A debate among US clinical experts in a rare inherited enzyme deficiency, Gaucher's disease, has flared up over physicians prescribing lower doses of a drug which, the New York Times claims, costs $300,000 per year for each patient at manufacturer-recommended dosages. The product at the center of the dispute is Massachusetts-based biotechnology firm Genzyme's blockbuster Cerezyme (imiglucerase for injection).
The NY Times report states that, for most patients, as little as one-fourth of the standard dose of the Gaucher's therapy would be effective. If true, this could generate savings of about $220,000 for some people. Unsurprisingly, patients who have been switched to lower-dose prescriptions of drugs, as well as payers, are concerned about the financial and medical effects of stronger and more expensive quantities of medicines being dispensed. In the case of Cerezyne, however, the evidence suggests that no harm is caused by taking the full dose, but that there are risks of cutting back treatment, according to Gregory Pastores, an expert on the condition at New York University.
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