Pharmaceutical company Sandoz has come up with a means of controlling the distribution and monitoring of an antipsychotic drug. Under this system, called 'bundling', drug distribution and weekly patient monitoring are handled by two private companies under contract with Sandoz, which also has the effect of keeping the price high.
Clozaril treats schizophrenia. Although it has been shown to control psychotic symptoms better than other drugs, it has also been shown to produce agranulocytosis, a potentially fatal blood disorder, characterized by a decrease in white blood cells, in 1 to 2 per cent of patients.
In response to an American Food and Drug Administration ruling, Sandoz came up with a ingenious scheme entitled the Clozaril Patient Monitoring System (CPMS).
Although the monitoring system does help to prevent risks of death from agranulocytosis, it also boosts the price of the drug per patient to $172 per week - that's $9,000 a year - making it the most expensive drug in America.
Dr Carl Salzman of Harvard argues that independent treatment centres could handle the necessary monitoring and distribution required by the FDA without boosting the price of the drug or limiting its availability.