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Alam
part eccentric ... part fun .... stubborn .. but not stuck up ... very open to different views, ideas and possibilities ... varied interests ... engineer ... mba ... trying-to-be-a-good-entrepreneur ... ex-software ... ex-quality ... ex-tobacco ... ex-alcohol ... trying-to-be-ex-cancer
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Friday, February 23, 2007

Chemo 6 - Time to think of the inequities

Today was an odd day ... atleast it had odd beginnings ...

The day started off early ... too early ... I was up at 2 in the night (after having slept at 9 the previous) ... then tossed around in the bed ... couldn't get much sleep ... generally waited for the sun to come up ... and when the sun finally did rise ... I got up ... had bath ... had breakfast ... and when it was time to take medicines ... oddity again... I ended up taking Metformin (Diabetes medication, causes nausea) ... rather the nurse gave it to me (not her fault too, seems like the junior resident goofed up) ... apparently I was not supposed to take Metformin (it will add to the nausea of Chemo) ...(Latter Addition: Maybe the doctor didn't goof up, I am still taking the medicine ... though one doctor was saying that he would take it off ... that doc is on leave ... I have to check on the next OPD appointment)

Then ... The Chemo nurse couldn't find a good vein in my right hand ... so got the IV line set up on the left hand ... that's a second consecutive week for the hand ... the veins of my left hand had turned red after last week's Chemo ... I wonder if repeating the hand was a good thing to do ...

... there was more action for the morning ... the blog post (that I was writing in the morning) ... got accidentally deleted ...

Anyways ... Chemo started around 10 in the morning ... its 7:30 in the evening ... the chemo is still going on ... it has already outlasted a "sabzi wali maggi", two mausambis, Tehri, a cheese sandwich, mutter-paneer and rotis + a shot of Insulin ... (obviously, today was the day-off for diabetic-diet :-) ... it might go on for another hour or so.

Rituximab was the star of the day ... it went on for six long hours ... gave me enough time to ponder on the absolute unfairness of it's pricing ... The drug is Hi-Tech, cloned, artificially-engineered, trans-species, genetically-modified, all the hu-ha and the works ... at 1.35 lacs/700 mg dose ... the price is impressive too ... but I don't want to crib about the absolute price per se ... Typically a fortune is spent in developing a hit drug like Rituximab ... after all, the pharma firm(Roche in this case) would have spent lots on chasing thousands of molecules.. spending millions on clinical trials etc ... Roche has to recoup these costs and make some profits too ... hence the high prices ... In other words ... they have a case when they ask for a pound of the patient's flesh ... lets not begrudge them their rightful due ...

What I totally oppose is this - While, Roche asks for a "pound of flesh" (high price) from its American patients ... it's demanding both legs, both eyes and the good arm (impossible price) from the Indian ones ... Here's how - The drug appears to be 25% cheaper in India ( my dose would have costed around 1.8 lacs in America) ... but, in actuality, it is still way beyond the average Indian's reach ... The Aam Aadmi has to spend 12 years of his earnings on a 4 dose treatment ... the American Joe needs to spend just 5 month's of earnings for the same treatment ... how very unfair.

Indian cancer patients are getting a raw deal ... we are being made to shell out a disproportionately large portion of our life's earnings to sustain R&D cost of new drugs ... in practice, we are cross-subsidising patients who are way better-off than us ... enough is enough ... we better wake up and smell the coffee ... It's time we start taking exceptions on patent-protection of life-critical drugs ... or at least threaten the Pharma firms with such exceptions ... we have to have down to earth prices in this country...

Phew!!! ... that was serious stuff ... I have been typing away with one hand for way too long now (IV drip is on the other hand) ... the Chemo's got over too ... time to take a break ... we'll catch upwith you again in the next post ... till then ... ciao

7 comments:

Mayank said...

Dear doc,
Dont feel sorry for ROche. You are right about the huge amount of R&D that leads to the product. But private companies come into the picture much later, when the smell a viable product. The very basic R&D is still funded by the public sector. You may have a better idea of how much profit they are making.
I know this- if I have a bacterium, I can extract 10,000 units of a pirticular enzyme with a cost of ten dollars. Roche produce the same enzyme large scale(cost per unit is less), and sell it at 50 dollars per hundred units( ofcourse with quality assurance!).You do the math.
Take care

Anonymous said...

Be happy that at least there is a drug out there!!!

nothing spectacular said...

sariir - e - khamaa ya click - e - computer?? :-)

Alam said...

@ nothing-spectacular
Kisi ney to mera (actualy Ghalib ka) sher padha aur samjha bhi... I had given up the hope of someone reading it (understanding comes much later)

Jim said...

There's a court case going on, between the Government of India and Novartis, challenging the 15 year patent rule in India. Am not sure if the pharma industry is any more ethical that the tobacco industry. Anyway, it's good to see you in your elements...

Tom said...

Thank you very much for sharing your thoughts.

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