You don't get it. Its not just the asbackward pricing issue but a long acting vancomycin is not particulary safe and takes control away from the physcian. Let alone the risk of resistance due to the long 1/2 life. There is a reason these drugs were up for sale the last decade and nobody bought them.
Lilly discovered it in the late 90’s and shelved it (just like dapto) because they were leaving the space. Intermune then bought it, but it didn’t fit into their portfolio of rare disease products, so they were searching for a partner with the expertise needed to develop it. Targenta then bought it, but they screwed up the trials. MDCO then purchased Targenta and they began the new trials and have brought it to market.
The pricing is just fine, $2,900.00 is a fair price for a long acting agent. Dalba is $4,500.00. In fact, analyst were disappointed that it was priced so reasonably, especially if you can transition the patient out of the hospital sooner, and without worrying about where the patient is going to their Dapto infused. Dapto is roughly a little over $3,200.00 for a 10 pack. Dapto gets a lot more expensive when you all are pushing the off label “higher doses”, which you all do.
The 3 hour infusion that all of you are making a big deal about pales in comparison to having to get yourself to either a hospital's infusion suite or Dr's office, every day for 7 to 14 days for your 1/2 hour infusion. The time that one spends trying to get there and back for your Dapto therapy is significantly longer than the 1/2 spent in the chair, and you have to do that every day.
Many patients can’t get themselves there or don’t have the support in place to get them there every day. That’s a BIG COMMITMENT! What happens when patients can’t get to the infusion suite for whatever reason? Resistance is what happens, and it happens a lot more than these Dr’s suites let on.
Let’s not forget that people actually need to go to work and many can’t afford to take off half the day to get their Dapto infused, which brings me to home infusion. Why would you want to have a port in your arm and have to infuse yourself for 7 to 14 days when you can have your one time supervised infusion and be done with your treatment? What happens when patients don’t infuse their daily Dapto for whatever reason? Resistance is what happens, and it happens a lot more than these HI companies let on.
Let’s not forget that all of you sell the “spread”, that dirty little word that you all have several speakers touring the country discussing in great detail. You know damn well which speakers I am referring to!!!!! GS and TC know, as well as all of the SSD’s know what these guys are out there selling, but they just turn their backs to it. Just like one of the SSD’s talking about taking all of the “Zyvox hospital skin business”!! Please, they were telling us to try and get that pneumonia business and you all know it!!!! SHAME ON YOU!!
This drug offers 100% COMPLIANCE.
As far as control goes, the drug has synergy with many other commonly used antibiotics. If for some really bizarre reason, a patient did have resistance, they could add on one of the many synergistic drugs that were very well studied and documented. As per Ralph Cory M.D., resistance should not be an issue BECOUSE of its long half-life and the fact that it has 3 mechanisms of action.
Let’s not forget that Dapto is only out for about 10 years and there’s already MANY documented reports of resistance developing in patients during therapy. Resistance also been documented in patients that have never been exposed to Dapto or Vanco. That one mechanism of action can be a real problem.
Orbactiv has been studied in thousands of patients and the side effect profile is pretty much the same as any other drug.
Don’t forget that both Zyvox and Dapto were both met with resistance from the ID community, many of these academic centers vowed that they would NEVER use these drugs, now look at them.
