sticker shock

[cellio]

Good heavens. I had not realized that list price for my allergy medicine is almost $3/day. (My co-pay, fortunately, is 50 cents/day.) C'mon, guys; develop generics! Besides, it would lower my co-pay a bit. :-)

Fortunately, I do not take allergy drugs year-round -- just for about 6 weeks in the summer, starting soon. I have mild allergy symptoms for longer, but I tend to develop immunities to allergy drugs after a while, and I'd rather not do that again.

Comments

[kellev.livejournal.com]

After how long do start to develop an immunity?

[cellio]

It varies based on usage patterns. In the past when I've taken something for pretty much "full allergy season", it's lost its effectiveness after a couple years. (The second year it comes back strong but loses effectiveness more quickly than it did the previous year. It's weird; you'd think the winter would be enough time to recover.)

What I do now is "spot treatments" -- I take the drugs for the worst part of the season and, individually, for smaller periods of time when things are particularly bad. So far this has been working; in fact, my last drug change was due to the FDA, not due to an immunity. (Fie on banning Seldane just because some people are stupid and don't read the neon orange stickers with the bold print...)

I don't know how long an immunity lasts; maybe I could bounce between two allergy drugs (alternating years) and solve it that way? (I don't even remember what I took before Seldane now.) I should ask my doctor. It's been a while since I've discussed this immunity problem with him anyway. (I should, um, maybe get my decennial checkup...)

[kellev.livejournal.com]

What is considered the worst part of the season?

[cellio]

For me, it's usually mid-July through the end of August, sometimes mid-September. I don't know what, botanically speaking, this corresponds with. (Temporally, it corresponds in part to an annual two-week camping trip.)

[rectangularcat]

You know, last time I tried to quit claritin, I started having a sun allergy. Argh. Well now in the winter, I taper the dosage off to one every two or three days but I don't want to have that red rash again!

It's amazing how expensive that stuff is in the States. I buy Zyctec for my mom (really for my step-dad and siblings) here (it's over the counter) and mail it to them (I physically cross the border and mail it from Blaine, WA). It's 50% of the price her insurance would reimburse her for (25$ CDN for 48 pills of 10mg).

I know Claritin is over the counter now for you, but still it is outrageously priced compared to how much I can get it here for! Weird eh?

[cellio]

Back when I had a prescription for Seldane, I rarely filled it here. Instead, I bought it over-the-counter in Toronto. I figured that if challenged at the border I could just mention my prescription. Since I could legally get it in the US, I didn't think this was drug-smuggling. :-)

In truth, while I paid less over the counter than I did via insurance co-pay, the real reason I wanted the Canadian Seldane was that in the US I got these huge tablets to take twice a day, while in Canada I could buy nice coated one-a-day capsules that went down without any hassles. I have a strong gag reflex; these things matter.

[rectangularcat]

Well considering a lot of pharmacies ship medications to the states, I think it's even legal!

[cellio]

What's legal for corporations isn't necessarily legal for consumers, however. There could be rules on the books that say that individuals moving controlled substances across the border are breaking the law, even if a reasonable person would say this case is ok. I was betting that if I was ever challenged, I'd get a warning (once) and then I probably wouldn't do that any more. Now, it's not an issue because even though those Seldane capsules are otherwise attractive, I'm not going to try to bring in something that wouldn't otherwise be legal for me to have here.

[kellev.livejournal.com]

Is Claritin over the counter for you in Canada?

[rectangularcat]

Yes, it's been OTC since 93 or 94, I remember being upset about that as I had to pay more for it than my insurance copay! (2$ for an entire prescription with my university health plan at the time)

Re:

[kellev.livejournal.com]

How much does a box of 20 pills cost in Canada?

[rectangularcat]

I get generic 10 mg claritin - 72 pills for 10$ canadian.

The real Claritin is about 16$ for 24 or 36 I can't remember which. I haven't bought it in ages since the generic stuff works very well for me.

Re:

[kellev.livejournal.com]

*gasp*

[jducoeur]

There are alternatives to Claritin nowadays. IIRC, there's a company on the Web called something like Blue Sky Pharmacy (in Canada) that sells a generic Loratadine by mail cheaply enough that even with the postage it's much cheaper. And my supermarket now carries a generic knockoff called Alavert that's about half the price of Claritin...

[rectangularcat]

I just get the generic stuff from the Real Canadian Superstore (Loblaws owned). I get 72 pills for less than 10$.

