Hi Terry,
This is a recent development, about the generic version of bortezomib (March 30, 2015). Of course it would be the same drug, and I guess if we are technical about this, would be 'injected' by a 'push'! I remember that from my 'induction' chemo back in '09.
But the point here is, it is not approved (yet?) for subQ injection, according to the press release I read. We have to abide by these sorts of regulations ... it is not as 'off the label' as in the US. (assuming you are in the US?). That is all I know about it, and am not a doctor, so this could be checked out further, in case of any other developments that way. I really thought it was interesting that a main myeloma drug such as Velcade does have a generic version. I understand that in other countries too there are generic versions of brand name drugs such as Revlimid.
It's a separate topic again, but there are concerns about the really high costs of chemotherapy drugs. It's quite difficult to have treatments with out insurance or government health care. These drugs are much more expensive than any prescription drugs, for other chronic conditions. For example, say a patient wanted to try a monoclonal antibody or an oral version of a proteasome inhibitor, why could they not just buy it for themselves?? That would be a pricey purchase, I think.
Forums
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Nancy Shamanna - Name: Nancy Shamanna
- Who do you know with myeloma?: Self and others too
- When were you/they diagnosed?: July 2009
Re: My story
Nancy,
The only press release I can find about the Teva generic in Canada says nothing about it being restricted in terms of how it can be administered:
http://www.newswire.ca/news-releases/teva-canada-announces-the-launch-of-prbortezomib-for-injection-a-generic-of-prvelcade-517410401.html
I recognize that rules in countries other than the U.S. limit how drugs can be used, often imposing restrictions that don't seem to make much sense. However, it would really surprise me if the generic version of Velcade was restricted in Canada to be administered in only one way, when the branded version, to which the generic is supposed to be equivalent, can be administered in multiple different ways.
The only press release I can find about the Teva generic in Canada says nothing about it being restricted in terms of how it can be administered:
http://www.newswire.ca/news-releases/teva-canada-announces-the-launch-of-prbortezomib-for-injection-a-generic-of-prvelcade-517410401.html
I recognize that rules in countries other than the U.S. limit how drugs can be used, often imposing restrictions that don't seem to make much sense. However, it would really surprise me if the generic version of Velcade was restricted in Canada to be administered in only one way, when the branded version, to which the generic is supposed to be equivalent, can be administered in multiple different ways.
Re: My story
Maybe you are right, Terry! I may have misunderstood that press release ... possibly subQ and IV injections are covered by that!
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Nancy Shamanna - Name: Nancy Shamanna
- Who do you know with myeloma?: Self and others too
- When were you/they diagnosed?: July 2009
Re: My story
Generally speaking, doctors in Canada are quite free with their decisions. If the doctor directs something to be administered in a slightly different way due to the doctor's knowledge and experience, it's not a problem.
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Little Monkey - Name: Little Monkey
- Who do you know with myeloma?: Father-stage 1 multiple myeloma
- When were you/they diagnosed?: March/April of 2015
Re: My story
Hi LM,
In Nancy's defense, the issue of reimbursement is very important in Canada. A doctor in a Canadian province, for example, might like to prescribe a newly diagnosed patient Revlimid, Velcade, and dex, but probably won't be able to do so in most (all?) cases because of reimbursement restrictions. Generally, those restrictions are tied, at a minimum, to a drug's approved use as laid out in the official Canadian product monograph (prescribing information).
So, if the product monograph for generic Velcade didn't specifically allow for its use in infusions, there might be reimbursement issues that would prevent the generic from actually being used in those circumstances.
You see the same thing occasionally in the U.S. Some U.S. health plans, such as Kaiser, tend to restrict reimbursement to drugs' officially approved uses of drugs. But that is more the exception than the rule, at least when it comes to oncology treatments.
(Also, to be fair, a reimbursement restriction related to a generic drug's official approved use probably would not persist very long – in Canada or the U.S. Since generics are usually cheaper than branded drugs, there would be a financial incentive for Canadian provinces and U.S. health plans to reimburse generic use, even when the use is slightly outside the officially approved use.)
In Nancy's defense, the issue of reimbursement is very important in Canada. A doctor in a Canadian province, for example, might like to prescribe a newly diagnosed patient Revlimid, Velcade, and dex, but probably won't be able to do so in most (all?) cases because of reimbursement restrictions. Generally, those restrictions are tied, at a minimum, to a drug's approved use as laid out in the official Canadian product monograph (prescribing information).
So, if the product monograph for generic Velcade didn't specifically allow for its use in infusions, there might be reimbursement issues that would prevent the generic from actually being used in those circumstances.
You see the same thing occasionally in the U.S. Some U.S. health plans, such as Kaiser, tend to restrict reimbursement to drugs' officially approved uses of drugs. But that is more the exception than the rule, at least when it comes to oncology treatments.
(Also, to be fair, a reimbursement restriction related to a generic drug's official approved use probably would not persist very long – in Canada or the U.S. Since generics are usually cheaper than branded drugs, there would be a financial incentive for Canadian provinces and U.S. health plans to reimburse generic use, even when the use is slightly outside the officially approved use.)
Re: My story
Hi Terry,
Ya, in most Canadian provinces, certain drugs are only approved for financial coverage for refractory cases; Ontario also has the Exceptional Access Program for coverage for non-approved drugs for special circumstances.
Ya, in most Canadian provinces, certain drugs are only approved for financial coverage for refractory cases; Ontario also has the Exceptional Access Program for coverage for non-approved drugs for special circumstances.
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Little Monkey - Name: Little Monkey
- Who do you know with myeloma?: Father-stage 1 multiple myeloma
- When were you/they diagnosed?: March/April of 2015
Re: My story
My dad had his blood test yesterday with the local hematologist. Preliminary results look good (calcium, creatinine, etc). Haven't received electrophoresis results yet.
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Little Monkey - Name: Little Monkey
- Who do you know with myeloma?: Father-stage 1 multiple myeloma
- When were you/they diagnosed?: March/April of 2015
Re: My story
Hi Little Monkey,
Wondering if you have any results back from the last hematologist visit?
Kim
Wondering if you have any results back from the last hematologist visit?
Kim
Re: My story
Hi Kim
Calcium and creatinine levels are fine, I saw him yesterday and I forgot to ask him about any results from the electrophoresis test.
I think I will go with him next time he sees the local hemo, so I can have her go through some of the numbers with me.
Day to day, it's the damage the SBP did to his spinal cord which troubles him the most, he doesn't have too many, if any, C-R-A symptoms.
Calcium and creatinine levels are fine, I saw him yesterday and I forgot to ask him about any results from the electrophoresis test.
I think I will go with him next time he sees the local hemo, so I can have her go through some of the numbers with me.
Day to day, it's the damage the SBP did to his spinal cord which troubles him the most, he doesn't have too many, if any, C-R-A symptoms.
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Little Monkey - Name: Little Monkey
- Who do you know with myeloma?: Father-stage 1 multiple myeloma
- When were you/they diagnosed?: March/April of 2015
Re: My story
Thanks to all who wrote on this thread, I got my dad to read the thread and the various advice and opinions given.
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Little Monkey - Name: Little Monkey
- Who do you know with myeloma?: Father-stage 1 multiple myeloma
- When were you/they diagnosed?: March/April of 2015
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