"One girl's hope, a nation's dilemma; A Cambridge firm's drug worked wonders, but was hugely costly - more than Costa Rica thought it could spend on one child among so many" by Stephen Heuser, Globe Staff | June 14, 2009
BARRANCA DE PUNTARENAS, Costa Rica - The Cambridge drug company Genzyme had just found its first potential patient in Costa Rica. And now that it had found one, it would supply the drug to Tania, but at an astonishing cost - $160,000 a year, possibly for the rest of her life.
This was far more money than the Costa Rican government had ever paid for a drug, and Genzyme would not bend on the price. The country's health officials were forced to weigh the prospect of a healing gift for one girl against the needs of a nation struggling to care for millions.
What unfolded in that village was a dramatic example of the hard choices often forced by the inventions and ambitions of the biotechnology industry, an increasingly important part of global healthcare and a critical growth sector for Massachusetts. Its high-priced cures are creating both great wealth and great moral dilemmas....
Actually, they are sucking us dry.
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For Genzyme, it wasn't luck. It was another step in a remarkable business strategy: In countries from Colombia to Taiwan to Libya, the Cambridge firm has compiled an extraordinary track record of searching out patients like Tania, providing desperately needed treatment, and then successfully pressing their governments, even poor ones, to pay full price for the most expensive drugs in the world.
That strategy has helped Genzyme bring in more than $1 billion a year on Cerezyme alone, and to develop an arsenal of similarly expensive drugs for other rare diseases. And Costa Rica would soon learn a lot about Genzyme's determination to be paid when it considered the cost of saving Tania Gonzalez, how it would drain resources from other patients, and decided that its answer was "no."
But THEY WILL TAKE CARE of YOU, AmeriKan!!!!!
. . .
If Cerezyme was not just another drug, the Cambridge firm that manufactured it did not consider itself just another drug company. When
Genzyme's solution, elegant in its way, was to set a price high enough to earn a substantial profit no matter how small its pool of patients.
Is it just me, or was that last bit of "elegant" journalistic flair an offensive insult?
Then the company surprised the medical world - and its investors on Wall Street - by showing that American health insurers could be persuaded to pay the six-figure price tag.
And EVERYBODY WINS except YOU, Amurkn -- and world -- taxpayers, business owners, and citizens!
And with the only effective treatment for Gaucher disease, Genzyme never needed to lower the price, even as production efficiencies raised profit margins on the drug to as much as 90 percent.
And yet we are told there is no vencap and the others around here are shutting their doors.
The drug started to bring in tens of millions of dollars a year, then hundreds of millions. Today this one drug, prescribed for about 5,000 patients, has transformed Genzyme and its chief executive, Henri Termeer, into one of the great success stories of biotechnology, fueling its expansion into a $16 billion company with offices and factories worldwide.
By the early 2000s, Genzyme had reached most of the known Gaucher patients in the United States, so it had begun pushing outward to new markets. Genzyme created divisions within the company to find overseas patients; it hired experts to cajole balky governments into paying for the patients' Cerezyme doses. Some of the company's successes were extraordinary: hundreds of patients in Brazil. Patients in Taiwan, Kuwait, and Bulgaria. The government of Libya's Colonel Moammar Khadafy pays for Cerezyme for a handful of patients.
Almost makes you wonder WHERE the DISEASES COME FROM, eh, cui bono?
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As it notched these successes, the company stayed largely under the radar of public health activists who were pushing drugmakers to discount AIDS drugs and other lifesaving medications whose retail prices were financially out of reach to many governments.
Biotechnology drugs like Genzyme's, though crushingly expensive for each patient, were so rarely prescribed that they did not attract the same attention, and Genzyme followed an extremely disciplined "one price" strategy: find patients; donate the drug at first if necessary, but press constantly to be paid full retail price.
Sort of like a STREET DEALER gives the TEENAGE KIDS FREE DOP at first!!!!
Costa Rica was part of this plan, a nearby country whose government, though poor, dedicates much of its budget to healthcare.....
And no military.
The list of drugs approved by the Costa Rican government - fully paid for, and available to any citizen who needs them - fills a paperback book 190 pages long. The drug plan is just one part of a national healthcare system that Costa Ricans see as a source of national pride.
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Dr. Albin Chaves is the official responsible for reviewing new drugs and helping decide whether the country should pay for them. His job, in short, is to stretch the country's drug budget so it helps as many people as possible. And the choices he faces, between the needs of desperate individuals like Tania and the needs of the nation, can be unbearable.
