E-DRUG: Cost of Thalidomide
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Canada: The Staggering Cost of Survival with Help of Thalidomide
The Globe & Mail
http://www.theglobeandmail.com/servlet/ArticleNews/TPStory/LAC/20050815/THALID15/TPHealth/
By LISA PRIEST
[copied as fair use]
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......
<snip>
........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........
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Joana Ramos, MSW
Cancer Resources & Advocacy
7303 23rd Ave. NE
Seattle, WA 98115
206-229-2420
http://ramoslink.info/
Joana Ramos <joaninha@comcast.net>