[Ip-health] The Guardian: Drug-price hikes don't lead to better cures. We must find another way forward

Joanna Keenan joanna.l.keenan at gmail.com
Thu Sep 24 06:02:33 PDT 2015

The Guardian
Drug-price hikes don't lead to better cures. We must find another way
Philipp du Cros
Thursday 24 September 2015 04.30 EDT

Cycloserine is a nasty drug – it can make patients psychotic, aggressive
and even suicidal. But the 50-year-old drug is also one of the only
available treatments for multi-drug resistant tuberculosis. Doctors and
nursing staff from Médecins Sans Frontières/Doctors Without Borders (MSF)
use it in over 20 countries.

Cycloserine is also one of two drugs that have been in the center of a
controversy this week over sudden price hikes on old, patent-expired drugs.
(The other is the 60-year-old drug Daraprim, used to treat a parasitic
infection that primarily affects people with HIV. Turing Pharmaceuticals,
helmed by Martin Shkreli, bought the drug and raised the price 5,500% –
from $13.50 to $750 per pill.) Cycloserine was acquired by a company that
raised the price from $500 for 30 capsules to a staggering $10,800, before
returning it to the original owner in the wake of an ensuing uproar.

The original owner also hiked the price, though by a lot less. All this
over a nasty drug that TB doctors like me know full well have awful
side-effects on people.

Pharmaceutical companies justify their high prices on medicines by saying
profits are the only way to recoup the expensive research costs and pay for
future innovation. But evidence doesn’t support their claim: if the
high-price system worked so well, doctors wouldn’t be clamoring to access a
toxic, old drug they know could harm their patients in an attempt to cure

The entire cocktail of drugs to treat MDR-TB is awful and the cure rate
abysmal. Imagine if, after two years of taking drugs like cycloserine with
horrific side effects, including eight months of daily painful injections,
you have just a 50% chance of being cured. TB research and development is
such that, for those with drug-resistant strains, there is no immediate
hope of new drugs replacing all the toxic drugs, or for shorter and better
combinations of drugs, to reach a cure.

It’s time for a change. We at MSF believes there is another, better way to
deliver the treatments for TB that we’re so desperately waiting for. The
3Ps Project – push, pull and pool – aims to develop an entirely new regimen
of drugs for all strains of TB through an open, collaborative approach and
incentives that reward collaboration and pays for research upfront rather
than relying on high prices.

It rewards funds for compounds that are ready to be tested in humans in
combination with other compounds – TB needs more than one drug to cure it.
The 3Ps Project then pools the intellectual property and scientific data
generated to enable the collaborative research that will take these
compounds from the bench to the bedside. Grant funding is awarded
throughout, especially to fund the clinical trials on the new regimens.

We must move beyond the idea that high prices are the only way to make drug
development happen and stop swallowing the line that as long as we pay high
prices, diseases that have until now been neglected will suddenly find the
research backing they need. It’s simply not the case.

While the 3P Project is targeting TB – a disease for which MSF treats
nearly 40,000 people a year – the principles of alternative funding can be
applied to other diseases which suffer from habitual industry neglect. It
can also help us to avoid the exploitation and price gouging by the
pharmaceutical industry on old drugs like cycloserine. Because honestly,
we’d much prefer not to have to fight for this drug.

Joanna Keenan
Press Officer
Médecins Sans Frontières - Access Campaign
P: +41 22 849 87 45
M: +41 79 203 13 02
E: joanna.keenan[at]geneva.msf.org
T: @joanna_keenan


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