"One is not God to decide," Chaves remembers thinking when he saw Tania's case.
Costa Rica's healthcare system was considered a success story, and it was succeeding not because it spent freely, but because it spent carefully. The challenge of paying for Cerezyme, a product at the extreme high end of the brand-name drug business, was something new....
I despise biotechs now
In Genzyme's new glass Kendall Square headquarters, the president of the firm's international group, Sanford Smith, keeps a brass gong outside his office. Every time a foreign government agrees to pay for one of the company's drugs, he takes out a mallet and rings it.
That does it.
Then burn the place to the ground!
In each country where it does business, Genzyme approaches the payment process differently. In Brazil, a single boy with Gaucher disease and his well-connected family helped get the costly drug approved; today Brazil is one of Genzyme's biggest customers. In China, the company is currently providing the drug for free to 130 patients, while building a research facility to strengthen its ties with the Chinese government. In some countries, too poor to ever afford the drug, Genzyme donates it indefinitely, taking a tax write-off in America.
(Americans, when is enough enough?)
What it won't do is offer a discount. Although discounts are becoming more common on pharmaceuticals sold in lower-income countries, Genzyme follows a "full price or free" model, and works hard to be sure it's the former.
But remember, THEY CARE about YOUR HEALTH!!!
"If you're going to give on the price someplace, everyone's going to ask for a deal, and then you've got a massive mess - so from day one, it was one price," said Alison Taunton-Rigby, a former Genzyme executive who was with the company when it began setting its price policy.
Geoff McDonough, current head of the division that sells Cerezyme, says the policy allows the company to maintain the profit margin needed to research future drugs, while also keeping a door open for the truly impoverished....
It's not the drugs making me sick; it is reading this outright shit. These people are fucking scum.
In Costa Rica, Genzyme offered to donate Tania's dose of Cerezyme for two months. But it had also hired a local healthcare consultant to figure out how the company could start getting paid. The consultant, an American-educated businessman named Roman Macaya, had an idea: use the Costa Rican courts to force the government's hand.
Genzyme, he suggested, could take advantage of a feature of his country's legal system: a national ombudsman who represents the rights of common people in cases where they feel wronged by the government. Tania was, by this time, 10 years old, a village girl, poor and photogenic. The health ministry had just denied her a potentially lifesaving drug. She was a perfect case.
Like Laurie Metcalf and the poor African boy, 'eh?
I'm SICK of being PREYED UPON by these SCUM-SUCKING WEASELS, aren't you?
Macaya helped Tania's family prepare the complicated paperwork necessary to sue the federal government. He was joined by a Genzyme employee from Cambridge, Jhon Cuervo. The national ombudsman agreed to meet with the Gonzalez family. As Macaya predicted, he promptly took the case.
To Jose, to his neighbors, it did not look like an American drug company putting pressure on their nation's healthcare system. It looked like the little guy against the government, with Genzyme quietly helping out the little guy....
Yeah, AND THEMSELVES!!!!!!
Dr. Manuel Saborio Rocafort, who runs the only medical genetics department in Costa Rica, and Macaya are delighted that they found a way to pay for Tania's drug. Both, however, say they have grave misgivings about a system in which an American company can set its prices in America and then charge them in relatively poor countries like Costa Rica.
The Costa Rican healthcare system has survived paying for Tania's medicine. What worries its leaders is the precedent. Energized by Genzyme's success, more companies have developed high-tech drugs for other rare diseases. Genzyme's pricing approach has become the standard for similar drugs. Overall, biotechnology drugs like Genzyme's account for a growing share of pharmaceutical spending every year - more than $75 billion worldwide....
Albin Chaves, in the ministry of health, has begun pressing for an international agreement that would force drug companies to scale their prices to a country's GDP. Under such a scheme, Costa Rica would pay more than impoverished Nicaragua, but far less than wealthy countries like the United States and those in Europe.
Why should WE BE GOUGED by these looting f***ers?
Specialists who follow global drug pricing say those agreements will be reached in the future, if ever, and it's not clear who would even administer them. With global health activists still focusing chiefly on vaccines and tropical diseases, the cost of biotechnology drugs remains far from center stage.
For Costa Rica, this is not the end of the story: It is the beginning, and there is no way to know how it will end. Other biotech drugs loom on the horizon. Recently another Gaucher patient was diagnosed, and the cost of Cerezyme has increased. By this summer, the country expects to be paying Genzyme $350,000 per year, indefinitely, to treat just two of its 4 million people.
With Genzyme laughing all the way to the bank!
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