E-DRUG: New heat-stable oxytocin alternative (2)
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[Moderator's note: I have found prices for carbetocin acetate powder from $50 /gm to $10 / kg - with a variety of suppliers and minimum orders. Please could e-druggers share their real experiences with prices and presentations of carbetocin, BS.]
What about the price difference between the 2 products?
Kind Regards,
Yvon de Jong
Project Officer EPN/ReActEcumenical Pharmaceutical Network
Ngong Road
Nairobi
Kenya
Yvon de Jong <ydejong@epnetwork.org>
E-DRUG: New heat-stable oxytocin alternative (4)
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We, especially those of us in countries like mine, Sierra Leone, where maternal mortality reduction continues to be a shameful failure, should be excited about any opportunity to improve on the situation through whatever means, including Pharmaceutical Care. However, it is also equally important that we are clear about the Pharmaceutical Science underlying such opportunities.
Having read the report, it is not clear to me whether it is the property of carbetocin as a "drug" substance which lends itself to a more heat-stable formulation, or indeed the inherent heat stability of the "drug" substance itself. If it is not the inherent property, then my question is; has a similar or identical formulation for Oxytocin been tried before? After all, "a bird in the hand is worth two in the bush"!
Finally, Like Yvon de Jong, I am also curious to know the price element of this new formulation.
In the meantime, I say 'well done' to WHO, MSD for Mothers, Ferring Pharmaceuticals, and indeed others, for continuing to look for ways to solve an important health problem.
Murtada M. Sesay BPharm. MSc. MMI. MCIPS.
Health Supply Matters Ltd.
[Control Selection - Control Spend - Control Service]
38 Milton Margai College Road
Goderich, Freetown
Sierra Leone
Murtada Sesay <kindiatown@hotmail.com>
E-DRUG: New heat-stable oxytocin alternative (7)
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Dear Murtada, dear Yvon,
The manufacturer Ferring Pharmaceuticals has published stability data on the
new formulation which can be accessed here:
https://www.ncbi.nlm.nih.gov/pubmed/29700898
It shows stability of the carbetocin formulation under ICH climate zone IV
conditions (30°C/75% relative humidity) for at least 3 years. These
conditions are important for the most target countries.
Carbetocin is an analogue of oxytocin. We have to keep in mind that they are
peptides. These are in general more likely unstable or more sensitive
substances when exposed to high or even very low temperature. A stability
of three years under climate zone IV conditions is fairly good when we think
about longer drug supply chain cycles.
Pricing: A five-times difference in price for the API (active pharmaceutical
ingredient) is high. We would need analytical data about the two offers
reflecting e.g. the spectrum and amount of possible impurities and other
quality parameters to be able to judge.
I have experienced many health facilities without a fridge. The oxytocin
ampules were stored at "room" temperature. That is lottery if they still
work or not.
Kind regards
Andreas
APOTHEKER HELFEN e.V./German Pharmacists Aid
Dr. Andreas Wiegand
Geschäftsführer/General Secretary
Maria-Theresia-Straße 28
D-81675 München/Germany
Email: andreas.wiegand@apotheker-helfen.de
E-DRUG: New heat-stable oxytocin alternative (5)
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This link may help Murtada Sesay, providing information about the
cost-effectiveness analysis of carbetocin and oxytocin:
https://www.thieme-connect.com/products/ejournals/html/10.1055/s-0038-1655747
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Cost-effectiveness of Carbetocin versus Oxytocin for Prevention of Postpartum Hemorrhage Resulting from Uterine Atony in Women at high-risk for bleeding in Colombia
Authors: Yaneth Gil-Rojas, Pieralessandro Lasalvia, Fabián Hernández, Camilo Castañeda-Cardona, Diego Rosselli
Results In the vaginal delivery model, the average cost of care for a patient receiving prophylaxis with uterotonic agents was Col$ 347,750 with carbetocin and Col$ 262,491 with oxytocin, while the QALYs were 0.9980 and 0.9979, respectively. The incremental cost-effectiveness ratio is above the cost-effectiveness threshold adopted by Colombia. In the model developed for cesarean section, the average cost of a patient receiving prophylaxis with uterotonics was Col$ 461,750 with carbetocin, and Col$ 481,866 with oxytocin, and the QALYs were 0.9959 and 0.9926, respectively. Carbetocin has lower cost and is more effective, with a saving of Col$ 94,887 per avoided hemorrhagic event.
Conclusion In case of elective cesarean delivery, carbetocin is a dominant alternative in the prevention of PPH compared with oxytocin; however, it presents higher costs than oxytocin, with similar effectiveness, in cases of vaginal delivery.
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Thomas.
Assistant Lecturer and PhD student at the University of Rwanda - CMHS
- SMP - Pharmacy
International Researcher at the Pharmaceutical Institute of Tübingen
University, Germany
Thomas BIZIMANA <bizimanathomas@gmail.com>
E-DRUG: New heat-stable oxytocin alternative (6)
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Dear all,
I was looking at paper on this heat stable product, by Umit Kartoglu and others, on status of the product across a range of temperatures along the supply chain. As they infer, one other factor that must be uppermost in our minds, is the quality of the heat stable oxytocin. Consistent adherence to manufacturing protocols will be essential, and therefore close monitoring of the finished product and all parameters affecting the product along the supply chain, will be critical.
For the paper, please see:
https://www.researchgate.net/publication/317152998_Stability_of_oxytocin_along_the_supply_chain_A_WHO_observational_study
(PDF) Stability of oxytocin along the supply chain: A WHO observational study
Postpartum haemorrhage is the leading cause of maternal mortality in low-income countries and oxytocin is the drug recommended by WHO for preventing and treating it.
Bonnie
Bonface Fundafunda PhD., MBA., B.Pharm
Zambia
Email: bcfunda@hotmail.com