NEW NAME, OLD DRUG, COSTS A LOT MORE

On December 11, 2006, the Food and Drug Administration ordered pharmaceutical firms to halt all manufacturing and marketing of unapproved drug products that contain quinine due to potentially fatal side effects. There are a number of quinine-containing products sold throughout the United States, but there is only one product currently approved by the FDA.

Quinine is traditionally associated with treatments for the deadly tropical disease malaria, but doctors also prescribe it for a number of "off-label" uses such as treating leg cramps or other similar conditions. These off-label prescriptions are not approved by the FDA, and are usually up to the discretion of the prescribing doctor.

This action by the FDA means that companies can no longer manufacture new unapproved quinine-containing products. The only FDA-approved quinine-containing drug is Mutual Pharmaceutical Company, Inc.'s Qualaquin, and it is used only to treat complication-free malaria because the potential benefits of quinine outweigh the dangers.

It wasn't too many years ago that we were able to sell QUININE SULFATE capsules for approximately $40 for 100. I guess those days are gone. WHY? Well, it seems that this new, SPECIAL Rx version - FDA approved - is here to save the day. Whew! That's a relief. Big Pharma to the rescue, AGAIN. What does this special version cost? Your pharmacist probably has to pay around $107 - for 30 doses! That's $3.60 PER CAPSULE, compared to 40 cents a year or so ago. Instead of just informing patients and doctors about the potential dangers of improper quinine use, our "health" system has found a way to sell the same substance at NINE TIMES the original price (assuming the pharmacist is able to sell this product for no profit at all).

To make this situation more onerous, consider that it is probably illegal for a pharmacist to obtain quinine sulfate powder and make a capsule for you. That's because the LAW says that compounders may NOT duplicate a product that is commercially available. We're also not allowed to "come close" to the commercial product. I presume, however, that if somebody needed a special strength, say 120mg, or 100mg, a compounder would be able to help out. Yes, preparing a less potent strength would mean that the cost would be higher than the original pricing. But, even if it cost twice as much it would still be at least 75% less expensive than the new prescription drug.

In the end, though, why should any of us worry about an exorbitantly priced drug? The insurance company will pay for it, won't they? But I wonder, where does the insurance company get the money to be so kind? From everyone who pays an insurance premium, that's where. Those guys really know how to run a business. I often wish I could run mine in a way that I could charge whatever I wanted and people would HAVE TO pay my price.

If your doctor thinks you would benefit from a proper dose of quinine sulfate ask him or her to check with the local compounding pharmacist. It is possible that you actually need a dose much less than the 324mg dose offered by the drug maker. If that's the case your pharmacist might be able to step up, prepare your doses, and do it at a price that would be far more reasonable than the commercial version.

 

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