Tuesday, January 20, 2015

"Science" Takes ACLS Backwards

Food and Drug Administration (FDA) regulations have become the new pathway to riches for the pharmaceutical industry.

First, there was generic colchicine, used for years and years to treat gout for  pennies a pill.  The only problem was, there wasn't an FDA trial proving colchicine's efficacy in the treatment of gout.  Takeda Pharmaceutical, seeing the opening, performed a trial and rebranded the formerly generic colchicine to Colcrys®, "the only authorized generic indicated to prevent and treat gout attacks."  And how much does Colcrys® cost?  Just $203 for thirty tablets at Costco.

But that's not all.

Today I learned that generic vasopressin (which can be stored at room temperature in stable form on crash carts), must be switched to the FDA-approved brand called Vasostrict® that requires dilution and refrigeration.  It seems the generic form of vasopressin will no longer be available to be kept on crash carts since it's not "FDA-approved" for the indication of "increasing blood pressure in adults with vasodilatory shock (post-cardiotomy or sepsis) who remain hypotensive despite fluids and catecholamines." Vasostrict®, on the other hand, is "now the first and only vasopressin injection, USP, product with an NDA approved by the FDA." The catch is, it must diluted before use and discarded after 18 hrs (or after 24 hrs if refrigerated). This little regulatory quirk is a big deal for America's hospitals looking to save costs.

But hey, why should we worry about costs in health care?  After all, you can never be too safe.



drbob said...

Actually, I believe quinine came before colchicine as the first 'branded' generic of a drug that has been out for 100's of years - went from pennies a pill to the Qualaquin branded quinine which is about $3 a pill.

The best story in this topic is AcThar (Questcor) a branded ACTH (from pig pituitary extracts) used for infantile spasm and MS that previously cost about $80 but now is $40,000 for a 5 day course of treatment.

Alan Kogan, MD said...

Avarice and greed, the two most powerful aphrodesiacs on earth have been patented by Big Pharma and licensed to the ABIM and ABMS. Congress gets their cut and it's a win-win-win situation; of course except for the rest of the population...the 99.9%.

The more things change, the more they stay the same,