I'm sorry, but you are wrong.

[sethcohen.livejournal.com]

It is not up to the generic company as to when a generic hits the market in the United States. It is a matter of FDA approval and patent law.

In the US, drug companies have 20 years on their patents from the date of first discovery. That is, when they declare that they are researching a novel molecular compound, that's when the clock starts ticking. Depending on the drug and how long it takes to make it through the clinical testing and clinical review process, a drug company may only have a few years to market and sell their product before their patent runs out. This is important, as the cost of developing a new drug product in the US is above one hundred million dollars. Yes, I typed that correctly. $100,000,000.00 and up.

The drug molecule is readily available. The drug (as opposed to the delivery system - you know, the thing you swallow) is not usually manufactured by the company whose name is stamped on the tablet. When the patent runs out, all the generic manufacturer has to do is to acquire some of the drug, and put it into a compatible delivery system that matches the dissolution, absorption, and elimination of the brand product. Until that patent runs out, it is illegal to market a generic equivalent for a brand product. Usually, the generic company has already tested their product and has it ready to ship the instant the patent has expired...but they can't ship it before then. It's against the law.

That's how it works. Any questions?

Re: I'm sorry, but you are wrong.

[cellio]

Thanks for the information! I didn't realize that's how it works, or that development was anywhere near that expensive. I wonder how that figure breaks down among actual development, testing, paperwork, and marketing. I hope that testing is the largest part of that, but I fear it might be paperwork.

(It was also a generic, frustrated "guys", not a particular target.)

Re: I'm sorry, but you are wrong.

[sethcohen.livejournal.com]

Part of what has pushed the cost of drug development up in the last decade in the US has been the advent of direct-to-consumer marketing.

The most time-consuming part is the paperwork, but I guess if you define paperwork differently than I do, you might get a different answer. I can't tell you much about the actual numbers for any given drug...any way you slice it, it's not cheap.

Also, getting a generic to market is a lot less expensive than getting a novel compound to market, obviously.

costs

[cellio]

Part of what has pushed the cost of drug development up in the last decade in the US has been the advent of direct-to-consumer marketing.

Good point. I hadn't been paying attention to that, as I watch little TV and that's where (I gather) the ads are most prevelant. Well, that and my inbox, but I would be delighted if I would stop receiving spam for Viagra. :-)

My mind still boggles at the costs. In particular, it boggles at the notion that this is worth it for the drug companies -- that they make enough in those few years when they own the market to make up for hundreds of millions of dollars of R&D. Industries of that magnitude are just a bit outside my area of experience. :-) I'm sure drugs aren't the only area where it plays out like this; I'd imagine that things like aircraft are similar in scope. But still... wow.

Re: costs

[sethcohen.livejournal.com]

You will never stop receiving spam for Viagra. You might as well ask for the moon on a silver platter. So is life.

The next industry where you see things like this is probably the auto industry, not the aircraft manufacturing industry. Airplane design is much more static than automobiles, and car sales are based more on advertising than actual differences between products. Granted, the cost to get a vehicle to market is less than the cost of getting a drug to market, but I'll bet that the advertising costs are not far off. Next, you should consider Hollywood and their costs and marketing. We could go on and on, but I'm sure everyone has the picture now.

Re: Claritin and generics

[lefkowitzga.livejournal.com]

The case with Claritin is unusual in that it is the first case of a "citizen's petition" rather than the manufacturer requesting the FDA panel review the drug for generic release. The 'citizen' in question was an insurance company that didn't want to pay for prescription Claritin, Allegra, and Zyrtec allergy medications due to the high demand. Here is an interesting article on the topic: http://www.washingtonpost.com/ac2/wp-dyn?pagename=article&node=&contentId=A48521-2002Nov27¬Found=true

Alergy prescriptions

[alfiechat.livejournal.com]

I used to take claritin d. I was aware that the drug went over the counter, but it slipped my mind the last time i ordered it. When i got to the pharmacy, imagine my surprise when the pharmacist said, that will be 100 some dollars please. I am surprised that i did not fall over right in front of him. Fortunately my doctor prescribed Zyrtec D and it works fine. The only thing i do not liek about it is that i have to take it 2x/day instead of once with the claritin.
However, my prescriptions have co pays of 10 or 15 dollars each time i get them filled. sigh. thank god for tax deductions.

Re: Alergy prescriptions

[cellio]

I currently take Allegra, and before that I took Seldane. Before that I don't remember.