Some interesting comments from KUNC commentator Dr. Marc Ringel via a NPR segment. He raises two points that are worth discussing. Firstly is Oracea really any better than generic doxycycline and secondly what does it say about the pharmaceutical industry (and insurance companies – ed) that a repackaged old product can be so expensive ?
Galderma would say that Oracea is sub-antimicrobial and 50mg doxycycline is a low-dose antibiotic. The distinction is that Oracea will maintain a blood serum level less than 1000 nano grams/mL (i.e. 1.0µg/mL) for the 24 hours post ingestion. 50mg of doxycycline will result in a blood serum level above the `antimicrobial threshold’ of 1.0µg/mL. This can potentially lead to side effects such as antibiotic resistance, abdominal upsets etc., although the amount by which this threshold is exceeded is still relatively small.
At best I would say that the pharmacological benefits of Oracea over 50mg generic doxycycline are are still up for debate.
As to the cost of Oracea, Galderma of course has shareholders like every large pharmaceutical company. Marketing to both health providers and directly to consumers make sense to gain the largest market share possible. Given that they are so few treatments directly targeted at rosacea sufferers it is clear why Galderma wants patients to ask for Oracea by name and for Oracea to be strongly associated as a front line rosacea treatment.
By way of comparison, in Australia pharmaceutical companies are prohibited from marketing prescription brand names directly to the public. Advertisements usually end with a request to ask your doctor for more information. This reduces the pressure doctors feel to prescribe a particular product but may also result in less consumer choice and involvement in their treatment.
In the end, for those with good insurance cover this whole topic is pretty moot as Oracea will be affordable. Additionally those who cannot afford Oracea have a cheap viable alternative in 50 mg of generic doxycycline once a day. See your doctor for more information.
KUNC: The Big Zit Rip-off, Marc Ringel
GREELEY, CO (2009-05-18) Most agree that something needs to be done to overhaul America’s healthcare system. But leave it to KUNC commentator Dr. Marc Ringel to illustrate the problem – through something as small and innocuous as a pimple.
Or you can buy Oracea, a brand-name doxycycline marketed by Galderma Laboratories. Oracea will set you back over $200 a month if you purchase it in this country or about $150 if you shop online and make your buy from a Canadian outfit. To be sure, the dosage of Oracea is 40mg, making it, like the baby bear’s porridge, just right.
…I cannot imagine, though, how the extra 10 mg in a 50 mg generic doxycycline capsule could cause close to the distress that too-hot or too-cold porridge did to Goldilocks. Nor do I see how Oracea would work better than the plain vanilla generic except, perhaps, for an enhanced placebo effect generated by spending so much money on a product marketed especially to this affliction. A person might figure that such an exorbitantly expensive brand name would just have to work better.
9 comments ↓
The cost of new medications versus their actual benefits is certainly a debate worth having! I am a physician and Rosacea patient. I was spending a little over $200 a month on Oracea and I found that it worked very well. However, I switched to once a day dosing of generic Doxycycline 100 mg and find the results are the same and it now only costs me about $5 a month for therapy.
I suspect I could probably cut back to only 50 mg of generic Doxycycline a day since there are reports of the effectiveness of this dose. I have never had any GI complaints or problems with photosensitization with generic Doxycycline and frankly I think these concerns are over-rated.
When I was trying to wean myself off doryx I went down to 50mg a day and then 50mg every second day and I think this helped me taper down. I did this over a few months and was eventually able to stop them altogether.
So for me 50mg of doxycycline a day was quite a satisfactory treatment.
davidp.
Hi Digital Davo, just reading the comments you and Dr. ThomasBarrows made in regard to Orancea. Could you or the Dr. answer a question I have in regards to treating Seborrhea Dermatitis? Can Doryx 150mg treat a person who has Rosacea plus Seborrhea Dermatitis. I did hear that Doryx is the generic form of Doxycline. A person on one of the other sites was given this for her Rosacea and Seborrhea Dermatitis and has had great results. It ‘s like her Rosacea is gone.
Thanks ,I hope someone can comment
Maureen
Hi Maureen,
150mg a day of doxycycline is a standard dose to reduce the papules and pustules of rosacea. Whilst other treatments like anti-fungals or topical steroids are often the first line treatment for seborrheic dermatitis it is possible that the anti-inflammatory and anti-biotic effects of doxycyline at that dose helps SD too.
davidp.
Hi David, Thanks for your comment. Do you know how long people can stay on Doxycycline?
Thanks Maureen
The regular antibiotic doses definitely work but for me there are two problems: 1)antibiotic resistance 2) I get other problems like yeast infections and urinary tract infections because the “good” bacteria also get killed by the antibiotics. So I end up spending money on doctor visits and probiotics…but still cheaper than paying the $300 for Oracea. I have insurance, but the expensive dermatology treatments are often not covered. I’d be willing to pay up to $100/month (still way overpriced) for Oracea. However, they insist on charging well over $300. Right now I have a card from the manufacturer to get the meds for $25 month for the next year or so…so they get me liking it so I stay on it. I still won’t be able to afford $300. Why don’t they just charge like $75 and they would have millions more people buying their drug??? If the $25 deal goes away, I will probably try the Periostat 20mg (doxycycline) twice daily instead. Not perfect but better than the 500mg twice daily of tetracycline I have taken in the past.
try 20mg twice a day… one in the morning and the other one drinking with water , crush it in there … u have your own extended released dose…
pass the voice… save the $$$ away from the pharma industry
I was on doxycyclin (40 mg) for five months and it worked well, though I had a slightly upset stomach from time to time. Then my doctor prescribed Oracea (40mg) over a 3 month period and it worked really well, with no side effects I could discern. But then she said she had to stop prescribing it after this time period, for 4 weeks at least. Now my skin has blown up again and my nose is swollen and pustular. I am back on metrogel and skinoren and find them almost totally ineffective. So my question is, how long term can one use Oracea for, because I for one, would be “happy” to afford it as long as I could.
Thank you,
John.
I am 52 years old and I used Tetracycline for about a year. The stomach upsets got worse and worse so that I absolutely could not take it anymore. I had nausea, and actual stomach pain. After stopping the Tetracycline, my face became a disaster with huge painful cysts forming under the skin and lasting for weeks.
I started Finacea, which helps to dry out the cysts, but not prevent them. These cysts were causing facial scarring and I was about at the end of my rope when I started Oracea.
I have no stomach upsets, and the drug is very effective in preventing the cysts on my face.
The drug company has a rebate program, where it will cover the cost of the medicine that your insurance doesn’t cover, and all you pay is a $25 copay for the medication. The program expires at the end of 2010, so you will have the $25/month copay for a year. Ask your dermatologist about it.
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