Big dosage, big profit: Does Genzyme encourage larger dosages than we need?

Pharmaceutical drugmaker Genzyme (GENZ), based in Cambridge, Massachusetts, specializes in creating drugs for rare diseases. It's a small market, but it's highly lucrative: the Orphan Drug Act gives the company tax credits and enhanced patent protection, virtually guaranteeing that its drugs become blockbusters.

Consider Genzyme's drug Cerezyme, which treats a rare, chronic genetic disease called Gaucher, and which has an astonishing price tag that netted the company $1.24 billion last year -- more than a quarter of its total revenue. But when a recent manufacturing problem threatened a potential Cerezyme shortage, Genzyme's response seemed to confirm some critics' long-held suspicions that the company may be encouraging inflated dosage -- and therefore higher sales -- of its drug, which costs patients hundreds of thousands of dollars a year.