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-----Original Message----- From: Carole K. Menser <[log in to unmask]> To: Jorge Romero MD <[log in to unmask]> Date: Friday, January 25, 2002 7:01 PM Subject: Re: Re: Cabaser Dr. Romero -- Thank you for this valuable information. The cost would, indeed, be prohibitive as a therapy for PD (at the moment). I agree that it would be a beneficial project for Parkinson's organizations to put some pressure on Pharmical/Upjohn to approve it for PD. In response to my query, I have had several e-mails from PWPs in Canada and abroad who testify enthusiastically of cabergoline's efficacy and low incidence of side effects. Anyone on the list in a position to initiate a campaign to lobby Pharmical/Upjohn? Carole Menser, M.A. PWP Ted (54/46/40) >-----Original Message----- >From: Jorge Romero MD <[log in to unmask]> >To: [log in to unmask] <[log in to unmask]> >Date: Thursday, January 24, 2002 7:22 PM >Subject: Re: Cabaser > > >>Message From: Jorge A Romero <[log in to unmask]> >> >> >>Cabergoline, a dopamine agonist, is marketed by Pharmacia/Upjohn in the US >>as DOSTINEX. In Europe, the same company markets it as CABASER >> >>In the treatment of Parkinsonism, in Europe, it has received very good >>reviews. It has a long duration of action so that once daily >administration >>is enough. >> >>In the United States it was approved by the FDA in 1996 for the treatment >of >>hyperprolactenemia in women. Hyperprolactenemia is a condition which >causes >>abnormal lactation. >> >>The catch: The company has marketed it and priced it for the treatment >>of hyperprolactinemia ( two 0.5 mg tablets a week suffice. The retail cost >>of 8 tablets is $235, or nearly $30 per tablet.) >>For $235 one obtains one month therapy for hyperprolactinemia. >> >>For Parkinsonism, the daily dosage ranges from 0.5 mg to 4 mg per day (in >>some studies as high as 6 mg/day) and therefore the cost would be >>prohibitive ( and I bet insurance companies would refuse to cover it.) >> >>The minimum cost would be at least $1000 per month at those prices, and >more >>likely to be two or three times that, or even more that, depending on the >>dosage. Perhaps some pressure from PWPs may expedite its approval by the >>FDA for Parkinsonism in the US, and more realistic pricing by the drug >>company. >> >>It is my understanding that Pharmacia/Upjohn made a deliberate decision to >>market pramipexole in the US instead of cabergoline, for Parkinsonism. >>Pramipexole was approved by the FDA in 1997. Cabergoline was approved for >>hyperprolactenemia in December 1996. The literature on cabergoline and >>parkinson's disease goes back to the early 1990s. It is possible that the >>failure of the FDA to approve it for Parkinson's Disease may have more to >do >>with Pharmacia/Upjohn's marketing strategies than with any inherent >>scientific difficulties in its approval. I do not know what efforts >>Pharmacia/Upjohn has made to market cabergoline in the US, but it would >make >>sense to speculate that they would not try very hard to market a drug to >>compete with pramipexole, which is also theirs, and has been recently >>introduced. >> >>Jorge Romero, MD >> >> >>----- Original Message ----- >>From: "Nigel Harland" <[log in to unmask]> >>To: <[log in to unmask]> >>Sent: Thursday, January 24, 2002 1:56 PM >>Subject: Cabaser >> >> >>> Carol, >>> It is my understanding that Cabaser has not yet been approved >in >>> the USA for the treatment of PD. >>> However, I believe it is available under another name, Dostinex ?? as a >>> treatment for lactation problems in women. >>> I have seen it marketed over here under both names. >>> Perhaps an understanding Neuro' might consider prescribing it for PD. >>> Regards, >>> Nigel >>> >>> ---------------------------------------------------------------------- >>> To sign-off Parkinsn send a message to: >>mailto:[log in to unmask] >>> In the body of the message put: signoff parkinsn >> >>---------------------------------------------------------------------- >>To sign-off Parkinsn send a message to: >mailto:[log in to unmask] >>In the body of the message put: signoff parkinsn >> > ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn