Money for nothing

[bromley]

Dear all,

The following was posted on the MSRC website:


Copaxone

Sales of the multiple-scelrosis drug totaled $1.18 billion in 2005, 26% more than in 2004.

Teva Pharmaceutical Industries Ltd. has announced, in conjunction with the release of the Sanofi-Aventis group's financial results, that global in-market sales of its multiple-sclerosis drug Copaxone reached $323 million in the fourth quarter of 2005, representing an increase of 24% over the comparable quarter of 2004.

For the full year 2005, global in-market sales of Copaxone reached an all-time high of $1,176 million, representing an increase of 26% over 2004.

US sales in the fourth quarter 2005 rose 26% over the fourth quarter 2004 to $220 million. For the full year 2005, US sales rose 25% compared with 2004, to $782 million

Teva says that, according to IMS data in the US, Copaxone continued to strengthen its position as market leader, reaching an all time record market share of 34.3% in December 2005.

For the fourth quarter 2005, sales outside the US, mainly in Europe, increased by 19% over the comparable quarter of 2004, to $103 million. For the entire year, sales outside the US increased by 27% to $394 million.

Source: by Globes, Israel business news



My questions:

The CRAB manufacturers are all posting big increases in revenue. Does this mean MS is on the rise or have prices gone up?

For other drugs the patents run out and other manufacturers can make them and sell them cheaper. Why does this not happen with MS drugs some of which have been around for 15 years?

My Rebif box arrived on Friday. I called the nurse today who is coming round to teach me how to inject. She said that she has been inundated with calls from new-starters this morning!

Ian

[viper498]

I think the amount of diagnosed people is on the rise. Mostly due to the MRI. If you have an indicative MRI, then they stick (no pun intended) you on one of the CRAB's. I think its a scam. I am thinking strongly about quitting Rebif. I think the whole thing seems suspicious.

[Houdini]

I think there's another explanation (in addition to a rise in newly diagnosed patients). The conventional wisdom among many neuros -- at least in the US -- appears to be be shifting from a wait and see posture (before prescribing CRABS) to a "get-on-CRABS-as-soon-as-MS-is-a-likely-diagnosis" posture. Whether this shift is being driven by the drug companies, or by the clinical observations of neuros in the field, is hard to determine. I suspect it's a combination of both.

[viper498]

Yes I agree with you on that aspect as well. Which is good in a way. But its very expensive. It would be worth it if the CRAB's did make a big difference in delaying progression.

Why don't the CRAB manufacturers lower their prices now????? Since the volume has stepped up considerably isn't it fair to say that the cost of making them would be lower?
Brock

[JFH]

My Rebif box arrived on Friday. I called the nurse today who is coming round to teach me how to inject.

Good luck with the jabs Ian

[Brownsfan]

I personally know 2 people diagnosed within the past 2 months. And everytime I go to a doctor and tell them I have MS, I always get comments like, "oh yeah, we have 2 nurses who were recently diagnosed". I think the number of cases are rising. Oh wait, according to NMSS the numbers have been flat at about 400,000 for the past 20 years in the US.

[mrhodes40]

Even generics will not be "cheap" as these are somwhat difficult to make. It's not a chemical like the usual drug it's more a biologic. here's a group working on making it for less http://news.bbc.co.uk/1/low/england/1706073.stm

I agree it's the CRAB position of get everyone on it NOW! Used to be wait and see was an OK approach. NO longer. It has slowly become standard practice to advise all to get on it.

If I may be so bold, the pharma has a lot of control here. ALl they have to do is to perform a few studies saying after time the treated vs untreated patient is very different in terms of lesion load or disability (i do not think this is at all proven ) and I ask you WHO IN THE WORLD WILL PRODUCE RESEARCH THAT SAYS NO IT DOES NOT? Who would fund that? so the actual scientific evidence which is biased and one sided becomes the only evidence in a given subject, that of give CRAB for example. Therefore the individual doctor is not practicing evidence based medicine if he ignores "scientific" evidence, never mind it was never a real scientific debate but marketing.

Marie

[sojourner]

I love the "courtesy calls" my husband gets from Biogen. Just making sure everything is going well with the old Avonex....yeah right. Just making sure the revenue stream keeps flowing.

I must say, though, the contract nurse that came to teach us how to stick it to my husband was really excellent. Much better than the care he has ever received at the neuro!

[LisaBee]

Based on the numbers, and assuming Copaxone costs $1200 a month ($14400 a year, and assuming the price is universal throughout the world, there are approximately 82000 people world-wide taking Copaxone, and about 54,300 (over one-half) are in the US.

I think the reason that Copaxone use is increasing is those already mentioned - earlier diagnosis based on MRIs and a push for early treatment. Also, I don't know if neutralizing antibody development among interferon users is prompting them to switch to Copaxone.

Lisa

[NHE]

Even generics will not be "cheap" as these are somwhat difficult to make. It's not a chemical like the usual drug it's more a biologic. here's a group working on making it for less http://news.bbc.co.uk/1/low/england/1706073.stm

From the news article...

Mr Baldwin explained that the researchers take the gene of the protein and put it into bacteria.

The bacteria then manufacture the protein - but, instead of it remaining inside the bacteria, it is naturally pushed out into the surrounding fluid.

This method makes it easier to isolate the protein in a concentrated form.

One of the problems with this technique is that the Ifn-B is still produced in bacteria. Bacteria build proteins differently from us mammals. They don't glycosylate them, i.e., attach sugar groups to the protein. Ifn-B is a normally glycosylated protein. This is one of the reasons why the problem of neutralizing antibodies is greater in patients on Betaseron as compared to patients taking Avonex. In effect, the absence of the sugar groups makes the bacterially produced protein seem more like a foreign protein. What these folks need to do is to engineer some mammalian cells to secrete Ifn-B. It shouldn't be hard to do, e.g., attach a targeting sequence which directs the cell to secrete the protein which is then cleaved leaving the native glycosylated protein intact. If I remember correctly, there are known examples of such targeting sequences for the secretory pathway that might work with Ifn-B.

NHE

[viper498]

IMHO, they need to forget IFNb technologies and focus more time on more effective treatment. While everything you said is probably true, I don't think it makes sense to pursue the refining of IFNb.

Brock