According to this article from Forbes, the efficacy of ketamine in the treatment of depression was discovered by a team, led by Husseini Manji, at the National Institutes of Health. Now Manji, as well as four other researchers from that NIH project, have moved to Johnson & Johnson. In other words, a discovery made by public sector employees, and indeed the knowledge that those employees garnered while on the public payroll, has moved into the private sector. They will undoubtedly make far more money there, of course. And much of that money will come from depressed patients (or their insurance companies/exchanges). Yesterday I passed over fairly quickly the often malign role of pharmaceutical companies, and this looks to be a textbook example of the way they take publicly funded discoveries and turn them into private profits, at the expense of the very public that paid for the research with tax dollars.
Ketamine was synthesized in 1965 as a derivative of PCP, and so has been available as a generic for quite a while. Which is to say that the potential profits from ketamine are limited by competition among various producers. But notice that the researchers are trying to tweak ketamine to create a new form of the drug:
Manji is embracing ketamine as lead that will help develop other drugs, the first of which could be available by 2017. Four of the NIH scientists who have worked on ketamine in depression have followed him to J&J. The first of these medicines, esketamine, is an isomer of ketamine; like many drugs, ketamine molecules come in two forms with the exact same molecular formula but different arrangements of atoms.
The researchers say, as you would imagine they would, that they hope one of the derivatives will be easier to administer and efficacious at lower doses. And that is all for the good. But we need to be realistic about this: Johnson & Johnson is not funding this research in order to help the rest of us. They want a drug they can patent and then sell at monopoly prices until the patent expires. If you compare the prices of, say Cymbalta (still under patent) and citalopram (widely available as a generic) you can see what this means for patients: Cymbalta can cost nearly $200 per month, depending on where you buy it; citalopram is available from WalMart for $4 per month.
If Johnson & Johnson is able to tweak ketamine and patent the new drug, they will be following the footsteps of Forest Laboratories, which did the same thing with the anti-depressants citalopram (originally sold in the US as Celexa) and escitalopram (Lexapro). Lexapro is just a tweaked version of Celexa; pharmacologically there is no distinction. As the patent for Celexa wound down, Forest Laboratories looked to "evergreen" that drug by making minor adjustments in the chemical, thereby creating Lexapro. When citalopram became available as a generic, Forest had a new cash cow in place with its Lexapro patent. Devious but legal.
And while on the topic of drugs and monopoly prices, in this entertaining article on my second favorite favorite summer drink, the gin and tonic there is a mention of the Dutch monopoly on quinine, the tree bark extract used to treat malaria:
We linger amazed at the inhumanity of the Dutch, who cultivated the fever tree on Java—and who cultivated a virtual monopoly from Amsterdam, fixing prices without remorse while malaria patients died.So, nothing new in the world of pharmaceuticals!
And just for the hell of it:
My favorite summer drink: A margarita. NOT frozen.
Third favorite: Pimm's Cup. Though I prefer it with ginger beer rather than lemonade, which I'm told is considered an abomination in some quarters.
And speaking of time seeming unreal, one of my favorite songs for those moments when fuzzy buzzy guitars and feedback are just the gorgeous thing. "You make me feel like time's not real. . ."
Who knew feedback could be so sexy?
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