Cheap Drugs can we afford to develop them? or Can we afford not to develop them?

#MSResearch Do we want cheap drugs?

We have been talking about the cost of drugs in the US, but we can also bring it back to the UK. 

The occasion is a recent trial of Simvastatin in progressive MS, which costs £1-2 per month; that's £12-24 per year for an MS treatment!  The nearest ‘big pharma’ kid on the block with regard to treating progressive MS is Gilenya, whose trial finishes in 2014. This drug costs £14,000 per year give or take a few thousand quid. In the States multiply this by two (yep, ProfG is right about the US paying more for their drugs).

So if we say 10% of MSers have progressive MS, okay it will be more, then with 10,000 progressive MSers in the UK, drug costs would be about £200,000 p.a. (statins) versus about £140,000,000 (big pharma) per year. 

Lets say 30 years on drug is £4,200,000,000 (pharma) versus £6,000,000 (Simvastatin).

So for the government to fund an academic clinical trial costs say £1,500,000 (it costs pharma a lot more because their staff are being paid), that means about £3,000,000 for two trials, plus a few hundred thousand for the licensing. Even if we add £100,000 p.a. for keeping the licence there is considerable saving to the NHS – spend about £15 million to save over £4 billion. 

Maybe George Osborne, Ed Balls, and the other Cronies need to digest these figures and then maybe they will do something about them?  Maybe GPs in charge of the money will see the value of prescribing something that does not cost the earth. 

Now, we don't know whether Gilenya will work, and also we don't know how well it could work compared to Simvastatin. If Gilenya is much better, the cost savings go out of the window based on efficacy, so let's hope it's great.  However, we don't really know yet whether Simvastatin will work either as no more then phase II studies have been done.  More studies are needed. 

Will they be done? 

Big Pharma assume, and they’re probably right, that academia will not come through with the goods......after all they haven't so far and big pharma don't see any "disruptive Influences" (common board room language) on the horizon to inhibit their 20+ billion dollar market.

If simvastatin does come to the market at a cost of £2 a month, there will be no more investment by big pharma developing better drugs for progressive MS. Because if they can only charge £2 a month there will be no interest.  If the drugs work better they still will only be able to charge an increment.  
This is called Pharmacoeconomics.
Putting progressive MS to one side for the moment, what about a case where we know of cheap drugs that work in people with RRMS as well as anything that Big Pharma have to offer?  

Which drugs are we talking about?  There are a number, some could be developed quicker than others.

For one example you (or the NHS) would have to spend about £2,000 a life time (in fact more likely close to £1,000 only) per person compared to £320,000 - £560,000 (£8-14,000 p.a. for current DMT x 40 years).  

So now doing the sums with 100,000 MSers and every one of DMT that is £56,000,000,000 versus £200,000,000 for a £1-3 million outlay to get the drug licensed.

Is there a will to take on Big Pharma? Or are all Neuros in the pockets of Big Pharma?

What effect would this have on Big Pharma’s interest in MS?  

But what would be the effect on all of us if we don’t do it?  Will the NHS survive? Unfortunately, I think this one may be easier to answer!

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