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From: werner@aecom.yu.edu (Craig Werner)
Newsgroups: sci.bio,soc.motss
Subject: Re: Why AZT is so expensive
Message-ID: <2446@aecom.yu.edu>
Date: 16 Sep 89 03:57:37 GMT
References: <26871@shemp.CS.UCLA.EDU> <1187@nih-csl.UUCP> <2434@aecom.yu.edu> <1704@hydra.riacs.edu>
Followup-To: sci.bio
Organization: Albert Einstein Coll. of Med., NY
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In article <1704@hydra.riacs.edu>, drogers@riacs.edu (David Christopher Rogers) writes:
> The "cost of clinical trials" being used to justify the cost of AZT would
> be funny if the clinical trials weren't in such a shambles.
> 
> I've even heard it said how much money B-W has LOST on AZT.  Even THEY 
> haven't claimed any loss of money on this product.
> 
>     Quite a  commonly used pharmaceutical drugs  cost more than that, but 
>     are used for only short periods of time.  AZT is taken 4 times a day, 
>     for the rest of one's life, or until  it can no longer be tolerated.  
> 
> How many "commonly-used" drugs have a profit-margin of > $5000 per person/yr?
> And a customer base that may be >1M in a few years??
> 
>     That's why it costs so much. It's not the first prescription that 
>     gets you, it's all the refills.
> 
> Damn right.  The only debunking to do here is the myth of the drug company
> acting in the interests of the patients, when it's actually soaking the
> patients and the taxpayers on its government-granted monopoly.
> 
> David Christopher Rogers

	Hey look, it's easy to shout "conspiracy," and it attracts a lot
of attention.  I never implied that any drug company acts solely in the
interest of patients.  Of course, the more patients that are helped, the
more sales they have, and the better the bottom line. So they obviously
care a little bit.
	The cost of clinical trials and the drug they gave away during
the "compassionate use" phase prior to initial approval was worth, by
some estimates $100 million dollars.  Standard practice is to try to
recover that money within three years.  Since initially it was only
approved for those with AIDS, a moving target of roughly 20-40,000
people implies you have to make several thousand dollars per person.
Hey, life isn't fair sometimes. Of course, now that the number of
patients that the drug has been approved for has increased, they should
(and have already announced that they will) lower the price (but probably
not as much as they should.)

	What if AZT were sold at cost.  A rough guess at the chemistry
says it should cost roughly $2/pill.  Boroughs-Welcome quotes $1.50 a 
pill. They're better chemists than I give them credit for.  4 pills a 
day, 365 days/yr.  That's still over $2000/yr.  AZT is just plain
expensive.
	On a yearly basis, consider Ibuprofen by comparison.  I paid 3
bucks for 24 pills. That lasts me a month or so, because I just get
migraines, but imagine I had arthritis and took 6 a day. That's turns
into over $1000/yr, and Ibuprofen is almost a commodity. You can buy it
in the supermarket.  But expressed as a yearly figure, it ends up in the
same neighborhood as the commonly quoted price for AZT.
	For another comparison, remember that on a gram for gram basis
AZT costs roughly 20% of the price of Cocaine.


-- 
	        Craig Werner   (future MD/PhD, 4.5 years down, 2.5 to go)
	     werner@aecom.YU.EDU -- Albert Einstein College of Medicine
              (1935-14E Eastchester Rd., Bronx NY 10461, 212-931-2517)
          "Disinformation is one thing, but misinformation is unforgiveable."