Bayer holds the patent for Cipro - the brand name version of ciprofloxacin,
the most effective drug for treating anthrax - until December, 2003.
However, Bayer's ability to produce sufficient amounts of Cipro
is questionable and, as the drug's sole patent holder, Bayer charges
approximately 50% more than what the generic version is likely to
cost. Federal law - 28 U.S.C. §1498 - allows the United States
to purchase products like ciprofloxacin for official use from manufacturers
other than the patent holder.
"If we increase the number of manufacturers producing Cipro,
we're more likely to have enough on hand should we need it,"
Schumer said. "Knowing we have enough Cipro just in case would
go a long way towards calming the public about potential shortages
and hopefully dissuade people from buying, stockpiling and taking
a drug they currently don't need."
The government currently has enough Cipro to treat approximately
2 million people for sixty days - the length of time generally necessary
to treat anthrax. HHS Secretary Tommy Thompson has requested an
additional $643 million to purchase antibiotics including Cipro,
but that would only cover the treatment of an additional 1.5 million
people for sixty days. As the sole patent holder, Bayer can set
the price for Cipro and latest reports indicate the price has risen
significantly above the $3.20 per pill level. - approaching $400
per patient in total . Patients using Cipro take two pills per day
for sixty days. On average, generic drugs cost approximately 50%
less than the brand name prescription version, allowing the United
States to obtain more than double the current amount available with
the funds Thompson has requested. Schumer also said that by purchasing
Cipro directly from generic drug manufacturers, Bayer could be forced
to lower prices for private purchasers like hospitals who want to
increase its supply of ciprofloxacin.
Although Bayer has announced it will begin increasing Cipro production
by 25%, its ability to produce sufficient Cipro beyond the additional
ten million units already requested by the US government is unclear.
Having multiple manufacturers produce ciprofloxacin simultaneously
would significantly enhance the nation's ability to obtain as much
of the antibiotic as it needed, should the occasion arise. Generic
manufacturers including Par Pharmaceuticals, Ranbaxy Pharmaceuticals,
and Teva Pharmaceuticals have told Schumer they could produce as
much as fifty to sixty million pills per month, treating approximately
1,000,000 people per month. Schumer also pointed out that producing
ciprofloxacin in multiple locations decreases the chances of production
snags or other problems impeding manufacture of the best known antidote
to anthrax.
"We cannot just rely on Bayer to ensure we have a sufficient
supply of Cipro," Schumer said. "First, Bayer can only
produce so much Cipro, and we should not put our best response to
anthrax in the hands of just one manufacturer. Second, buying Cipro
only from Bayer - who charges a lot more than generic manufacturers
would - means we spend a lot more and receive a lot less. Hopefully,
we won't even need to use the Cipro we already have on hand, but
if we make arrangements to purchase it from multiple generic drug
manufacturers, we'll have it if we need it."
Schumer also called on the Food and Drug Administration (FDA)
to grant final approval to the five generic drug manufacturers who
already hold tentative approvals to manufacture ciprofloxacin. Any
manufacturer seeking approval solely to sell its product to the
United States government can file a "paragraph IV certification"
and receive clearance to begin production immediately. Denying certification
could delay availability by at least 60-90 days, and since generic
production of the drug will take an estimated 60-90 days before
it becomes available, additional supplies of ciprofloxacin could
be unavailable until April, 2002.
Schumer said that in order for any of the generic manufacturers
to reach agreements with HHS, the United States would have to agree
not to seek indemnification from the generic drug manufacturers
if Bayer successfully sued, and would also have to agree to indemnify
the manufacturers in the event Bayer successfully sued them for
patent infringement. Federal law permits the United States to purchase
products from manufacturers other than the patent holder, but says
that the government could be liable for the patent holder's recovery
of "reasonable and entire compensation for such use and manufacture."
28 U.S.C. §1498. No injunction preventing the generic manufacturers
from producing ciprofloxacin and selling it to the government is
available under §1498.
"Although it seems unlikely that Bayer would sue to prevent
the United States from obtaining Cipro," Schumer said, "if
that happens, the generic manufacturers need to be protected. Otherwise,
they can't sell Cipro to the government and that puts us back to
square one."
Although Bayer is the single patent holder for Cipro, the validity
of its patent is in question. The Federal Trade Commission (FTC)
is currently investigating possible anti-trust violations concerning
a reported payment of over $200 million by Bayer to Barr Laboratories,
the first generic drug manufacturer of ciprofloxacin to file with
the FDA, to keep Barr's product off the market and avoid competing
with Cipro. Bayer's payment to Barr prevents any and all generic
drug manufacturers from producing ciprofloxacin until Bayer's patent
expires more than two years from now.
Schumer is the author, along with Senator John McCain (R-AZ),
of the Greater Access to Affordable Pharmaceuticals Act (GAAP),
bipartisan legislation to improve access to generic drugs. The legislation
would remove a number of obstacles currently blocking entry of many
low-cost generic drugs to the market, including eliminating potential
abuses of the 180-day exclusivity period granted to the first generic
applicant, which has enabled Bayer to keep lower cost versions of
ciprofloxacin off the market. The bill makes the exclusivity period
available to the next-filed applicant if the first applicant has
reached a financial settlement with the brand-name to stay out of
the market until the patents have expired, fails to go to market
within 90 days once their application is effective, does not get
FDA approval within 30 months, fails to challenge a new patent within
60 days, withdraws their application, or is determined by the HHS
Secretary to have engaged in anti-competitive activities.
A copy of Schumer's letter to Thompson is attached.
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