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Old 17 September 2016, 01:32 AM
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Spit Take The Woman Who is Allergic to Water

Rachel wakes up – and drinks a kind of poison that feels like a glass of stinging nettles. As it slips downs her throat, she can feel it blistering her skin, leaving a trail of red, itchy welts behind. Later that day, scorching drops of the stuff start falling from the sky. At the local leisure centre, she watches others splash around in a pool of the irritant. They seem unfazed, but the moment she dips her toe in, she’s faced with burning pain.No, this is not some bizarre alternate reality. This is the world of Rachel Warwick, who is allergic to water. It’s a world where relaxing baths are the stuff of nightmares and snorkelling in tropical seas is as appealing as rubbing yourself with bleach. “Those things are my idea of hell,” she says.
http://www.bbc.com/future/story/2016...ergic-to-water
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Old 17 September 2016, 03:26 AM
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Elphaba?

Seriously, though, that sounds horrifying. The article did a good job of answering some of the obvious questions, although I wonder about things like reactions in high humidity, snow, etc.
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Old 17 September 2016, 03:48 AM
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I have heard of that condition before. The fact that you're allergic to your own sweat is pretty terrifying.
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Old 17 September 2016, 05:52 PM
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That article was an emotional roller-coaster. The agony of this bizzarre condition, the promise of an effective treatment, and then the depressing stagnation of "oh, hey, but this will probably always be out of reach for you because we can't move the little green pieces of paper around in a sensible and compassionate way to relieve human suffering that is within our technological grasp to do. Sucks to be you, Tantalus."

(Edited after I had enough coffee to get my Greek myths straight.)
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Old 18 September 2016, 01:31 AM
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Well, it probably won't forever be out of their reach. They did say the patent was expiring, which means cheaper generics will be out there and hopefully it'll be within their grasp soon.

Or does the pharmaceutical industry work differently there?
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Old 18 September 2016, 01:58 AM
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Quote:
Originally Posted by Saitaina View Post
Well, it probably won't forever be out of their reach. They did say the patent was expiring, which means cheaper generics will be out there and hopefully it'll be within their grasp soon.

Or does the pharmaceutical industry work differently there?
I think the problem is that the drug is not currently listed as prescribable for this condition. It takes studies to demonstrate that it is effective and reasonably safe (the safe part is probably covered by the previous studies for the current condition it treats). The drug company won't want to sink several million dollars into proving a drug is useful for a condition when they will not be able to have the patent's exclusivity for much longer. And worse, this is a condition that afflicts very few people, so the costs would be very hard to recoup even if they had the patent longer.

This would be an orphan-drug situation is there were not a condition this drug was already good for. Maybe the concept needs to be broadened, if it has not already been broadened in actual use.
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Old 30 November 2016, 08:24 AM
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Quote:
Originally Posted by Saitaina View Post
Well, it probably won't forever be out of their reach. They did say the patent was expiring, which means cheaper generics will be out there and hopefully it'll be within their grasp soon.

Or does the pharmaceutical industry work differently there?
The big problem with a generic version of this drug is that it is an antibody. That means that it is produced by living cells, and is a large biological molecule with potentially thousands of atoms. A generic version produced by a different strain of a starting organism would probably differ somewhat in actual structure, making the approval process for biosimilars more complicated as you have to test it more thoroughly to demonstrate that it is functionally identical.
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Old 30 November 2016, 06:08 PM
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Basically to get a generic approval for an existing small molecule drug, you need to be able to demonstrate that your medicine contains exactly that small molecule, in the specified amount, and that your formulation is absorbed and excreted at the same rate to make sure that the levels in a patient's blood will be the same within acceptable margins. You do not generally have to demonstrate effectiveness or more than basic safety as your product is identical biologically to a product which was already thoroughly tested in those regards when the brand name version was approved. Because most of the risk and most of the tests are cut out of the process, the generic drug company has much much less money to recoup through prices. This competition is what makes generic prices so much lower.

The "mab" at the end of the name of this drug means "monoclonal antibody", meaning they are created by exposing identical cells to an immunogen. The person making the generic version will not have identical cells to work from, so the end product may differ substantially in amino acid sequence and cannot be assumed to be equivalent in safety, effectiveness, or dosage. To be considered biosimilar, the generic company must submit extensive documentation to show that their product really is similar enough to be substitutable. This requires extensive testing, so the approval process is intermediate in rigour between generic small molecule and new drug approval. There is still some risk that the product will just not be close enough. This is the reason why biological drugs like this do not get as much price-lowering pressure when generics are approved.

ETA: also keeping the price up is that biologics generally need to be injected or infused rather than consumed in pill form, and are likely to be temperature-dependant and/or have a short shelf-life.

Last edited by Silkenray; 30 November 2016 at 06:13 PM.
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