reveals the ripple effect associated with the US Food and Drug Administration (FDA) Unapproved Drug Initiative approval of colchicine (Colcrys). The investigators’ goal was to document the trends in national spending before and after the approval of Colcrys and to secondarily determine the proportion of this spending that was attributable solely to the price increase. Medicaid and Medicare data files through 2017 were used to analyze trends. Among the key findings was that the 2017 combined Medicaid and Medicare claims exceeded $340 million. Medicaid spending for colchicine increased almost 3000%, from $1.1 million in 2008 to $32.2 million in 2017. The investigators confirmed that 58% of the increased spending was due to the price increase alone.