Canada on drugs

People are facing ruin in Canada because they can't afford a medicine that costs less than ten cents a capsule to produce.

The drug is thalidomide, once used as a sleeping pill and to alleviate morning sickness for pregnant women, with the well-known terrible effects on their offspring. The disease is multiple myeloma, a bone-marrow cancer. Thalidomide has been found to be effective in treating this cancer, starving tumours of blood and stimulating the immune system.

In Canada, the drug is sold for as much as $37.50 per capsule. Over the past five years, the price of Thalomid, as it is now called, has increased in price ninefold. The US-based manufacturer, Celgene Corporation, has found itself a nice little dodge that keeps the generic version off the shelves.

Here's how it works. The patent on the drug expired in 1976. Ordinarily, this would open up the market for generic drug manufacturers to offer it at a much lower price. But the only access to thalidomide in Canada is through Health Canada's special-access program, by which unapproved drugs can be provided as an emergency measure on a per-patient basis when other treatments are contraindicated.

Because the drug has not been approved, generic drug manufacturers are not permitted to sell it in Canada. But Celgene Corporation is in no hurry to ask for such approval, given the profits it is raking in through the special-access program. A year's supply of the drug can cost a patient as much as $54,000.

In Brazil, where the drug is provided free to patients by the government, the drug costs less than a dime per capsule to produce. The system in Canada doesn't work that way. Big Pharma has always done well here: the process of "evergreening" continues, for example, by which generic drugs are kept off the market for years after a patent expires, through adroit litigation.

Even George W. Bush has recognized the measures to which Big Pharma has resorted to keep its profits high:

When a drug patent is about to expire, one method some companies use is to file a brand new patent based on a minor feature, such as the color of the pill bottle or a specific combination of ingredients unrelated to the drug's effectiveness. In this way, the brand name company buys time through repeated delays, called automatic stays, that freeze the status quo as the legal complexities are sorted out.

In Canada, a half-hearted review of evergreening is going on, after an outcry over Liberal connivance with Big Pharma during a session of the House Committee on Industry, Science and Technology in 2003. The Committee backpedaled quickly after that, agreeing to review the practice, but no changes are yet in place, and the ones proposed will not do the trick.

The system as a whole is in need of radical change if generic companies can be so easily kept from putting low-cost pharmaceuticals into the hands of needy Canadians. In the meantime, citizens like 75-year-old Dorothy Ingraham will pay until they are bankrupt for a drug that costs pennies to make, and worry what might happen to them when the money runs out.

Your morning smile

I hate to say it, but my sympathy for Cindy Sheehan is dropping fast.
--Angry in the Great White North, August 14, 2005 08:28 a.m.