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Can Genzyme Make $3.5B a Year Giving Away a Drug for Free?

When Genzyme (GENZ) holds its December meeting to explain to investors why it believes sales of its new multiple sclerosis drug alemtuzumab might hit $3.5 billion a year (and thus justify its stubborness regarding Sanofi-Aventis' (SNY) buyout offer), members of the audience might want to ask if it is possible that the right hand of Genzyme's supply chain can remain in the dark about what the left hand is doing.

That's because alemtuzumab is already on the market under the name Campath as a treatment for chronic lymphocytic leukemia, a blood cancer. Very little alemtuzumab is needed to treat an MS patient, so Genzyme is exploring ways of raising the price in order to meet its $3.5 billion revenue projection.

One possibility is that Genzyme will offer to supply the cancer patients with Campath free of charge. In return, the company would like the FDA's permission to market alemtuzumab under a different name and charge the MS patients more than $30,000 a year.

In that scenario, what is to stop doctors getting their hands on the free cancer supply and using it to treat MS patients? Currently, Campath is sold in sets of 30mg ampules and delivered as an intravenous infusion. It wouldn't be too difficult to mix-n-match those vials to deliver the several 12mg doses MS patients need.

I suspect Genzyme will be hoping to pull off the same sleight of hand that Roche (ROG.VX)'s Genentech unit has done with Lucentis for age-related macular degeneration and Avastin for cancer. For an eye treatment, Lucentis costs $2,000 a dose. If you use Avastin instead it only costs $50. Genentech has refused to study the difference between the two drugs and has funded charities for the blind to make sure they defend use of the more expensive drug. It's up to to doctors and patients to take the "risk" of using one drug to treat the other condition.

Whether this will wash with Genzyme's alemtuzumab is another matter. Everyone knows it's the same substance. The question is, will Genzyme be able to make its supply chain and its drug packaging so obstructive that it becomes nigh impossible to use Campath for MS?


Image by Flickr user Samuel Hughes Photography, CC.