High Cipro Prices Bring Drug Patent Issue Home

"Be Prepared with Cipro!"

"Have Cipro by TONIGHT!"

Enter the name of the drug into a search engine, and dozens of companies promise to lay your fears to rest. Cipro -- a popular wide-spectrum antibiotic -- has become instantly famous since Sept. 11 as the most recommended treatment for the deadly inhaled form of anthrax.

Online pharmacies -- which previously did the bulk of their business selling "lifestyle" drugs like Viagra and Propecia -- are receiving thousands of orders for Cipro as the number of U.S. anthrax cases mount by the day. A spokesperson for Healthmeds.com told Wired News on Oct. 10 that the company was receiving hundred of orders per hour -- and that was before the reports this week that 31 people in the U.S. Senate office building tested positive for exposure to the bacteria.

But there's a problem: the drug costs a small fortune. Germany's Bayer AG holds the patent on Cipro -- one of the newest and most effective antibiotics -- until 2003. The going rate on the Web is $84 for 14 doses, or $6 per pill (plus extra for an "online consultation"). Given that the recommended regimen for people exposed to anthrax is two Cipro pills daily for 60 days, a full course costs a whopping $720.

At these prices, people in the U.S. are getting a sense of the dilemma faced by people with AIDS, whose antiviral drugs can run into the hundreds of dollars per week. And, not surprisingly, some of the worried well are now taking up the cry for cheap generic drugs.

On Oct. 16, Senator Charles Schumer (D-NY) urged Health and Human Services Secretary Tommy Thompson to purchase ciprofloxacin, the generic version of Cipro, for the nation's emergency drug stockpile. According to Schumer, purchasing the generic drug would both decrease costs and provide a larger and more stable supply. "We cannot just rely on Bayer to ensure we have a sufficient supply of Cipro," said Schumer. "[I]f we make arrangements to purchase it from multiple generic drug manufacturers, we'll have it if we need it." Schumer hopes assurance of a sufficient supply will reduce the public's anxiety and discourage personal hoarding and inappropriate use of the drug.

With some pharmacies already running short of Cipro, Bayer said it would triple its production of the drug -- working around the clock and reopening a closed factory -- and would be able to meet U.S. demand. But as the mini-outbreak spread this week, Bayer acknowledged that it may have to outsource some of its production.

Generic ciprofloxacin is already available in several countries, where it can cost as little as $20 for a two-month supply. At least five generic drug manufacturers have been tentatively approved to begin producing generic ciprofloxacin when Bayer's patent runs out. India's Ranbaxy Laboratories told Schumer that it could provide 20 million doses of generic ciprofloxacin at a "very attractive" price. On Oct. 16 Canadian generic drug producer Apotex, Inc. began producing 1 million generic ciprofloxacin pills under contract with Health Canada, saving the government CAN$1 million. Although the manufacturer lacks a license to circumvent Bayer's patent, company president Jack Kay told the Toronto Star, "They [Health Canada] said they don’t care, they need the drug." And on Oct. 17 the Canadian government announced it had overriden Bayer's patent for Cipro.

Meanwhile, the Bush administration has requested $1.5 billion for bioterrorism preparedness (a tenth of the amount allocated to bail out the airline industry), of which $643 million would go toward stockpiling drugs. Assuming the entire amount was spent on Cipro at the heavily discounted government bulk price of about $2 per pill, the allocation would buy roughly 321.5 million doses, enough for a full course of anthrax treatment for about 2.6 million people. At the Indian price of $20 for a full course of generic ciprofloxacin, or roughly 17 cents per pill, the government could purchase about 3.8 billion doses, enough to treat 31.5 million people for the same outlay. Apotex, the Candian generic drug producer, will sell the drug for $1.37 per pill.