What's happening to money?

[Cyclone]

I know it's high, I've read enough summaries to have an idea about it.

I also know that testing a drug for repurposing is a lot easier, because it's already undergone the basic trials that prove it's not toxic and doesn't have terrible side effects (for a given dose and schedule). Retesting for another use is more about it's efficacy than it's safety, unless the dose/schedule is significantly changed.

 

There is always a risk that a drug will be replaced by a newer/better/cheaper one, it's not that unusual. And if someone could make a profit by performing the test and proving the use, then they'd be doing so right now... So long as the cost of the testing is less than the saving to be made by using the drug, then the NHS would be saving money, which is a good thing.

 

---------- Post added 03-06-2015 at 09:38 ----------

 

Some testing has apparently been done already

 

The National Eye Institute of the National Institutes of Health conducted clinical trials (Comparison of Treatments Trials, or CATT) to study the relative efficacy and safety of Avastin and Lucentis. In May 2011, they reported that Avastin and Lucentis were found to be nearly equally effective in treating AMD.

 

Larger studies needed though

Although Avastin was associated with a greater number of serious adverse events than Lucentis, the researchers could not determine whether these differences were due to statistical chance or to real differences between the safety profiles of the two drugs.

[Obelix]

The best interests of the public in this case would be for the testing to be done independently (maybe by the NHS) and then the cheaper drug to be used. It will still be cheap, and an older more expensive drug can be dropped. Tough for the capitalists who lose this time, good for everyone else.

 

Hows that going to work when the drug company holds the patent on the drug?

 

The NHS is not set up to do drug testing, nor should it be. Also you would be surprised by the cost of doing such testing - there is no way the NHS with it's layers of creaking bureaocrats and paralysing inertia could hope to test it as cheap and quickly as a drug manufacturer.

[Cyclone]

What's the patent got to do with it. That stops anyone else manufacturing it, it doesn't stop people investigating its effects on MD or licensing it for use with MD or buying it for use with MD.

[L00b]

Hows that going to work when the drug company holds the patent on the drug?

Good question.

 

But Lucentis and Avastin are not the same compound, I understand?

 

The Lucentis patent(s) will be directed at the compound, its manufacturing process, and its treatment of MD.

 

Analogously, the Avastin patent(s) will be directed at that compound, its manufacturing process, and its treatment of certain cancers.

 

So the Lucentis patent(s) may have no relevance at all insofar as treating MD with Avastin is concerned.

 

Unless Novartis were first to patent the use of Avastin for treating MD (secondary use patent), of course. In which case they could try to prevent Avastin from being used to treat MD.

Edited June 3, 2015 by L00b

[Obelix]

What's the patent got to do with it. That stops anyone else manufacturing it, it doesn't stop people investigating its effects on MD or licensing it for use with MD or buying it for use with MD.

 

Oh it does.

 

The drug is sold to the NHS for a specific purpose - it's licenced for a specific curative regime. You can use it for what the manufacturers specify - if you prescribe it off label they can enforce in court if they want to.

[Cyclone]

You might be right, I'd have to go and research it to check. But morally it sounds wrong. It sounds like a manufacturer of car engines telling you that you can't use that engine in a winch (best example I can come up with off the top of my head) or a maker of Towels telling you not to use it as a dog blanket.

[Obelix]

Good question.

 

But Lucentis and Avastin are not the same compound, I understand?

 

The Lucentis patent(s) will be directed at the compound, its manufacturing process, and its treatment of MD.

 

Analogously, the Avastin patent(s) will be directed at that compound, its manufacturing process, and its treatment of certain cancers.

 

So the Lucentis patent(s) may have no relevance at all insofar as treating MD with Avastin is concerned.

 

Unless Novartis were first to patent the use of Avastin for treating MD (secondary use patent), of course. In which case they could try to prevent Avastin from being used to treat MD.

 

They are different compounds yes. You would know better than me I suspect but when the manf. provides Avastin they will do so under licence and specify the treatment regime that the licence covers. outside that regime the use of it would be contrary to the licence issued and as such they could I expect enforce in court.

[Cyclone]

A license doesn't normally apply to a physical consumable item though. That's called a purchase, and after you own it, you can do what you like with it by virtue of the ownership.

[Obelix]

You might be right, I'd have to go and research it to check. But morally it sounds wrong. It sounds like a manufacturer of car engines telling you that you can't use that engine in a winch (best example I can come up with off the top of my head) or a maker of Towels telling you not to use it as a dog blanket.

 

Ultimately it comes down to a simple choice.

 

Do you want cheap drugs now and never develop anything new.

 

Are you going to pay into the R&D fund and let them develop new drugs for future use.

 

What we have at the moment isn't perfect but it does work as the discovery of new drugs continues. It could do with tweaking - antibiotics are a prime example where new research is not occuring as it's never profitable to do so. I can see before too long that a tax on all drugs sold will be used to establish a Govt fund to do such research. But ultimately it comes down to drugs are one of the most expensive things to discover and bring to market safely, and that's probably never going to change regardless of how we do it.

 

---------- Post added 03-06-2015 at 11:52 ----------

 

A license doesn't normally apply to a physical consumable item though. That's called a purchase, and after you own it, you can do what you like with it by virtue of the ownership.

 

Normally consumable items don't have intellectual property tied up in them however.

[L00b]

They are different compounds yes. You would know better than me I suspect but when the manf. provides Avastin they will do so under licence and specify the treatment regime that the licence covers. outside that regime the use of it would be contrary to the licence issued and as such they could I expect enforce in court.

That's a breach of contract situation, however, not patent infringement

A license doesn't normally apply to a physical consumable item though. That's called a purchase, and after you own it, you can do what you like with it by virtue of the ownership.

Correct-ish, as maybe just a tad too broad-brushed.

 

It depends on whether the ownership comes with contractual ties (as alluded to by Obelix, and e.g. software EULAs spring to mind as another example) or not. Highly-regulated items (such as drugs) comes with lots of ties.

 

But then, and thankfully, there is also a ton of over-arching legislation for curbing anti-competitive market practices implemented as 'abusive' licensing clause (e.g. and non-exhaustively, Arts 101/102 TFEU). It's certainly not a free-for-all for big pharma.

Normally consumable items don't have intellectual property tied up in them however.

All consumable items have IP of one sort and/or another tied up in them