Infant drug sold for $15,000 a gram should cost US$250 to make: experts

Even with $43 million, provinces could only give the drug to fewer than 7,000 premature babies

Infant drug sold for $15,000 a gram should cost US$250 to make: experts
Mothers of premature babies are in a panic as Canada goes through the worst season of respiratory syncytial virus (RSV) in six years. The virus is the most common cause of pneumonia and bronchitis in infants, and while there is a drug that can protect them, it’s so expensive that provinces have to ration it tightly.

Synagis (also known as palivizumab) is an anti-RSV drug that costs between $5,000 and $9,000 per infant per year, according to CBC News. Provinces will pay for it, but the price tag has forced them to set up criteria to determine which infants are qualified to receive the drug.

All in all, the provinces spent around $43 million on the drug last year — enough to protect fewer than 7,000 premature infants. In Canada, around one in 12 babies are prematurely born every year.

When AbbVie, the company that markets the drug, was asked about the price, a representative told CBC News that factors including “R&D and manufacturing costs and product distribution” contribute to the price. The manufacturer, AstraZeneca/MedImmune, did not immediately respond to the news outlet’s questions.

Some experts doubt that manufacturing costs could account for it. “The cost actually to develop a single gram of antibody is … estimated to be between US$100 and US$130,” said Robin Sparrow at the World Health Organization’s Geneva-based Technology Transfer Initiative. Her group believes it will need only US$250 to produce a full treatment of Synagis.

The drug sells for $15,000 a gram, and the required amount depends on the weight of the infant. “You should be able to produce it for $100 to $200 per treatment,” said Han van den Bosch, a professor at the Utrecht Centre for Affordable Biotherapeutics in the Netherlands.

AbbVie actively markets the product through patient education campaigns and handling administrative paperwork in some provinces; the company also gives funding to some Canadian hospitals. In a 2015 position statement, the Canadian Paediatric Society said that doctors engaging in manufacturer-funded research should not have a say in deciding who gets Synagis treatment.

Staying independent from the company is difficult: not only does it have a monopoly on Synagis in Canada, but it’s also very aggressive. Dr. Kim Barker, Nunavut’s medical officer of health, told CBC News that she constantly gets emails and calls from the company. “We've got one of the highest RSV rates, so they see us a good candidate to maintain the purchasing of the product,” she said to the news outlet, adding that company sales representatives fly in at least once a season.

AbbVie is also involved in running Ontario’s Synagis program, processing all enrolment forms and telling family doctors which infants are qualified and which aren’t, said Health Ministry spokesperson David Jensen.

The drug can be purchased privately from McKesson Specialty Pharmacy, although sales numbers and prices aren’t publicly available. AbbVie’s spokesperson said private sales represent only 0.1% of total Canadian sales.


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