8 March 2013
The long term management of COPD has been affected by the latest “me-too” drug to be announced. Until now the only long-acting anti-muscarinic drug available was tioptropium.
Until now, Boehringer-Ingelheim have had this important field to themselves. But now, Almirall SA have invaded. The Spanish pharmaceutical firm have cunningly priced their new drug at £343 a year compared with tiotropium’s £386.
There does not seem to be any therapeutic difference between the two drugs and Almirall have produced a dinky new inhaler which, in silhouette looks rather like a London taxi.
The drug has now been approved in all European countries except one. This is Germany and their reaction is hardly surprising considering the nationality of Boehringer Ingelheim. Incidentally, for those of you who are interested in these things, Ingelheim am Rhein is on the west bank of that noble river west of the local capital, Mainz. It is also known as Rotweinstadt in honour of the fact that, unusually for Germany, a superb red wine, Ingelheim Spätburgunder (Late Burgundy) is produced here.
But we are straying from the subject because, in all honesty, it is difficult to get enthusiastic about “me-too” drugs.
Should we use it?
Well it depends on how much cost is important to you and your practice. Certainly there seem to be no clinical grounds for changing a patient from tiotropium to this drug. By the way, the new drug is called Eklira. To sum up:
- Ipratropium is the cheapest but has to be used four times a day
- Aclidium is the next cheapest and is used twice a day
- Tiotropium is the most expensive but is taken only once a day
You pays your money . . .
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