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Author Topic: Re: Changes to the treatment of Addison's disease in the UK. Florinef cost.  (Read 11975 times)

pp3460

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I've just looked at Rip Off Britain and there is a form you fill out under Contacts but I'm a little worried about the wording in case I get any of the information wrong with regards to the why's and wherefore's of this.   I am under the impression Florinef was discontinued purely so that another version could be brought out and the prices increased? 

And they've done this for money but also is it because it being a human drug that there is or was a shortage for humans - that I'm not entirely sure about, but I know there was a shortage a couple of years ago.  Why have they suddenly licensed a product for animal use ?  I know once there is a product for animals, it has to be given to animals over a human drug.   

But as you say, it's the way it's been handled.  I found out by chance as did a few others, from something I saw on a facebook page.  I knew before my vets did.  And my new vets practice are very laid back about the whole thing - the specialist I saw seemed to take it more seriously.

Any help  would be great Jo.  Thanks. 
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pp3460

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Our posts just crossed Jo - great I will wait to see or hear then .  Thanks you too !
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Jo CIMDA

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Hi

Here are a few pointers that may help.  Just use what you want (or not) and add your own personal concerns - coming from an owner of an Addisonian dog.

Jo

Basically, without prior warning, the only treatment previously available for dogs with primary adrenal insufficiency (Addison's disease) in the UK was changed in April, 2016 from a human oral drug, Florinef, to veterinary licenced injectable drug, Zycortal.

Florinef is a mineralocorticoid tablet that is given on a daily basis and it has been successfully used for decades in the UK for the treatment of Addison's disease.  The cost of this tablet could be bought for as little as 6.00 per 100. Blood tests to ascertain the optimum dose are weekly to start with, and when dogs are stabilised, blood is taken approximately every 3-6 months to check that the dose is correct. Dose is dependent on the size of dog and the individual's needs. This was an affordable treatment.

Zycortal is an injectable mineralocorticoid that is given approximately once every 25 days. The dose is adjusted based on weekly/monthly blood tests initially, and when stable every 4-6 months. 

One vet has estimated cost of Zycortal, based on the dogs weight to be - small dog  approximately 35 - medium dog approximately 53 and large dogs will be more. This includes vets fee. Vet costs will vary from region to region and practice to practice.

Zycortal is the same as Percorten-V (DOCP) and this has been used to treat Addison's disease in the USA for many years and it is successful in 80% of dogs.


When Zycortal was launched in April of this year, the cost of Florinef escalated from 6.00 per 100 tablets to quotes of 180-200 per 100 tablets.  The pharmaceutical manufacture has quoted 30 for 30 tablets. Many veterinary surgeons and pharmacies will no longer stock Florinef because it is now too expensive.


Veterinary surgeons and veterinary specialists have expressed their concern about this sudden, enforced change in treatment because they are unable to assess their patient's treatment based on clinical judgement, for example, some older dogs have been on Florinef for more than ten years and, because of the increase in costs, and a licenced product for animals with Addison's disease is now available, the owner may not have the option to continue with their current Florinef treatment; or the dog may not respond to the new treatment and Florinef will be financially prohibitive and the owner may have little option but to put the dog to sleep.

There can be no compromise with the treatment of Addison's disease because if an Addisonian dog is not treated it will very quickly go into an adrenal crisis and die.  The consensus of opinion is, this new treatment should have been phased in sympathetically and its use not enforced by increasing the cost of Florinef to such an extent it makes the drug unaffordable.
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pp3460

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that's great Jo (for me as well!) thanks very much.  My Jenny is in RVC tomorrow and Tuesday having a dental as we think tooth problems only - hopefully anyway.  I'm always nervous with anaesthetic so I will wait until that's over and then get something sent over to ROB this week.  thanks for your help again.  :)
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Jo CIMDA

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Fingers crossed for today and tomorrow.  The RVC is a great hospital. She is in the right place.
Jo
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pp3460

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Thanks Jo - that's why I chose to go there as I have a new vet I'm unsure of as yet.   However, they've postponed tomorrow's dental because their blood testing machine's kaputt and need to check her lytes before she goes under.  So Jenny has a week's reprieve ......... me too, the drive there and back was a nightmare.  So I will have a look at typing something up to ROB. 
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Jo CIMDA

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Hi

Yes, the M25 this morning around J23/24/25 was very troublesome.  You can breathe out for a week now.

Jo
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pp3460

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 :) am just going to have a look at getting something in writing to one of the consumer websites now Jo ..... will keep you updated .....thanks again.
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