December #77 : Bundleland - by George M. Carter

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Table of Contents

*69: AIDS, We've Got Your Number

Sleeping With The Enemy

Enter the Dragon

Change of Heart

Name Game

Chimp and See

Pop Tart

Milestones

Magilla Guerrilla

Spin Cycle

Poetry in Motion

Gifts That Keep Giving

All Versed Up

Obit

Let's Get Naked

Vax for HIVers

States of Emergency

Bundleland

Fat Chance

Hep C, Hep Do

Fed Tape

Gift of Life

Publisher's Letter

Mailbox

Bishop Rainey Cheeks



Most Popular Lessons

The HIV Life Cycle

Shingles

Herpes Simplex Virus

Syphilis & Neurosyphilis

Treatments for Opportunistic Infections (OIs)

What is AIDS & HIV?

Hepatitis & HIV


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December 2001

Bundleland

by George M. Carter

Schering-plough has long taken heat for packaging, or "bundling," its hepatitis C (HCV) treatment, interferon (Intron A, an injectable) and ribavirin (Rebetol, a pill). Dubbed Rebetron, this combo has been the standard HCV treatment for years, though other interferons have entered the race. And with bundling, of course, patients wishing to use Schering's ribavirin -- the one and only such anti-hep nucleoside analog -- with a different brand of interferon have had to buy Intron A they don't want.

When Schering's new pegylated interferon (PEG-Intron) was green-lighted for use with ribavirin, many patients were doubly delighted: First, PEG-Intron is injected just once a week rather than the three-times standard; second, the drugs were unbundled, finally making ribavirin available separately. But be careful what you wish for: Shrewd Schering had an ace up its sleeve. It unbundled the two drugs, all right -- and proceeded to price ribavirin higher!

The average wholesale price for one month's high-dose Rebetol is $1,653. Yet Rebetron costs $1,511 -- that's $142 less. Why so pricey? "In reality, there was no price for ribavirin alone. There was a price for Rebetron," says Schering rep Robert Consalvo. "That therapy had a therapeutic value, and this new therapy has a new therapeutic value." Who "new"? So, the two-product package costs less -- and presumably has a lower "therapeutic value" -- than the one product alone? Welcome to Wonderland, where less is more.

Well, Alice, consider the bright side. You only have to take Rebetol for a year. And with a full supply running you some $18,000 -- that's not even counting the price of a competitor's interferon -- a year of anti-HIV meds looks downright cheap. That's just the comparison Schering makes. "In the long run," says Consalvo, "the cost of lifetime HIV therapy is a lot more than one year of PEG-Intron or ribavirin."

If this logic fails to compute, the Hepatitis C Action & Advocacy Coalition's James Learned has a tip: You can legally buy "compounded," or homemade, ribavirin for $150 to $225 monthly from Fisher's Specialty Pharmacy in Pittsburgh (call 888.347. 3416). Money talks. Is Schering listening?




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