Bayer to Boost Production of Anthrax Treatment Cipro
German drug maker Bayer AG plans to increase by 25% production of the antibiotic Cipro, the only drug approved by the FDA to treat inhaled anthrax, in order to help meet "surging demand" amid fear of a potential bioterror attack, the Wall Street Journal reports. After the Sept. 11 attacks on the World Trade Center and the Pentagon and several cases of anthrax exposure in Florida, pharmacies have reported a "sharp increase" in Cipro prescriptions. In New York, NDCHealth, a drug research company, reported that Cipro prescriptions "jumped" 27% in the week that ended Sept. 28 compared to one year earlier (Fuhrmans, Wall Street Journal, 10/11). The pharmacy benefit manager AdvancePCS reported that prescriptions of Cipro for residents of Boca Raton, Fla., where doctors have identified two men and one woman exposed to anthrax, have increased about 50% since Oct. 1 (Petersen, New York Times, 10/11). A drug wholesaler in California sold 835 bottles of Cipro in September and 600 in the first 10 days of October, up from 445 in August (Ornstein, Los Angeles Times, 10/11). The PBM Express Scripts Inc., said that it has seen prescriptions of Cipro increase nationwide since Sept. 11. Bayer plans to increase production of the bulk ingredients of Cipro by 25% on Nov. 1 and will resume production at a facility in Germany to help meet demand (New York Times, 10/11).
The Wall Street Journal reports that Bayer may have "stepped up" production of Cipro "at the behest" of the U.S. government for military use or as part of a national stockpile. Bayer and government officials did not comment on whether the government had a role in the increase, although a Bush administration official confirmed earlier this week that the government has discussed a possible increase in production with Bayer. Bayer has supplied the CDC and the Department of Defense with Cipro as part of bioterrorism defense programs for more than a year (Wall Street Journal, 10/11). In addition, the State Department has asked embassies worldwide to purchase a three-day supply of Cipro for employees (New York Times, 10/11). However, Karen Dawes, senior vice president for marketing and sales at Bayer's U.S. division, said that discussions with the government "played less of a role" than increased demand in Bayer's decision to boost production of Cipro (Wall Street Journal, 10/11). Bayer reported $1.6 billion in Cipro sales worldwide last year (Hartford Courant, 10/11).
The "surge" in demand for Cipro "suggests" that Americans have begun to stockpile the drug to prepare for an anthrax attack (Wall Street Journal, 10/11). The Los Angeles Times reports that fears of an anthrax attack have "triggered a run" on Cipro, with many Americans paying more than $5 per pill and "ignoring health warnings" about the danger of overuse of antibiotics (Los Angeles Times, 10/11). Dr. Raulo Frear, vice president for clinical services at Express Scripts, warned that overuse of antibiotics could lead to new drug-resistant bacteria. In addition, he said that Cipro could prompt "adverse reactions" in patients who take other drugs. Many health experts also warn that Cipro "is useless" after anthrax symptoms appear (New York Times, 10/11). A delay of several hours may "substantially lessen chances" of survival, the Los Angeles Times reports (Los Angeles Times, 10/11).
In the past few weeks, a number of Web sites that sell Cipro have appeared on the Internet (New York Times, 10/11). USA Today reports that at least 12 Web sites that offer online prescriptions hope to "capitalize on Americans' fears of anthrax" (Rubin, USA Today, 10/11). According to USA Today, the Web sites sell Cipro using "come-ons as strong" as "Anthrax prevention" and as "misleading" as "Buy Anthrax Vaccine." The Web sites offer 15- or 30-day supplies of Cipro and "online consultations" with doctors who prescribe the drug (Appleby, USA Today, 10/11). The Web sites sell a month's supply of Cipro for about $300 to $400 (Rubin, USA Today, 10/11). The FDA has warned Americans that Cipro purchased online "could be counterfeit or contaminated" (New York Times, 10/11). "How do you know what Cipro looks like?" Paul Nasca of the Medical Board of California asked, adding, "I could probably make $300 to $400 per day" by selling sugar pills online (Rubin, USA Today, 10/11). In addition, public health experts have said that purchasing Cipro online could lead to a shortage or antibiotic resistance problems (Appleby, USA Today, 10/11). Those who purchase Cipro online also could develop side effects, such as nausea and vomiting, and would not have a doctor to treat them. The American Medical Association and the Federation of State Medical Boards have "condemned" online Cipro sales (Rubin, USA Today, 10/11).
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