Thursday, 11 June 2015

Bibliometrics: drug repurposing

Will the repurposing of off-patent drugs become a reality? #MSBlog #MSResearch

"The following SlideShare are the latest Elsevier metrics of our repurposing article. Good, bad or other research news? In future these kinds of metrics will be used to assess whether, or not, our outputs have impact. We believe the issue of repurposing is still being ignored and our article highlights what needs to be done to address this issue. At present we have had zero impact. 

We need an open and very public debate on this issue in particular with regard to the cost of MS drugs. The study below shows that since the launch of IFNbeta and GA in the 90's the cost of these innovator drugs have increase 5-6 fold. How come? The MS DMT market in the US is looking increasingly like a cartel, it is clear that market forces are not having the desired effect. 

Maybe the repurposing of cheaper drugs will act as a brake on this unsustainable trend? It is interesting that the same increase in drug price is not happening to the same extent in the field of rheumatoid arthritis. It is only a matter of time before politicians and payers take action."

Giovannoni et al. The problem with repurposing: Is there really an alternative to Big Pharma for developing new drugs for multiple sclerosis? Mult Scler Relat Disord. 2015 Jan;4(1):3-5.



Hartung et al. The cost of multiple sclerosis drugs in the US and the pharmaceutical industry: Too big to fail? Neurology. 2015 May 26;84(21):2185-92.

OBJECTIVE: To examine the pricing trajectories in the United States of disease-modifying therapies (DMT) for multiple sclerosis (MS) over the last 20 years and assess the influences on rising prices.


METHODS: We estimated the trend in annual drug costs for 9 DMTs using published drug pricing data from 1993 to 2013. We compared changes in DMT costs to general and prescription drug inflation during the same period. We also compared the cost trajectories for first-generation MS DMTs interferon (IFN)-β-1b, IFN-β-1a IM, and glatiramer acetate with contemporaneously approved biologic tumor necrosis factor (TNF) inhibitors.

RESULTS: First-generation DMTs, originally costing $8,000 to $11,000, now cost about $60,000 per year. Costs for these agents have increased annually at rates 5 to 7 times higher than prescription drug inflation. Newer DMTs commonly entered the market with a cost 25%-60% higher than existing DMTs. Significant increases in the cost trajectory of the first-generation DMTs occurred following the Food and Drug Administration approvals of IFN-β-1a SC (2002) and natalizumab (reintroduced 2006) and remained high following introduction of fingolimod (2010). Similar changes did not occur with TNF inhibitor biologics during these time intervals. DMT costs in the United States currently are 2 to 3 times higher than in other comparable countries.

CONCLUSIONS: MS DMT costs have accelerated at rates well beyond inflation and substantially above rates observed for drugs in a similar biologic class. There is an urgent need for clinicians, payers, and manufacturers in the United States to confront the soaring costs of DMTs.

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