E-drug: NYT- Profits on Cosmetic Save a Cure for Sleeping Sickness
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Reprinted under the fair use doctrine
of international copyright law:
http://www4.law.cornell.edu/uscode/17/107.html
February 9, 2001
Profits on Cosmetic Save a Cure for Sleeping Sickness
By DONALD G. McNEIL Jr.
PARIS, Feb. 8 � A cure for sleeping sickness, a disease devastating
parts of central Africa, may soon be available cheaply because it
has a second, profitable use: it eliminates facial hair in women.
The drug, eflornithine, is so effective at reviving even comatose
patients that it is known as the resurrection drug. The
Bristol-Myers Squibb Company and the Gillette Company have just
introduced eflornithine in a facial cream, Vaniqa, and Bristol-Myers
is close to an agreement with the World Health Organization and the
medical charity Doctors Without Borders for the companies to make an
injectable form to treat human African trypanosomiasis, better known
as sleeping sickness. The disease, spread by the bite of the tsetse
fly, drives victims mad before killing them.
It was nearly conquered in colonial times but has again become
epidemic in war-torn central Africa; about 300,000 people are
infected each year. It has been known for more than 10 years that
eflornithine
is a virtual miracle cure for trypanosomiasis, but stocks have run out
because early hopes that it would help fight cancer have been dashed
and medical production has stopped. The last 1,000 doses, held by
Doctors Without Borders, could be used by June. The shortage is cited
by critics of the industry who say multinational drugcompanies ignore
the poor.
Now production of eflornithine is resuming as an ingredient in the face
cream. And if the talks succeed, Bristol- Myers, with the help of the
Dow Chemical Company, Akorn Manufacturing Inc. in Decatur, Ill., and
Aventis, a French-German company that holds the basic patents to the
drug, will make 60,000 medical doses by June and donate them. "We're
very happy and very grateful for this," said Felix Kuzoe, a consultant
on sleeping sickness to W.H.O. "We approached Bristol-Myers in November,
and they gave us a very welcome reception and had an answer for us in
two months."
There is only one other treatment for the late stage of the disease:
melarsoprol, a caustic arsenic compound invented 70 years ago.
Melarsoprol kills 5 percent of those treated and damages the veins of
others; in addition, resistance to it is growing, so the long and
painful treatment is sometimes ineffective. Until recently,
eflornithine was made only by an American subsidiary of Aventis,
which ended production in 1999 when the drug turned out to be useless
against cancer, the intended target. (Coincidentally, another Aventis
subsidiary makes melarsoprol and a third makes pentamidine, which is
useful against early stages of the disease.) Bristol-Myers, W.H.O. and
Doctors Without Borders are very near agreement on a supply of the
drug, participants from all three said. The companies have offered to
donate three years' doses and then calculate a sales price for more;
Doctors Without Borders is asking instead for a guaranteed supply at $10
a dose.
"We don't want to find ourselves in three years in the same position we
are in now," said Daniel Berman, a co-director of the agency's campaign
to get affordable life-saving drugs to poor countries. A typical course
treatment is an injection a day for seven days, for a cost of about
$70. The companies are hesitating to guarantee a long-term price
because bulk eflornithine is corrosive and destroys the equipment used
to make it, and the process used to make the injectable form is
slightly different from that used to make the cream, meaning
manufacturing costs will increase. "You can't just squeeze it into a
syringe," said Robert Laverty, a Bristol-Myers spokesman. But
Bristol-Myers and Gillette could make large profits on Vaniqa. A
30-gram tube, about a month's supply for the removal of facial hair,
costs $54 at a Rite-Aid drugstore in Manhattan.
The two companies' development costs presumably have been relatively
low because the drug was first developed at the Merrell International
Research Center in Strasbourg, France, in the 1970's and preliminary
testing was done by other companies. Its usefulness in treating
sleeping sickness was discovered in 1979.
Bristol-Myers and Gillette have begun big advertising campaigns for
Vaniqa, which is sold by prescription. A six-page supplement to the
January issue of Cosmopolitan begins with pictures of three gorgeous
women with hairless lips and the words: "If the mustache that prevents
you from getting close is yours (not his), it may be time for a beauty
about-face. Millions of women like yourself battle unwanted facial
hair." Eflornithine suppresses the enzyme that causes facial hair to
grow, a discovery five years ago that was largely serendipitous, as many
drug uses are.
A spokeswoman for Cosmopolitan declined to say what the ad cost.
For sleeping sickness, eflornithine is the only drug besides melarsoprol
that is able to kill the parasite trypanosome after it has invaded the
brain. The giant American and European pharmaceutical companies have
come under intense fire in recent years not only for the high prices of
prescription drugs, but for ignoring diseases, like sleeping sickness
and malaria, that affect only the poor.
They are accused of ignoring research on diseases that kill Africans,
Asians and South Americans while concentrating their resources on
finding treatments for "lifestyle ailments" like impotence, baldness,
obesity (and facial hair) for customers in North America, Europe and
Japan who are, in dollar terms, 80 percent of the world's pharmaceutical
market. Eflornithine represents a case where it may be possible to serve
both interests at once.
"What we're trying to do is help them find a source of supply so this
will never be a question again," Mr. Laverty said, referring to the
W.H.O. and Doctors Without Borders. "The question is how this will be
funded indefinitely." He declined to say how much Bristol-Myers
expected to earn from Vaniqa or whether it hopes to sell future doses
of injectable eflornitine at cost or at a profit.
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