In reading a print version of a journal, like you do, my eyes wandered to an advert for a new antibiotic for C difficile, ‘to help release your patients from the threat of recurrence.’
Now, a new antibiotic is to be welcomed, but as far as I could tell this newer drug, fidaxomicin is no better than standard antibiotic treatment. There was no evidence presented in the advert. However, in a recent meta-analysis fidaxomcin was found to be non-inferior (technical language for no better) than vancomycin in curing C difficile infections. There is a little bit of evidence that it prevents recurrence, but the thing that gets me is the cost: for twenty 200mg tablets the cost is a whopping £1,350. As a comparison, 14 days of vancomycin costs as little as 30 pounds for a course.
Six days ago, the telegraph reported, ‘pharma firm hikes cost of epilepsy drug 24 times.’ The NHS is being forced to pay an extra £44m after Flynn Pharma bought the rights to Epanutin and then increased the price. The price has gone up from 66p to £15.74 for a 28 pack of tablets and the only thing that has changed is the packaging: must be some packaging.
President Aquino of Manilo, recently warned drug companies for raising the price of leptospirosis medicines by 750%. What was especially nice, was that the companies did all this because there was anticipation of an outbreak of waterborne illness due to widespread flooding. How considerate of them, economists must love this stuff – the law of supply and demand. President Aquino reported, ‘What you’re doing is antipeople, anti-Fiilipino.’
Last month, McKesson Corp, improperly raised the prices of a whole bunch of drugs costing Arizona businesses millions of dollars. They are now being sued.
Six days ago, Sanofi, hiked the price of Alemtuzumab, an off label drug used to treat MS by 2000%. They are set to make £237m profit from the NHS; the annual costs per patient will go up to £50,000.
Colcichine, a drug that has been around for many years to treat Gout, saw its US price rise from $0.09 per tablet to $4.85 after the FDA approved a newer version, and basically removed the older generic from the formulary.
The list goes on and on.
Obama recently said, ‘here in America – in the wealthiest nation on the earth- no illness or accident should lead to any family’s financial ruin.’ I wonder if he knew about this misaligned spiralling of drug costs. India is one ray of hope, as they refuse to bow to rises in drug costs, other countries should follow suit. The profiteering that is increasingly going on is, unaffordable, antihealth and as President Aquina says antipeople.
Why do all of these companies do this, it’s obvious, because they can? Medicine is increasingly becoming more about profit than health, more about revenues than quality of life, more about sales than people. The current situation is misaligned, and the sad thing about all this, is it seems there is nothing that can be done.
Jim
October 19, 2012 at 7:37 pmArbitrary price-hikes in anticipation of epidemics is the very worst sort of unethical profiteering, totally rotten. I sincerely hope that this is not reflected in the cost of fidaxomicin given the issue of C. diff. Unlike the leptospirosis medication we can’t see to what degree the fid price is being super-inflated, if in fact it is? In any case as you know, a/biotic drugs suffer from being both miserably difficult to discover, and having huge economic disincentives for development. Fid is comparatively new, compared to vanc, which is 50+ years old, so has a lot of costs to recover compared to vanc.
I’d not overlook the two advantages fid has over vanc, whilst providing the same efficacy, it is narrow-spec, thus does what many of us in the a/biotic research community would like – to treat specific pathogens without risking cross-resistance / wholesale disruption of the other microbiota; the other advantage is, as you say, recurrence rates are reduced. As recurrence is a major factor in C. diff, this is a good thing. Whether this evens out the costs with respect to the cost of extra bed-days that (statistically speaking) fid would reduce I’m not sure, but I’m sure the patients would appreciate it.
Max
October 19, 2012 at 6:07 pmA lot can be done about this in a way that is completely in line with international law. According to the TRIPS agreement WTO member countries may refuse to give patents for mere new formulations or new uses of existing drugs. Countries can also issue compulsory licenses – they are given the freedom to decide on the terms themselves – and these terms may include excessive pricing. It is not only India who have taken a more sensible position, it is also Argentina, Brazil, Thailand, Indonesia, and to some extent China. Of course, since the large pharma companies are in the US and EU, they are less likely to take strong positions on this.
Waldemar Ingdahl
October 19, 2012 at 6:06 pmExcuse me, the problem with the current pharmaceutical system is precisely the opposite. It put health before profit, it values quality before revenues and its much more about people than sales. That is why the absence of the market has previously given the patients the impression that the equivalent of a Ferrari sports car is for everybody. Then the medical authorities try to counter-balance this by constantly regulating about the prices and capping the demand through health-technology assessments.