Why all MPN drugs are costly other than HU?

[Aby1990]

Why all MPN drugs are costly other than HU?

[Manouche]

Not all. Aspirine is cheaper.

[Aby1990 in reply to Manouche]

Aspirine is just to prevent clotting is it? I doen’t do anything to HCT

[Chaz1]

The age old argument for the cost of drugs being so high is always due to the cost of researching, testing and getting approval for the use of the drug. Once a Pharmaceutical company researches & finds a drug that they think works they have to go through substantial animal trials followed by human clinical trials. Once they have passed all of these - and it takes years (obviously needs to, to ensure safe in the long term) they then have to put all their research in to be peer reviewed and approved by the medical Council. Each country pretty much reviews and approves individually so I assume there is a cost to the Pharmaceutical company to put it forward in each country. Then once its approved they can manufacture it & then promote it to the medical field in the country it has received approval in. This can be costly as its really a marketing campaign. The newer a drug, the more expensive it is & also if a drug is only ever likely to be used in a small patient cohort then it will be more expensive as they need to recoup costs per unit sold. So for example, say it costs a billion pounds to get a drug to the point its approved. (it is massively more) If they are going to sell a billion units then to make a profit they just need to charge £1.01 plus manufacturing costs per unit. If another drug costs the same to get to the same point and only will sell 1000 units because its a rarer condition it treats, or a less diverse use of the drug then it will be £1,000,000. 01 plus manufacturing costs to make a profit. A massive difference in cost to prescribe then. So from what I understand HU is cheaper because more people can use it across a variety of conditions therefore it will sell more units & be cheaper. It also depends a bit on how long a drug has been released for but that's too complex to go into here. But it doesn't cost less to develop a drug that will be used for a smaller patient cohort - it can in fact cost more as less research, less patients to participate in trials etc... So sadly drugs will continue to be expensive as they rightly have to pass all the steps to ensure its safe to use as well as being developed in the first place.

[Aby1990 in reply to Chaz1]

That’s how drugs becomes luxury ☹️

[Chaz1 in reply to Aby1990]

But also how we get drugs in the first place. Only option is to cut testing & hope that they work & don't cause long term issues, which obviously & quite rightly is never going to happen. We also need Pharmaceutical companies to continue to invest in research, as they do in lots of forms as well as into researching & creating & developing new drugs. The companies sometimes fund patients drug treatment, particularly in rare & expensive cases, not always but they do. They look at them so that what they develop can help, also countries & medical insurance companies negotiate for cheaper deals with individual Pharma companies for their drugs. Unfortunately there isn't other options, even if governments owned pharmaceuticals they still need to fund very extensive research & testing from somewhere & nothing is free unfortunately. Very difficult to change it.

[Aby1990 in reply to Chaz1]

True; but many people dying because they can’t afford costly drugs

[Chaz1 in reply to Aby1990]

Unfortunately there isn't a clear way to resolve it. I know some people set up gofundme pages for treatment costs, usually just one off treatment not long-term. In the UK we can have individual case reviews to see if we can have a more expensive drug. In developing countries charities fund some drugs/treatments & presumably have a deal for value for money. Sadly people are still dying from lack of food, water & hygiene so medicine costs won't be a priority until this is resolved as more die from lack of basics in the first instance.

[Innessant]

As stated it is mainly about recouping the cost of the Intellectual property (IP) associated with drug discovery. This explains why "new" drugs like Jakafi are expensive until their patent expires ( 15 years).

Thus Pharma Co must recoup costs within that period. When it is off patent there will be generic versions made which are far cheaper. (eg statins ex India).

In the case of Jakafi it is very expensive ( UK people dont know this as they dont pay personally...NHS pays ) and around $15,000 per annum to be treated.

Hydroxy Urea is a very old and simple chemical which costs peanuts to make. Same with aspirin (blood thinner) which is a miracle drug on a cost per use basis.

[Aby1990 in reply to Innessant]

Sorry I don’t understand what you mean bt statins ex india, can you explain

And when is it going to touch 15 years of jakavi?

[Wyebird]

Hu has been used since the ‘50s hence its low cost. Luckily enough for us in most cases it’s the one MOST tolerated by MPn patients.

[Innessant]

Statins are the most widely used drugs to control cholesterol /lipids in blood.(eg Lipitor). When they came off patent (Pfizer) the indian generic manufacturers started making private label versions and dropped the prices by >95%.Most NHS and US hospitals prescribe the identical generic drugs. Jakavi (ruxotonib,Novartis) patent expires in 2026

[Aby1990 in reply to Innessant]

So we can expect jakavi price drop after 2026 is it?

[Heidi-W]

Hopefully Jakafi price may drop a little after the patent expires in 2026 but as its not a drug that is used widespread like statins and aspirin it may still remain very expensive I'm afraid. Zoladex which is a hormone implant used for prostate cancer is technically so difficult to make Astra Zeneca its original manufacturer are still the main supplier and don't have much competition for the market share although prices have dropped from their original. We just have to hope that drugs like Jakafi are cheaper to produce in the future but yes the current price level reflects the huge amount invested in research and testing before they come to market.