Zytiga combined with breakfast lowers cost of treatment to one fourth

[Darryl]

Zytiga costs $1000 to $3000 dollars per co-pay per month for many patients in the USA. It costs insurance companies over $9000 per month. This puts Zytiga out of reach for many men with strained financial resources. Now, imagine if you could reduce the cost of Zytiga by one fourth, simply by taking it on a full stomach after breakfast rather than taking the full dose on an empty stomach. A new study shows that full and low fat meals increase dose effectiveness while having little to no impact on long term benefit. which means, you can eat breakfast and cut your treatment costs and have an overall easier go at treating yourself with Zytiga. Read more here: advancedprostatecancer.net/...

[AlanMeyer]

Interesting info.

But wait, it turns out that they also make abiraterone acetate in India! Look at this web page: dir.indiamart.com/impcat/ab...

Prices are all over the place but all appear to be Waaaaay less than the U.S. price from Jannsen Biotech.

I don't know if it's true, but I've heard that, although importing drugs from other countries is illegal, no American patient has ever been prosecuted for doing it. It's hard to imagine any district attorney trying to put a cancer patient in jail for importing the drugs that he needs to stay alive. Its also hard to imagine an American jury unanimously convicting him.

[Dan59 in reply to AlanMeyer]

According to that price sheet and the conversion it would be $358 a month total price, google.com/?gws_rd=ssl#q=rs... what the hell is wrong with our health care???

[herb1 in reply to Dan59]

thank your Congress and the Pharmaceutical Manufacturing Assn.

[Hidden in reply to AlanMeyer]

I get my omeprazole and, ahem, blue pills from India. Hey, if they can outsource my job to India and give the Pfizer CEO an $80 million retirement package then I can get a little creative with my pharmaceuticals.

[Dan59 in reply to Hidden]

WSO ,You are having no prob getting your needed drugs from India? Does it take a script? Do you just take a paper script from Dr. and send to India? Honestly I think we should all do this and let the Pharmaceutical Manufacturing assoc , feel the pinch.

[Hidden in reply to Dan59]

Omeprazole is over the counter. I can get them cheaper from India. The blue pill equivalents (knock-offs) are available, without a prescription, if you can avoid being scammed. Cipla makes a knockoff. First 3 letters are sil.....I don't know about getting serious anti-cancer drugs.

[davilwilson in reply to AlanMeyer]

Oh yes! You're truly correct. In India, there are pharmaceuticals like medixocentre.com/product/ab... who's selling the same generic as Zytiga. That's manufactured by top pharmaceuticals which cost only 2% of Zytiga. Previously, It was doubtful to use that It really matches Zytiga quality or not but I read the review for this generic drugs that are really very helpful for poor people who can't afford Zytiga. Even my cousin also bought the generic Zytiga. He started the course now, Soon I'll add the follow-up.

[Dan59]

Good Research Daryl, and for some men who have good liver enzymes, and good insurance eating a high fat breakfast with the full dose will give additional response, when Zytiga has failed. From My Expert Oncologist, Often when Zytiga stops working , it stops being absorbed and when it does eating with it brings it back, I did it for at least 10 months

watching liver numbers carefully of course , but they never left the low end of normal

Dan

[Hidden]

Not sure, but I believe the issue is that taking Zytiga with food can have highly variable rates of absorption for each individual patient depending on exactly how much fat is present in the meal and that this was the reason why Janssen recommended taking the drug without food. Too much absorption could lead to hepatotoxic levels of Zytiga and too little absorption (of the reduced dose) could result in sub-therapeutic levels of Zytiga in the blood stream. Can anyone corroborate this?

[herb1 in reply to Hidden]

With Zytiga and many other meds, I've always wondered whether the recommended practice is based on fact or simply required because that was the protocol under which it was approved.

[pjoshea13]

Darryl,

In the Duke study of 2015 [1]:

"Of those patients who took AA with food at PSA progression, a PSA decline was observed in 3 of the 19 (16%) men .... Testosterone declined in five out of seven patients from pre-food levels. The median time on AA therapy was increased by nearly 100 days in patients who switched AA administration from without food to with food."

The switch did not involve a reduction in dosage.

From the ASCO paper [2]:

"Despite a large food effect (~17-fold increase in CMax with a high-fat meal), AA was administered under fasting conditions in its pivotal trials."

"Low-dose (250mg/day) abiraterone acetate with a low-fat breakfast is non-inferior to standard dosing in a fasted state with respect to PSA and PK metrics. Although PSA response and progression are not clinically validated surrogates, given the pharmacoeconomic implications, these data warrant consideration by prescribers and payors."

While non-inferiority is important, I wonder what the optimal dose might be?

Perhaps this might require monitoring PSA, testosterone [T] & DHEA/DHEAS, as the study did. DHEA/DHEAS is a useful test, since pregnenolone can convert to T via DHEA. However, pregnenolone can convert to progesterone, which can convert to T without going through DHEA. So T seems to be the most useful test.

Which makes me think that T levels should play a role in determining whether to use Zytiga for non-CRPC. If Lupron, etc., has successfully reduced T to below the target, why use Zytiga?

Another question, in terms of getting value from the drug - I wonder what the optimum amount of fat in a meal might be, when taking Zytiga?

-Patrick

[1] ncbi.nlm.nih.gov/pubmed/257...

[2] abstracts.asco.org/197/Abst...

[Charlesd]

Have posted numerous times for those using Zitiga for assistance from the. PAN (patient assistance network) If you have a RX insurance they will consider helping with or covering all of the expense. Go on line to contact them.

[lincolnj8]

Thanks Darryl