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Drug-price hikes don't lead to better cures. We must find another way forward Drug-price hikes don't lead to better cures. We must find another way forward
(about 9 hours later)
Cycloserine is a nasty drug – it can make patients psychotic, aggressive and even suicidal. But the 50-year-old drug is also one of the only available treatments for multi-drug resistant tuberculosis. Doctors and nursing staff from Médecins Sans Frontières/Doctors Without Borders (MSF) use it in over 20 countries.Cycloserine is a nasty drug – it can make patients psychotic, aggressive and even suicidal. But the 50-year-old drug is also one of the only available treatments for multi-drug resistant tuberculosis. Doctors and nursing staff from Médecins Sans Frontières/Doctors Without Borders (MSF) use it in over 20 countries.
Cycloserine is also one of two drugs that have been in the center of a controversy this week over sudden price hikes on old, patent-expired drugs. (The other is the 60-year-old drug Daraprim, used to treat a parasitic infection that primarily affects people with HIV. Turing Pharmaceuticals, helmed by Martin Shkreli, bought the drug and raised the price 5,500% – from $13.50 to $750 per pill.) Cycloserine was acquired by a company that raised the price from $500 for 30 capsules to a staggering $10,800, before returning it to the original owner in the wake of an ensuing uproar.Cycloserine is also one of two drugs that have been in the center of a controversy this week over sudden price hikes on old, patent-expired drugs. (The other is the 60-year-old drug Daraprim, used to treat a parasitic infection that primarily affects people with HIV. Turing Pharmaceuticals, helmed by Martin Shkreli, bought the drug and raised the price 5,500% – from $13.50 to $750 per pill.) Cycloserine was acquired by a company that raised the price from $500 for 30 capsules to a staggering $10,800, before returning it to the original owner in the wake of an ensuing uproar.
The original owner also hiked the price, though by a lot less. All this over a nasty drug that TB doctors like me know full well have awful side-effects on people.The original owner also hiked the price, though by a lot less. All this over a nasty drug that TB doctors like me know full well have awful side-effects on people.
Pharmaceutical companies justify their high prices on medicines by saying profits are the only way to recoup the expensive research costs and pay for future innovation. But evidence doesn’t support their claim: if the high-price system worked so well, doctors wouldn’t be clamoring to access a toxic, old drug they know could harm their patients in an attempt to cure them.Pharmaceutical companies justify their high prices on medicines by saying profits are the only way to recoup the expensive research costs and pay for future innovation. But evidence doesn’t support their claim: if the high-price system worked so well, doctors wouldn’t be clamoring to access a toxic, old drug they know could harm their patients in an attempt to cure them.
The entire cocktail of drugs to treat MDR-TB is awful and the cure rate abysmal. Imagine if, after two years of taking drugs like cycloserine with horrific side effects, including eight months of daily painful injections, you have just a 50% chance of being cured. TB research and development is such that, for those with drug-resistant strains, there is no immediate hope of new drugs replacing all the toxic drugs, or for shorter and better combinations of drugs, to reach a cure.The entire cocktail of drugs to treat MDR-TB is awful and the cure rate abysmal. Imagine if, after two years of taking drugs like cycloserine with horrific side effects, including eight months of daily painful injections, you have just a 50% chance of being cured. TB research and development is such that, for those with drug-resistant strains, there is no immediate hope of new drugs replacing all the toxic drugs, or for shorter and better combinations of drugs, to reach a cure.
It’s time for a change. We at MSF believes there is another, better way to deliver the treatments for TB that we’re so desperately waiting for. The 3Ps Project – push, pull and pool – aims to develop an entirely new regimen of drugs for all strains of TB through an open, collaborative approach and incentives that reward collaboration and pays for research upfront rather than relying on high prices. It’s time for a change. We at MSF believe there is another, better way to deliver the treatments for TB that we’re so desperately waiting for. The 3Ps Project – push, pull and pool – aims to develop an entirely new regimen of drugs for all strains of TB through an open, collaborative approach and incentives that reward collaboration and pays for research upfront rather than relying on high prices.
It rewards funds for compounds that are ready to be tested in humans in combination with other compounds – TB needs more than one drug to cure it. The 3Ps Project then pools the intellectual property and scientific data generated to enable the collaborative research that will take these compounds from the bench to the bedside. Grant funding is awarded throughout, especially to fund the clinical trials on the new regimens.It rewards funds for compounds that are ready to be tested in humans in combination with other compounds – TB needs more than one drug to cure it. The 3Ps Project then pools the intellectual property and scientific data generated to enable the collaborative research that will take these compounds from the bench to the bedside. Grant funding is awarded throughout, especially to fund the clinical trials on the new regimens.
We must move beyond the idea that high prices are the only way to make drug development happen and stop swallowing the line that as long as we pay high prices, diseases that have until now been neglected will suddenly find the research backing they need. It’s simply not the case.We must move beyond the idea that high prices are the only way to make drug development happen and stop swallowing the line that as long as we pay high prices, diseases that have until now been neglected will suddenly find the research backing they need. It’s simply not the case.
While the 3P Project is targeting TB – a disease for which MSF treats nearly 40,000 people a year – the principles of alternative funding can be applied to other diseases which suffer from habitual industry neglect. It can also help us to avoid the exploitation and price gouging by the pharmaceutical industry on old drugs like cycloserine. Because honestly, we’d much prefer not to have to fight for this drug.While the 3P Project is targeting TB – a disease for which MSF treats nearly 40,000 people a year – the principles of alternative funding can be applied to other diseases which suffer from habitual industry neglect. It can also help us to avoid the exploitation and price gouging by the pharmaceutical industry on old drugs like cycloserine. Because honestly, we’d much prefer not to have to fight for this drug.