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Experts fear shortage of 'unprofitable' cancer drug
Photo: DPA

Experts fear shortage of 'unprofitable' cancer drug

Published: 18 Nov 2012 14:40 GMT+01:00
Updated: 18 Nov 2012 14:40 GMT+01:00

German cancer experts are warning of a looming shortage of one of the most widely used drugs to treat the disease – because pharmaceutical companies say it is not financially worth their while to make it any more.

Fluorouracil, also known as 5-FU, is a chemotherapy agent used to treat bowel and breast cancer. It is one of the most commonly prescribed drugs for cancer patients worldwide.

But many of Germany's top providers have stopped making the drug because it is not as profitable as other, more expensive ones. Of the six main companies which supplied 5-FU to pharmacies across the country, only one - Medac - is still is doing so, Der Spiegel magazine said on Sunday.

“The situation is starting to make us scared,” Thorsten Hoppe-Tichy, head of Heidelberg university hospital's pharmacy told the magazine.

“It is only a question of time until we run into serious problems,” said Wolf-Dieter Ludwig, an oncologist and chairman of the drugs commission of the German Medical Association.

Teva, a huge Israeli generic drug company, used to send 200,000 ampoules of 5-FU to Germany each year. This covered around a third of the country's needs.

Production was recently moved to Haarlem in the Netherlands, after which the company said that making the drug was not financially viable – an ampoule costs €3.90 in Germany. “One cannot economically market a sterile product of this kind with that,” said said Teva's German head Sven Dethlefs. Other, more profitable drugs will now be made at Teva’s Haarlem facility.

And the situation appeared less than encouraging for north Germany-based Medac. “The production of 5-FU is not profitable for us, either,” said company chairman Nikolaus Graf Stolberg.

He did say that the company would be looking to take a different business strategy, by offering as big a portfolio of drugs as possible to make up for the fact that some drugs were less profitable.

The Local/jcw

The Local (news@thelocal.de)

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Your comments about this article

17:46 November 18, 2012 by pepsionice
They've got the health insurance mafia stuck over a barrel. If they say they can't make a profit, then they won't manufacture it. They own the copyright, so there's nothing the government can do....except cooperate and raise the general pricing scheme by double, maybe even triple. And if this works.....you can play the same game with every other drug on the market. All this control business over the past decade now.....is going to come back and be a major problem for the government to explain how they survive in the future with gov't managed health care.
18:54 November 18, 2012 by Englishted
@ pepsionice,

Who has the copyright if "six main companies which supplied 5-FU to pharmacies across the country, "

What they are doing is operating a cartel and using blackmail to try to force the price up ,I think the E.U. will step in if they are doing this Europe wide or is it just in Germany.

If Israel wants European support, putting some pressure on Teva to restart production might help.
19:46 November 18, 2012 by zeddriver
Quite the dilemma. The government through their regulations. Makes it very, very expensive to bring a drug to market. In the US it usually takes ten years. Of course. The minute someone takes that new drug and has some bad side effects. Well you can then measure the line of drooling lawyers at your drug companies doors in kilometers.

Not to sure about this. Please correct me if I'm wrong. But doesn't the EU or some of the countries in the EU have government mandated pricing on drugs.

And of course. Why would you as a drug company even go through the process of researching a new drug. Unless there was a profit in it. So if you kill the profits you will kill the life saving drugs. It's all a balancing act.
20:10 November 18, 2012 by Berlin fuer alles
Who said drugs are life saving? Maybe concentrating on alternative preventative methods rather than the 'magic bullet' approach will provide the drug industry with the shot in the arm they need to motivate them to provide these drugs at an affordable price.
22:07 November 18, 2012 by crm114
if an alternative were found then the drug companies products would no longer be needed at any price. The reason why alternatives are not pursued with any vigour is because a lot of vested interests are threatened, god forbid, they may find that the silver bullet was unpatentable. How would they explain that to the shareholders.
22:39 November 18, 2012 by Lisa Rusbridge
@ Berlin fuer alles,

5-FU isn't used used always as a solitary drug, it's often used in combination with other drugs. Additionally the pill form of 5-FU (an IV drug) is Xeloda. It may very well be that Xeloda is replacing 5-FU. This article is very sketchy and seems to be taking an alarmist approach.

Alternative preventative approaches to preventing cancer are hogwash, at least in the modern western world. At least as long as people insist on eating crap diets made out of chemicals instead of food, smoking, living a stressful life and holding little radiations emitting devices next to their brain (cell phones). And even if you alter all that behavior, there's always genetics to contend with as the ultimate wild card. Honestly, reseaching alternative preventative approaches isn't even necessary. People just need to use common sense, which sadly isn't that common any more.
22:45 November 18, 2012 by zeddriver
@Berlin fuer alles

So you would Stop sending anti malaria medicine to those in the tropics? Or that Penicillin hasn't saved countless lives. Sure a healthy life style helps tremendously. But that isn't a guarantee of not getting sick or recovering. Ask Jim Fixx. The father of modern jogging for health. He fell over dead at 52. Genetics got him. All that running over the last 15 years of his life did nothing for him. But. Had his doctors diagnosed his congenitally enlarged heart. He could have been prescribed drugs that would have helped control it. His coronary artery was 95% blocked after all that running. Had that been diagnosed. That could have been repaired.

