Healthy Skepticism Library item: 2270

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: news

Priest L.
The staggering price of survival
The Globe and Mail ( Canada) 2005 Aug 15
http://www.theglobeandmail.com/servlet/Page/document/v4/sub/MarketingPage?user_URL=http://www.theglobeandmail.com%2Fservlet%2FArticleNews%2FTPStory%2FLAC%2F20050815%2FTHALID15%2FTPHealth%2F&ord=1124881622607&brand=theglobeandmail&force_login=true

Keywords:
thalidomide myeloma

Notes:

Ralph Faggotter’s Comments: This disturbing article reveals an important feature of pharmaceutical economics- namely that the price the consumer pays for a drug often has nothing to do with the cost of manufacturing it. In this case the price the patient pays for the medication is over 300 times the cost of producing it!

Full text:

By LISA PRIEST

Monday, August 15, 2005 Page A1

A 75-year-old cancer patient from Prince Edward Island is depleting her life
savings to pay $4,500 a month for thalidomide.

An Albertan, living on a small pension, cashed in some RRSPs to pay for the
drug to treat his multiple myeloma, a cancer of the plasma cells in the bone
marrow.

And an Ottawa-area father has paid thousands so his teenage son with brain
cancer could get the drug.

All of these people are wondering how a drug, almost a half-century old,
which can be made for less than a dime in a Brazilian government laboratory,
can cost as much as $37.50 a capsule in Canada.

They are not alone. The BC Cancer Agency, the only publicly funded
provincial cancer organization to fund thalidomide, is also disturbed by the
high cost of the medication, noting it has increased nine-fold over the past
five years.

“This drug which costs hardly anything to make, they have jacked up the
price on it year after year,” Susan O’Reilly, head of medical oncology for
the BC Cancer Agency, said. “. . . It’s disgraceful.”

For a drug that gained worldwide notoriety for causing horrific birth
defects more than 40 years ago, thalidomide has made a spectacular comeback
as a cancer drug.

It has done so, in part, because the very mechanism that caused those birth
defects — the damaging of blood vessel growth — has been found to help
starve some tumours. Thalidomide also helps stimulate cells of the immune
system to attack cancer cells.

The way this small, white capsule has come into its own is a story of
opportunity, scientific research and how, when it comes to cancer
medications, no price appears too high — even in Canada, which prides
itself on lower drug costs thanks to price controls.

Celgene Corp., the U.S.-manufacturer of the drug, which is sold under the
trade name Thalomid, said it provides the drug free to 15 per cent of its
cancer patients in the United States. In Canada, that figure is believed to
be much higher. And 40 per cent of the company’s revenue is used to fund
research and development of other medicines.

Brian Gill, Celgene’s director of corporate communications, said Thalomid is
priced relatively low when compared with other drugs used to treat multiple
myeloma, adding that “it truly reflects its therapeutic value in the
marketplace.” It is considered a last-ditch treatment for the illness.

Still, many are baffled at how thalidomide has managed to command such
dramatic price increases, particularly since the patent on the drug’s
composition expired in 1976.

Currently, the only way the drug can be obtained in Canada is through
Celgene under the federal government’s special-access program, Health Canada
spokesman Paul Duchesne said. Under this program, an unapproved drug can be
given to patients with serious or life-threatening conditions when
conventional therapies have failed, are unsuitable or unavailable.

Given its special status here, a generic company could not even attempt to
replicate it at a cheaper cost to patients because Thalomid has not gone
through the Canadian drug approval process.

While there are at least two patents attached to Thalomid, neither falls
under the jurisdiction of Canada’s Patented Medicine Prices Review Board,
which ensures the cost of patented medicines is not excessive.

In 2000, the BC Cancer Agency paid about $120 for a bottle containing 30
50-milligram capsules of the drug. The cost to that cancer agency today is
roughly $1,100 according to spokeswoman Nicole Adams.

Those not fortunate enough to get the drug free, either through the BC
Cancer Agency or through Celgene’s assistance program, are often left to pay
for it themselves……

……..On its website, Celgene describes Thalomid as “the current driver of
Celgene revenue growth.” Indeed, the U.S. health care system spent
$279.5-million (U.S.) on the drug in 2004, according to IMS Health national
sales perspectives, which supplies pharmaceutical and health-care
organizations with data on disease patterns and treatment trends. No
comparable figures were available in Canada……..