The Price Is Right!

No games.

Considering the pending (hopefully) approval of Acorda's (ACOR) Amaya/Fampridine-SR, let's explore the potential pricing.

Some have notice my comments on pricing:

http://www.ft.com/cms/s/2/b7b50454-af64-11de-ba1c-00144feabdc0,dwp_uuid=e8477cc4-c820-11db-b0dc-000b5df10621.html

I would like to clarify this:

1. Just because a drug is cheaper, does not make it better.

This is important from a safety point-of-view, and may be similar to the outcry by neurologists, nonprofits and patients regarding generic substitutions of epilepsy medication (antiepileptic drugs or AED). To sum this issue up, while generics are good because they are less expensive and are similar to the branded drug, there may be more variation when changing from one generic to another to another (as is done by retail pharmacies as their arrangements with the makers of generics change based on pricing deals).

For more on this, see the article from Neurology:

http://www.neurologique.org/Generic_Topiramate.html

So, the converse may be true: if you have a drug that could potentially cause seizures, if the dose was wrong (e.g. Amaya), then it may be dangerous if the blood levels of the medicine fluctuate depending on the batch of medication. This can be seen in, both generics and compounded medications.

This doesn't mean that compounding pharmacies are bad, they have served their purpose and have helped greatly, prior to Acorda taking a lead on getting this important medication FDA approved (hopefully this week).

If we ever see LDN (low dose naltrexone) take off, then we will have compounding pharmacies to thank for keeping the hopes alive (and ensuring that patients don't need to mix their own 50 mg naltrexone tablets in water and try to get the right amount).

2. Amaya's pricing question is not unique: compounding pharmacies often charge less for drugs than they cost when made by large companies (with stricter standards). An example of this was Rogaine. An example with a similar price struggle is transdermal (trans = across; dermal = skin) Testosterone. Compounding pharmacies may sell this at USD $85, while retail pharmacies charge USD $350 (Androgel or Testoderm) per month. This translates into a yearly cost of $1,020 at the compounding pharmacy vs. $4,200 at the retail pharmacy.

So, how do we summarize these two points:

1. Amaya will be safer than the compounded form.

2. Amaya's pricing issues are no different than other medications.

Here's to Amaya!

- Dr. Daniel Kantor, MD BSE
Medical Director
Neurologique

info@neurologique.org
www.neurologique.org