1510 How a longstanding essential generic medicine becomes … a specialised luxury product!

For some months, we have been aware of shortages and sharp, unexplained price rises of certain drugs, including in countries of the ‘North’. This is preventing access to care, especially for less well-to-do patients and often the cause of these problems is purely commercial.

 

Here is some information given by the New York Times about the dizzy rise in the price of Daraprim.

Pyrethamine, a generic medicine that has been used for sixty-two years to treat malaria and toxoplasmosis, is available under the trade names of Daraprim on the American market and Malocide in Europe. In the fifties in the United States one Daraprim tablet cost $1.

 

Daraprim is used:

-          Together with sulfadoxine to treat malaria under the name of Fansidar.

-          In combination with sulfadiazine to treat toxoplasmosis, a condition that can cause serious transplacental infections and that also strikes people with AIDS, whose auto-immune levels are low.

 

The trading rights in the USA for Daraprim, manufactured by the pharmaceutical firm GlaxoSmithKline were sold by the company to CorePharma in 2010[AR1] .  

Impax Laboratories bought up CorePharma and its subsidiaries in 2014. Impax then withdrew Daraprim from sale in pharmacies so that it could control the distribution itself. This enabled it to raise the price and prevent the production of Daraprim by generic manufacturers. In fact, in the USA, it is difficult for such firms to produce drugs owned by pharmaceutical companies as the overelaborate controls make it hard to acquire the necessary samples for the quality testing required. This in effect gives the owner corporations a monopoly of trading rights.

 

In August 2015, the marketing rights for Daraprim were bought from Impax by Turing Pharmaceuticals for $55 million and the cost per Daraprim tablet immediately rose from $13, 50 to $750. For patients needing long-term treatment, the annual bill increased to hundreds of thousands, or even millions, of dollars.

 

Faced with these prohibitive prices, the Mount Sinai hospital will no longer be able to keep Daraprim in stock. This will mean delays in treating patients; moreover, every case needing treatment with Daraprim will be subject to an in-depth study to see if an alternative treatment, less effective but cheaper, will not suffice.

 

When questioned about this, Mr. Martin Shkreli[1], 32, founder and director of Turing, replied that the drug was used so little that the impact on public health would be negligible and that he would spend the money saved on research into drugs to fight toxoplasmosis.

 

However, at the toxoplasmosis centre of Chicago University, the directors are not complaining that much because Turing has delivered Daraprim speedily to the patients, and sometimes at no cost. They hope to be able to ‘manage’ this new situation.

More recently, Mr. Shkreli has decided to reduce the price – but by how much is not yet known.

We could cite other examples of antibiotic and heart drugs whose prices have also risen dramatically after the transfer of marketing rights.

This is what happens when less than scrupulous individuals take advantage of weaknesses of a market that is insufficiently regulated and whose regulating authorities themselves are in part financed by pharmaceutical firms. (Food and Drug Administration).

 

(source : e-drug@healthnet.org , 21 September 2015).

 

Christian Roberti