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Healthy Skepticism Library item: 18922

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

Ferner RE, Hughes DA
The problem of orphan drugs
BMJ 2010 Nov 16; 341:
http://www.bmj.com/content/341/bmj.c6456.extract


Abstract:

Amifampridine (3,4-diaminopyridine phosphate) is approved for Lambert-Eaton syndrome under laws designed to encourage manufacturers to develop drugs for life threatening or chronically debilitating rare disorders-“orphan diseases.”1 2 It costs up to £44 200 (€52 000; $71 300) per patient each year (doi:10.1136/bmj.c6466). When bought from chemical suppliers, the equivalent dose of 3,4-diaminopyridine base costs £280. The clinical evaluation of the product relies on published literature that refers mainly to clinical experience with the free base form of 3,4-diaminopyridine.3 The European Union legislation under which it is licensed allows medicines to be designated “orphan drugs” during development, receive financial benefits before approval, and have several years free from competition if granted a marketing authorisation (licence).

The intention of orphan drug legislation in the United States and Europe-put bluntly-is to make the development of drugs for orphan diseases profitable. The unintended consequence is exploitation of the rules for profit. Like tax avoidance, this is legal, but not necessarily desirable.

The regulations can be …

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909