Increased medicine prices – Newspaper

THE government has been widely censured for allowing pharmaceutical companies to increase prices of 94 life-saving drugs by up to 260pc a few days ago. The criticism isn’t without justification. A report in this newspaper has quoted some patients as saying that they’ve either reduced their daily dose of medicines prescribed by their physicians or have been forced to discontinue the treatment altogether as prices shoot up, even though the government has yet to notify the new rates. Could anything be more disturbing than to see people stop treatment of serious ailments, even if it means serious health complications for them and difficulties for their families? Some medical practitioners have gone so far as to accuse the government of giving in to the blackmailing tactics of the pharmaceutical industry. Others have questioned the wisdom of allowing such a hefty increase, claiming that the price of raw material has come down substantially. Still others want the government to look into allegations of transfer pricing by the industry, which lets it move significant parts of its earnings to principals as cost of raw material.

The government’s claim that it has allowed the price increase under the ‘hardship category’ as per the Drugs Pricing Policy of 2018 to end the shortages of several medicines in the market (which forces patients to buy expensive imported alternatives) cannot be disputed. It is also a fact that drug manufacturing is a business for investors; if they don’t earn good returns on their investment they will pull their money out and invest in some other business. However, it is the job of the policymakers to find a way to strike a balance between the interests of the pharmaceutical industry and those in need of medication. One solution could be to help the industry bring down its cost of doing business to hold down drug prices. The other could be opening up the market for generic drugs in order to provide cheaper but good-quality medicines to those from the low- and middle-income segments.

Published in Dawn, October 3rd, 2020

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Increased Risk of Severe COVID With Anti-B-Cell MS Drugs?

Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

Concerns are being raised over an increased risk of severe COVID-19 outcomes in multiple sclerosis (MS) patients on anti-CD20 B-cell depleting drugs such as ocrelizumab and rituximab following presentation of new data.

A Global Data Sharing Initiative study, including information on more than 1500 MS patients, most of whom had suspected or confirmed COVID-19, has shown increased risks of hospital admission, treatment in the intensive care unit (ICU), and ventilation for patients on ocrelizumab and rituximab compared with other MS drugs.

The study was presented at a special session on multiple sclerosis and COVID-19 at a final “Encore” event on September 26 as part of the 8th Joint European Committee for Treatment and Research in Multiple Sclerosis-Americas Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS-ACTRIMS) 2020, this year known as MSVirtual2020.

This adds to an earlier report from Italy — which was published as a preprint in The Lancet — that shows similar findings. In the Italian study, among a cohort of 745 patients with MS and COVID-19, therapy with an anti-CD20 agent (ocrelizumab or rituximab) was associated with more than double the risk of a severe COVID-19 course after controlling for other factors.

However, analysis of clinical trial and post-marketing data on ocrelizumab, also presented at the MSVirtual2020 COVID session by Roche, showed no signal of an increased COVID-19 risk with ocrelizumab compared with that in the general population.

Several other studies reported at the session showed that older age, higher disability, progressive MS, presence of co-morbidities, and Black race are associated with increased risk of severe COVID-19 in MS patients, results that are in line with observations in the general population.

The Global Data Sharing Initiative study was presented by Steve Simson-Yap, PhD, a research fellow at Melbourne School of Population and Global Health, Australia.

Dr Steve Simson-Yap

“These data suggest an increased risk of anti-CD20 monoclonal antibodies [mAbs] with more severe COVID-19 outcomes,” he told Medscape Medical News. “The big question is: ‘Should we switch patients off these anti-CD20 medications during the current COVID crisis?’ “

Simpson-Yap said he and his colleagues are not making definite recommendations on the basis of these data. “But we do suggest that medical practitioners consider this risk when making a decision about treatment, particularly in patients who are older, have progressive MS, or severe disability.”

Lead author of the Italian study, Maria Pia Sormani, PhD, professor of biostatistics at the University of Genoa, Italy, commented to Medscape Medical News: “Our message would be that MS patients on anti-CD20 therapies should be more careful in protecting themselves against infection with COVID-19.”

“I cannot advise on whether it is appropriate to switch away from CD20 drugs, but these drugs have a very long duration of action — they are only taken twice a year, so it would take a long time for the immunosuppressive effects to wear off,” Sormani added. “Also, they have a profound effect on MS