Gleevec was authorised simply because the Human Genome Challenge was wrapping up, and it served as Exhibit A for many who have been on the lookout for proof that the period of gene-guided well being care had arrived. Francis Collins, director of the Human Genome Challenge, spotlighted Gleevec on the venture’s celebratory conclusion. Gleevec was exceptional, but it surely was not distinctive; relatively, Collins predicted a future the place any illness you can identify had its personal Gleevec.
Twenty years later, Gleevec retains its vaunted standing. “Earlier than Gleevec” and “after Gleevec” has come to mark the second when customized medication shifted from aspiration to actuality. Sufferers from Druker’s early trials who’re nonetheless alive function highly effective reminders of how Gleevec “modified all the things.” The president and CEO of the Leukemia & Lymphoma Society marked the 20-year anniversary of Gleevec’s FDA approval, noting, “It was the start of precision medication: the precise drug to the precise affected person on the proper time.”
That is the quick model anyway. A more in-depth have a look at what adopted after the FDA approval, alternatively, paints a special image.
There have been warning indicators straight away. The article in Time, after conveying the keenness, concluded by declaring that the drug offered for nicely over $2,000 a month. That translated into an annual price of between $25,000 and $30,000. The Novartis CEO admitted the worth was steep, however there was good purpose, he countered. The prevailing therapies for power myelogenous leukemia have been priced equally. Furthermore, the marketplace for Gleevec was small, and Novartis invested $600 to 800 million within the analysis and improvement of a brand new drug. The upper-than-usual price ticket was essential to offset the corporate’s monetary dedication to the lifesaving remedy; Novartis may not even make a lot of a revenue on its new drug. The value, the CEO stated, might even come down if the inhabitants of sufferers who took the drug expanded.
The value of Gleevec stayed within the $25,000-to-$30,000-a-year vary for a while. Then one thing unusual occurred. Round 2006, the worth started climbing. The marketplace for Gleevec had certainly expanded after its launch as a result of it modified a lethal blood most cancers into one thing that may very well be managed like a power illness, which by the Novartis CEO’s personal reasoning ought to have introduced the worth down. Across the similar time a number of different medication that labored equally, referred to as “tyrosine kinase inhibitors” primarily based on the proteins that they shut down, additionally got here out alongside Gleevec. One, actually, was Novartis’ personal Tasigna. Economics 101 would recommend the arrival of rivals drives down costs, however the actual reverse occurred. The newcomers have been priced even greater than Gleevec, within the $5,000-to-7,000-a-month vary. And the listed worth of Gleevec gravitated up towards that of the brand new arrivals. Beginning late within the first decade of the twenty first century, the worth of Gleevec steadily rose, 5 p.c one 12 months, 8 p.c one other, then almost 20 p.c. Sufferers who paid $2,200 a month in 2001 have been paying triple that quantity a decade later. By 2011, Novartis was making greater than $4 billion yearly.
The power myelogenous leukemia neighborhood, appalled by what was unfolding, ultimately cried foul. In 2012, sufferers and family members of these with the illness posted a petition to Change.org asking members of Congress to intervene on Novartis’ worth hikes. One affected person who was in Druker’s authentic trial of STI-571 complained, “It’s borderline prison to drive individuals to make the selection between life (having the ability to afford the Gleevec) and loss of life (being financially unable to purchase the drug that can save their lives).” One other supporter of the petition merely pleaded, “My grandma wants this medication.”