The Integrase Inhibitor MK-0518 will have a cost of 50 euros per day.

[blondbeauty]

Merck requests 50 daily euros by MK-0518 in France - it will boost the cost of the antirretrovirales The American multinational Merck & Co. (in Spain, Merck Sharp and Dhome, or MSD)  has made available to the French its inhibitor of integrase MK-0518 for 50 daily euros, (25 euros per dose), that supports the public system of health. This price is the one that Merck receives to provide the new antirretroviral through system ATU (abbreviations of Temporary Authorization of Use), an own mechanism of the neighbour country to facilitate the access to an experimental medication to people who need it with urgency before their definitive approval. Gallic system ATU does not have comparison in other European states, in many from which (Spain including) the programs of expanded access usually take the form of clinical tests. When it is thus, it is the company the one that provides the medication free, forced by the legal norm. But also it could if it wanted to resort to the formula of the nominal compasive use.  But it is like clinical test, is as nominal compasivo use, the previous access to the authorization supposes an important tool of marketing of the pharmaceutical product: an increasing group creates and previous of consumers of the medicine to which the State will have to pay the cost once completes the commercialization process. However, the price requested in the ATU necessarily does not have why to agree once with the cost of the medication in the market. But according to Frank Rodenbourg, of the Parisian coalition TRT-5, the convergence between the number of the precocious access and the one of the commercial sale it is every greater time. According to a comparative study of the company, Tibotec (in Spain, Janssen-Cilag) with medicines for several diseases, not only of VIH, the price of the ATU is the one of reference to the hour to establish what al will be asked for finally like reimbursement French system of health. There are exceptions, clear. When we are before a little common disease, from "the orphaned" denominated ones, the companies can get to request up to 10,000 euros to the month by patient to the ATU, that satisfies precise for humanitarian reasons. The company is conscious that it will be very difficult to them not to say impossible to maintain that price in the negotiation of commercial price, reason why any haste in initiating the authorization process does not occur (it more against the account leaves to maintain the drug to them in the limb of the expanded access), before the irritation of the political people in charge. Fifty daily euros suppose a new mark in the scaling of prices of the antirretrovirales that we believed shutdown in dry with darunavir.  MK-0518 would be the second more expensive drug for the VIH after T-20 (Fuzeon), that is in something more than 51 euros. In the case of T-20, his Roche manufacturer justifies so much by a very complex one and expensive process of production (it is a peptide with a chain of 36 amino acids that requires great amount of raw material to take place) because by his characteristics (indeed, the long chain of amino acids forces to its administration with subcutaneous injection after a something laborious process of reconstruction) it was going to have a segment of limited market. But MK-0518 is not a peptide (this is, does not have proteinic elements) injectable, but a molecule to take oral from the family of the naftiridinas (in particular, a naftiridina ketone), derived as well from the naftaleno, or popular naftalina. It will be so difficult to produce in chain? So far, all we know is that Merck has assigned a rather poor number of dose to European PAE (50 for Spain, under the argument of which their resources are limited. It is not understood that in the close future they want to sell this medicine for hundreds of thousands of people with VIH and that they still do not have the capacity to produce it in mass. Or they have still not started up all the necessary one for the manufacture on great scale (why), or they think that its market will be rather modest, throwing to small. The prices of the antirretrovirales in Spain usually are - although not always it is thus - a 30% less than the European price of reference. If MK-0518 ends up costing about 50 daily euros in France, in Spain it could be in 35, very over the 24 euros of tipranavir. MSD can be with difficulties so that its reimbursement is accepted mainly to this cost, that is not being justified, on the part of independent communities like the Basque Country, or so that it is prescribed without pressures on the part of the economic managers. It would be a counter-productive commercial strategy for the own drug, the company and of course the people with VIH that need it.

[lostboy]

50 Euros a day!!!!

It's like they have a license to print money.

[Dan J.]

When I took Mepron 1 teaspoon averaged out to 55.00 1 bottle is over 800.00 a month & I took two teaspoons of that vile crap everyday for almost 2 years. Thank God I don't have to endure that shit anymore.

[newt]

This is the price for the expanded acces programme.  The NHS and UK community is speaking to Merck about the price, whoch turns out roughly the same as T20, to say it's too damn expensive.  NHS purchasers are likely to say "no more than Kaletra or thereabouts or no go".  This may work for the UK, especially since MK-0518 has the potential to become first-line therapy/widely used and change the treatment paradigm. There's gonna be a supply problem I reckon.

- matt

[Ihavehope]

What are the promises and differences of this drug that it will be so damn expensive?