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Saturday, February 11, 2012

How Much Does Bexarotene Cost, Will Alzheimer's Patients Buy it Off Label?


Do you know where I can buy Bexarotene? Do you know a doctor that would prescribe Bexarotene off-label for my mother? Are you going to buy Bexarotene for Dotty?

By +Bob DeMarco 
+Alzheimer's Reading Room

How Much Does Bexarotene Cost, Will Alzheimer's Patients Buy it Off Label?
The Alzheimer's community caught on fire with the news that an already approved (FDA) cancer drug, Bexarotene, erased beta amyloid (Abeta) from the brains of mice stricken with Alzheimer's disease. It did this in a matter of hours and days.

A miracle?

Lets put it this way. The phones of doctors, neurologists, and pharmacists all over the world were ringing off the wall on Friday with loved ones of Alzheimer's patients asking, can I buy Bexarotene (brand name Targretin)?

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I received emails asking questions like these:
  • Do you know where I can buy Bexarotene?
  • Do you know a doctor that would prescribe Bexarotene off-label for my mother?
  • Are you going to buy Bexarotene for Dotty?

I answered those question as follow: at most pharmacies including Walmart, No, I can't discuss Dotty's private health information without her permission.

Here is one question that no one did ask. How much does Targretin (Bexarotene) cost?

Targretin is a tier 5 drug, this means it is very expensive. An Internet search indicated that 30, 75mg capsules cost $1,156.64.

If the drug were approved for my mother by her healthcare provider it would cost $381.69 (this can't happen). Although it would send her right into the Medicare donut hole. She already takes one very expensive Alzheimer's drug, and a few other medications.

Further research indicated that most cancer patients take more than one capsule a day. One thing we don't know. If in fact Bexarotene proved effective for treatment of Alzheimer's, what is the correct daily dosage? 75 mg, 150mg, 225mg, more? How many capsules each day?
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Best I can tell about 2,000 cancer patients have taken the drug. It appears that the drug is safe based on clinical testing, FDA approval, and the available research.

I am being asked if I think some Alzheimer's patients will start taking the drug. My answer is simple and straight forward, YES. I have no doubt this will happen.

All kinds of drugs are being taken for uses other than that for which they are intended. Oxycodone is a good example and you are welcome to search Google news to learn more. It is/was being sold at epidemic levels right here in Florida.

Here is what Dr. Gary Landreth, Professor of Neurosciences, Alzheimer Research Laboratory Case Western Reserve University, School of Medicine, said,

"Don't try this at home because we don't know what dose to give, we don't know how frequently to give it, and there are a few nuances to its administration. So one shouldn't be prescribing it off-label."

I know that many of you are probably thinking, why can't we just raise our hand, volunteer, and get this drug tested right now? I can assure you they would have a thousand volunteers in about 8 minutes.

Unfortunately, the drug is going to have to go through several rounds of clinical testing before the drug is approved for Alzheimer's. This will takes years.

Will the drug ever get tested and get approved by the FDA for Alzheimer's? The current drug Targretin is scheduled to lose its patent in 2016. So, in order for Targretin to be financed into a Phase 3 clinical trial it will need to be re-engineered and re-patented to make the numbers work. In other words, it is unlikely that anyone is going to step up and finance the testing of a drug that is likely to be an available generic by the time it is approved for Alzheimer's patients.

Here is a note to Dr. Gary Landreth and his colleagues, get the drug through Phase 1 and Phase 2 clinical trials and then call me. We will take up a collection and finance the Phase 3 clinical trial.

Yeah, I know most people think that sounds nutty, we are talking $50 million dollars, maybe more in this day and age.

Estimated annual sales of Namenda are running over $1.2 billion annually right now. So Alzheimer's patients are already spending the big bucks.

Next up is a test of 12 patients to see how Bexarotene is tolerated. We should have those results by the end of the year.

Original content Bob DeMarco, the Alzheimer's Reading Room