We've been dealing with this exact issue with Flovent for my son.
Amusingly our insurance's captive/preferred pharmacy wants to mail us the generic for $40 + 25 S+H instead of us buying it locally for $150. Except that they can't climate control the shipment and it's 20F over the rated temp of the inhaler here today, in the shade. So their in house pharmacist allowed an override.
It's fascinating isn't it? You'd never suspect that people are smuggling drugs out of prison, but the inhalers weren't the only thing either.
I'm not sure it's ever been looked in to, but having seen it first hand, I can tell you there's a whole hustle for people on the inside trying to get prescribed expensive drugs in order to supplement their meager existences.
This is a really good summary. It is mentioned by worth reiterating that evergreening does not prevent generic competition of the origional formulation or configuration. I think it is a bit of a misnomer to refer to these as patent lifetime extensions.
Having spend decades work with pharma companies, I agree that one of the main issues is missaligned incentives between patients and PBMs/health plans.
Bad patents are hard to quantify but a big part of picture. Should the patent office rejected Flovent + HFA as obvious? Another example would be Novarits patents on VEGF in silicone syringes. Litigating a global patent fight with Pharma companies with billions at stake is a huge barrier. The best way to prevent this IMO is more disgression in initial patent issue.
Original author here:
Yeah a lot of the evergreening techniques (chiral switch, etc.) don't prevent anyone from getting the original, though of course doctors may try to switch you. The inhaler thing is double bad because of the CFC ban.
I didn't dig into the details of the fluticasone HFA switch, but my impression is that while it's obvious to replace the propellant, apparently you do need to do some engineering (e.g., on the nozzle) to make it work right. I don't know enough about what they actually had to do to know if the patent should have been granted or not.
Because in the US, for a human being able to afford anything related to health is a business and not a right like other countries. You don't need to write a post for that.
We've been dealing with this exact issue with Flovent for my son.
Amusingly our insurance's captive/preferred pharmacy wants to mail us the generic for $40 + 25 S+H instead of us buying it locally for $150. Except that they can't climate control the shipment and it's 20F over the rated temp of the inhaler here today, in the shade. So their in house pharmacist allowed an override.
Still a royal PITA.
I once encountered a small scale smuggling operation in which prisoners were smuggling their inhalers out of a prison to sell on the street.
The prisoners were receiving as much as $10 per inhaler, funded by a family on the outside that couldn't afford the inhalers at pharmacy prices.
That's amazing. A lot of people import them from Canada, but this is much more interesting.
It's fascinating isn't it? You'd never suspect that people are smuggling drugs out of prison, but the inhalers weren't the only thing either.
I'm not sure it's ever been looked in to, but having seen it first hand, I can tell you there's a whole hustle for people on the inside trying to get prescribed expensive drugs in order to supplement their meager existences.
This is a really good summary. It is mentioned by worth reiterating that evergreening does not prevent generic competition of the origional formulation or configuration. I think it is a bit of a misnomer to refer to these as patent lifetime extensions.
Having spend decades work with pharma companies, I agree that one of the main issues is missaligned incentives between patients and PBMs/health plans.
Bad patents are hard to quantify but a big part of picture. Should the patent office rejected Flovent + HFA as obvious? Another example would be Novarits patents on VEGF in silicone syringes. Litigating a global patent fight with Pharma companies with billions at stake is a huge barrier. The best way to prevent this IMO is more disgression in initial patent issue.
Original author here: Yeah a lot of the evergreening techniques (chiral switch, etc.) don't prevent anyone from getting the original, though of course doctors may try to switch you. The inhaler thing is double bad because of the CFC ban.
I didn't dig into the details of the fluticasone HFA switch, but my impression is that while it's obvious to replace the propellant, apparently you do need to do some engineering (e.g., on the nozzle) to make it work right. I don't know enough about what they actually had to do to know if the patent should have been granted or not.
Because in the US, for a human being able to afford anything related to health is a business and not a right like other countries. You don't need to write a post for that.