@crm114

If you found a holistic magic bullet. You would become rich. In fact MOST medicines are just synthetic versions of a natural holistic ingredient. Aspirin(salicylic acid). Naturally occurs in the bark of the Birch tree. The heart drug Digitalis. Is found naturally in the foxglove plant. The fact of the matter is this. The government with it's millions of pages of regulations. The very long time frames to do studies. Along with predatory lawyers laying in wait to sue a doctor or drug company. Means that bringing new drugs to market. Whether they are holistic or not. Is very expensive. All of these costs will be factored into the price. And yes. The drug companies are not innocent either. That is why I say it's a balancing act.
22:55 November 18, 2012 by IchBinKönig
Hug a Progressive today.
22:59 November 18, 2012 by DavidtheNorseman
Kudos to Graf Stolberg for continuing. However no company can take an eternal loss.

Perhaps a provisional German government subsidy to the Graf's company granting costs + 10% until a newer, better drug evolves?
04:10 November 19, 2012 by JWS
Asprin,

Willow Bark
05:58 November 19, 2012 by IchBinKönig
'Tussin,

Vitamin D from the Sun, regulated and taxed first, of course.
06:24 November 19, 2012 by jmclewis
It looks like the Government has removed the free market from this product and removed the profit incentive to make it. If there is a demand and it is growing because of a lack of supply the price should go up and the drug companies start making it.
07:13 November 19, 2012 by mitanni
The patent has long expired (the drug was invented in 1957). These are generics makers who say that they can't make enough of a profit at the €3.90 per dose that the German government is willing to pay in order to make it worth their while; they have more profitable uses for their manufacturing equipment and factories. Generics makers generally are the good guys; they are in a competitive market, they can't play games with patents. There is no leverage that the government has; you can't force manufacturers to produce something. All the German government can do is offer more money for the drug.
10:41 November 19, 2012 by Berlin fuer alles
@ Lisa Rusbridge 'At least as long as people insist on eating crap diets made out of chemicals instead of food, smoking, living a stressful life and holding little radiations emitting devices next to their brain (cell phones)'

That is what I mean by preventative medicen. Reducing the above would go a long way towards reducing the need of drugs. By the way, after diseases of he heart and cancer, medical care is the biggest cause of death in the US (Journal of the American Medical Association published, Dr. Barbara Starfield).
12:50 November 19, 2012 by sre30016
@mitanni

Oh please. There is no good or bad here, its just business. Never assume its anything else.

The generics don't have to spend any money on R&D and they have none of the risk of bringing a drug to market. If all drug companies turned into generics there would be no more new drugs :-)

I've love to know what 'enough of a profit is'. Only enough to pay the top executive 2 million a year bonus rather than 4 :-)
12:55 November 19, 2012 by Dizz
I wonder what the case is for patent protection if the owner and / or licensees voluntarily cease production? The article also refers to Teva as a manufacturer of generic drugs, it seems there may be a case therefore for the drug to go the generic route. In that case there are plenty of companies around the world who are specialised in generics production usually without the heavy overhead of R&D who might be able to step in if allowed.
13:45 November 19, 2012 by sre30016
In this case, there are no patent issues as the drug is 40 odd years old. The generics companies round the world, apparently don't want to make it as they won't get enough of a profit margin, or thats how I am understanding the article.
14:07 November 19, 2012 by veetann
Comment removed by The Local for breach of our terms.
16:16 November 19, 2012 by StoutViking
@Englishted

"If Israel wants European support, putting some pressure on Teva to restart production might help."

How is Israel, as a state, responsible for a company? It's not a state owned company, have you check their stock shareholding reports recently? It's almost 98% pulic owned.

And mind you, it's the Dutch division which made the descision.

Your above statement is like saying the EU must stop cooperate with US foreign policies unless they lower the price of Happy Meals in McDonalds.

It is indeed sad that human life can be evaluated with money, but this is the reality in which we live in. I used to work for a doctor years ago, lended a book of medical caricatures from him once. This one really touched me. Two doctors at a medical convention's parking lot: One with a fancy sports car, the other in a deadbeat old beetle.

Doctor with a sportscar: "What's your practice?".

Doctor with beetle: "Cardiologist. You?".

Doctor with a sportscar: "I'm researching for a sollution against male hairloss".
20:12 November 19, 2012 by Englishted
@StoutViking

The state is not responsible agreed ,however if the drugs company still has the ability to produce the drug in Israel ,then the government could if it choose apply a little pressure .

I would say this is more like the German government's approach to General motors in connection with Opel.

P.S. Hope the sportscar driving Doctor finds his solution soon as I'm coming under pressure as well.
20:47 November 19, 2012 by PNWDev
@king #8

I give you a 10 out of 10 for that comment. Hilarous stuff, but so true.
22:49 November 19, 2012 by crm114
zeddriver, if i found a non-synthetic magic bullet i might initially make some money but pretty soon after many others would be doing the same so no big bucks to be made, if however i was able to contrive to produce a less effective but similar bullet that i could patent then i would be in clover. The unpalattable truth at the heart of the health industry is that it requires us to remain sick for its continued good health, and that is perverse.
22:45 November 20, 2012 by zeddriver
There are many things that are patented. You talk as if that was a bad thing. The patent does not last forever. In the US I believe it's 8 years. And on average it takes 10-12 years to get a drug to market once they have found something that shows promise. Last I checked. It was the peoples bad habits and willingness to live in large cages called cities. That spreads disease like a fire.

Check out this article

http://www.forbes.com/sites/matthewherper/2012/02/10/the-truly-staggering-cost-of-inventing-new-drugs/
09:55 November 21, 2012 by authun
Thanks for the comments (with which I even sympathize), but please learn how to use periods properly, zed.

It makes it. A bit. Irritating. To read.
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