Dear mr. Calisher,
It is not possible for me to give you a reply to all your questions about
ribavirin, in fact I offer only a small contribution which I hope will be of
some interest to you.
Ribavirin is not registered in Norway but available on so-called special
application. One use is as inhalation for treatment for treatment of RSV in
children. Powder for inhalation is registered in Sweden at a cost of 9.000
SEK (= USD 1.500) for 3x6 g. For this indication it is also used in Norway.
From our statistics, I see that also tablets of 200 mg has been delivered
but I do not know for which indication(s). The wholesaler cost of 180
tablets are NOK is USD 1.000 which gives a retail price (excl. VAT) of
approx. USD 1.300. Thus it is indeed a very expensive drug!
I checked with our wholesaler about availability and he could not remember
any delivery problems. If you want to, I could try to check the situation in
Sweden where the inhalation is registered. (Company called Swedish Orphan,
manufactured by ICN).
From the 1993 edition of Martindale (unfortunately I do not have access to
the new ed. yet) I find that the drug is being tried in lassa fever,
measles, hepatitis and Aids. It lists 4 different brand names:
Viramid by Alfa Farmaceutici Italy
Virazide by ICN, Canada and USA, Vivatec Sweden and Sanofi Switzerland
Virazid by Britannia Pharmaceuticals, UK and Huber, Spain
Virazide by Ciba Italy
I see immediately no reason why the drug should be so expensive or in so
short supply as there seems to be many manufacturers. Unless, may be due to
reduced interest, some have stopped producing it. Without doing a literature
search I cannot remember seeing any information indicating an increased
demand. And it seems that the only well proven indication is RSV in
children, and Lassa fever. Could it be that RSV has been on the rise? Or is
it just that the number of countries which has approved this indication has
risen?
Regards Kirsten Myhr
Ms Kirsten Myhr, MScPharm, MPH
Bygdoy Alle 58B
0265 Oslo
Norway
Tel: +47 22 56 05 85 (h)
Fax: +47 22 24 90 17 (w) Tel: +47 22 24 90 39 (w)
E-mail: myhr@online.no
or (w): kirsten.myhr@helsetilsynet.dep.telemax.no
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