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No replacements for ritonavir in the works?
Mar 24, 2004

Hello, wonderful doctor people! I've been following the scandal/hubbub over ritonavir since the price increase happened last December, and noticed that a lot of the complaints of docs like you and activists stem from the fact that ritonavir is the only drug out there that can be used to "boost" the effect of other drugs in a regimen.

If that's the case, then why aren't researchers and companies that are competing with ritonavir making new drugs that can replace ritonavir as a "booster"? Wouldn't these drugs be theoretically easier to make than other drugs, since all they'd need to do is make existing drugs work better?

Response from Dr. Wohl

The ritonvir price increase just happened. Even imagining that there is a ritonavir-like drug on some pharmaceutical company shelf somewhere, the company would need to embark on a series of clinicial studies to demonstrate the safety and efficacy of this agent. Then comes the filing for approval followed by manufacturing and marketing. As you can also imagine, this would take time.

Th shortest distance between 2 points is a straight line. Point A is where we are now and point B is where we want ritonavir to be priced. We need to move to get the drug priced in a way that eliminates the hardships the increase has burdened many of our patients with. We can't wait for a new drug to come over the hill.

Meanwhile, some are looking at using saquinavir + atazanavir as they mutually boost one another and a few brave souls are using low dose Kaletra to boost other PIs until we get to B.

DW



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