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Apr. 3rd, 2010 12:22 am![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
which_chickSometimes I do not understand things.
Scabies* is a mite infestation on one's skin. It makes people's skin red and itchy and all with bumps on it. Now, there are a variety of treatments for scabies, most of them topical applications. The topicals are not always well-tolerated by patients. (*I do not have scabies. I know someone who does, though, which is why this topic came up.)
For scabies, you can also, apparently, take Ivermectin, according to the American Academy of Family Physicians. In fact, according to the paper, Ivermectin is *just* as effective as the topicals. And it's well-tolerated by most people. In an estimated six million people taking the drug for parasites, "No serious drug-related adverse events have been reported."
The paper suggests dosing Ivermectin at a rate of 200 mcg / kg bodyweight. Orally. And it says that "A single dose of ivermectin for a 154-lb person costs about $38." It's a prescription drug.
Okay. Got it. Fine.
But... I buy ivermectin, regularly. It is sold over the counter as 1.87% paste, in tubes. It's set (I am a lable reader) to deliver ivermectin at a rate of 200 mcg / kg bodyweight, the same dosage rate as is suggested for the treatment of scabies in the paper above. And (doing the math) I can buy enough ivermectin to do one 250 lb person for about $1.25. It comes in tubes suitable for dosing 1250 lbs of patient. (The patient is a horse, usually. Ivermectin sold thusly is supposed to be used an equine antihelminthic.)
Why does ivermectin cost $38 per 154 lb person but $6 per 1250 lb equine? Sure, you get pills for humans and paste for horses, but really. If you don't have any money, you can handle the paste. It's not *tasty* but it won't kill you. Why is it sold over the counter for ponies but requires a doctor visit and a prescription for people? Why is it so much more *expensive* for people than it is for horses? It's the same stuff. Why is there such a barrier to access for people but not for horses? (People don't react badly to it -- six million people taking the stuff and no serious drug reactions. You can't get "high" off of it. It tastes like shit in paste form.) I don't think that Kids Today are gonna run out and down tubes of horse wormer if it suddenly became available over the counter and labled for humans.
I think, basically, that most humans do not read lables. I further think that people would not BUY ivermectin for deworming horses if it cost $246.75 (the $38 per 154 lb person scaled up to dose a 1000 lb horse) every three months. You can sell a hell of a lot of ivermectin to horse people at 6-bucks-per-tube, though. A hell of a lot.
Horses consume a lot of wormer. People, not so much. People can probably be conned into paying forty-bucks-per-ivermectin-treatment, particularly if they have like the $10 co-pay or some shit. Horse people won't pay that kind of freight (almost $250, when scaled up) to deworm their horses, though, and there is no co-pay in the horse doctoring world.
So... ivermectin is cheap for horses and SIGNIFICANTLY more expensive for humans. Still think it has nothing to do with what the market will bear?
Scabies* is a mite infestation on one's skin. It makes people's skin red and itchy and all with bumps on it. Now, there are a variety of treatments for scabies, most of them topical applications. The topicals are not always well-tolerated by patients. (*I do not have scabies. I know someone who does, though, which is why this topic came up.)
For scabies, you can also, apparently, take Ivermectin, according to the American Academy of Family Physicians. In fact, according to the paper, Ivermectin is *just* as effective as the topicals. And it's well-tolerated by most people. In an estimated six million people taking the drug for parasites, "No serious drug-related adverse events have been reported."
The paper suggests dosing Ivermectin at a rate of 200 mcg / kg bodyweight. Orally. And it says that "A single dose of ivermectin for a 154-lb person costs about $38." It's a prescription drug.
Okay. Got it. Fine.
But... I buy ivermectin, regularly. It is sold over the counter as 1.87% paste, in tubes. It's set (I am a lable reader) to deliver ivermectin at a rate of 200 mcg / kg bodyweight, the same dosage rate as is suggested for the treatment of scabies in the paper above. And (doing the math) I can buy enough ivermectin to do one 250 lb person for about $1.25. It comes in tubes suitable for dosing 1250 lbs of patient. (The patient is a horse, usually. Ivermectin sold thusly is supposed to be used an equine antihelminthic.)
Why does ivermectin cost $38 per 154 lb person but $6 per 1250 lb equine? Sure, you get pills for humans and paste for horses, but really. If you don't have any money, you can handle the paste. It's not *tasty* but it won't kill you. Why is it sold over the counter for ponies but requires a doctor visit and a prescription for people? Why is it so much more *expensive* for people than it is for horses? It's the same stuff. Why is there such a barrier to access for people but not for horses? (People don't react badly to it -- six million people taking the stuff and no serious drug reactions. You can't get "high" off of it. It tastes like shit in paste form.) I don't think that Kids Today are gonna run out and down tubes of horse wormer if it suddenly became available over the counter and labled for humans.
I think, basically, that most humans do not read lables. I further think that people would not BUY ivermectin for deworming horses if it cost $246.75 (the $38 per 154 lb person scaled up to dose a 1000 lb horse) every three months. You can sell a hell of a lot of ivermectin to horse people at 6-bucks-per-tube, though. A hell of a lot.
Horses consume a lot of wormer. People, not so much. People can probably be conned into paying forty-bucks-per-ivermectin-treatment, particularly if they have like the $10 co-pay or some shit. Horse people won't pay that kind of freight (almost $250, when scaled up) to deworm their horses, though, and there is no co-pay in the horse doctoring world.
So... ivermectin is cheap for horses and SIGNIFICANTLY more expensive for humans. Still think it has nothing to do with what the market will bear?
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no subject
Date: 2010-04-03 04:35 am (UTC)1) The inactive ingredients are probably different between the horse and human formulations of ivermectin--which may make a difference in the pharmacokinetics and tolerance of the drug. Species differences make a big difference in this regard.
2) The company that makes ivermectin provides (or at least used to) huge quantities of the drug for free to developing countries, where a vast variety of worms and other parasites that humans get are common as muck. (Schizosomiasis is the second most common disease after tooth decay and it's just one of the *many* things that ivermectin is good for). Probably most of those 6 million users are getting it for free--so it's likely that first-world users of the human-formulated drug are subsidizing the very poor people elsewhere. Which I, at least, have not problem with.
no subject
Date: 2010-04-03 05:23 am (UTC)no subject
Date: 2010-04-03 01:19 pm (UTC)Anyways, aren't you the one who loves to go to these horrifically expensive gourmet/class restaurants for the experience & the better food, where they sell you the ingredients for at least 20x and maybe 100x markup?