Saturday, November 27, 2010

a generic issue



as i muddle through my daily routine,, well aware that so many issues are far beyond my grasp such as ADAP funds in Colorado and nationally, budget cuts, dropping drugs from the covered formulary, co-pays for indigents living at poverty level, among other plans have spurned concerns around work and the state that perhaps we are not looking in the right place.

those concerns include the discussion of the patent expiration of 3TC. It is a drug that is not in that much use the past decade. FTC (chemically similar to 3TC) and Tenofivir are the drugs-du-jour when  combined as Truvada and also with Sustiva to make Atripla- the latter being the once a day marvel that has helped push bare backing out of the shadows.  3TC and FTC are similar enough (according to some doctors I work with) to perhaps interchange individually and could perhaps be used in combination with the other drugs on an individual basis.

the concern is that removing access to drugs may not be the the kindest, nor the most efficient with regard to caretaking our citizens. there seems to be a very very large channeling of funds to the biotech company responsible for the distribution of these drugs-du-jour. the question is how much loyalty and gratitude is required for the groundbreaking work that has been brought to the table. and at who's expense? to illustrate just a glimpse of what i am describing here is a list of revenues posted at gilead's (pharmaceutical engineer) investor site

Antiviral Franchise
Antiviral product sales increased 19 percent to $1.60 billion in the first quarter of 2010, up from $1.34 billion for the same quarter of 2009. The increase was driven primarily by sales volume growth of Atripla and Truvada.


Atripla
Sales of Atripla for the treatment of HIV infection increased 36 percent to $692.9 million for the first quarter of 2010, up from $509.9 million in the first quarter of 2009, driven primarily by sales volume growth in the United States and Europe.

Truvada
Sales of Truvada for the treatment of HIV infection increased 11 percent to $657.8 million for the first quarter of 2010, up from $590.4 million in the first quarter of 2009, driven primarily by sales volume growth in the United States and Europe.

damn that's a hefty income. no wonder when looking at truvada singularly, approximately 1/2 or more of all the combinations that are prescribed by physicians in the US include this blue pill. If 1/3 of these could be switched to a 2 drug combination with a generic,   then could the monies be diverted to address the waitlists and the mental health medication that is so necessary to support drug adherence in patients with mental health issues?

there is so very much of American ADAP funding going to this pharmaceutical conglomerate. is it impossible to think that we might try to save some monies here? how much does it cost to make equal access to everyone?  is health care reform still going to be for those who can afford it first? Generic lamuvidine is available outside our borders, but not here in the states.

there are currently around 5 companies in the US who have been approved for the production of the generic of 3TC. since there is currently very little demand for it, there is understandably little interest in producing it. but if the national ADAP offices were to be effectively looking for cost-cutting measures as most of American households are having to do right now, would the landscape on demand for 3TC change?

currently there are over 1000 Americans on waiting lists to start drug therapy for HIV. reviewing just one pharma's income for a year makes me wonder how much does the right to good health cost? perhaps if pharmas were to redirect their lobbying monies to patient care, there would be no waitlist or budget crunch. perhaps if the market were opened up a bit, the free trade tendency would drive down pricing to a level that didn't burst the state's budgets? can we count on our lawmakers to do what's best for everyone, and not just for a few? will we require low-salaried employies to pump out gads of paperwork to save the income of a select few? what is good business and what is over the top? when do we become "good americans" again?