The story of Ximelagatran

People complain all the time that pharmaceutical companies are ripping us off, and that they spend millions wining and dining doctors, money that is better spent giving us cheap medications. Instead, Big Pharma is buying doctors houses and speed boats and private islands while charging $1 zillion dollars for life saving meds.

I am not a fan of Big Pharma. I barely take anything from pharmaceutical corporations except a meal every now and then. I do not believe in taking pens or whatever else. However, I can't help but defend them a little, because I think that it's only fair.

And a nice summary of the story of Big Pharma is the story of Ximelagatran, a direct thrombin inhibitor. It was developed by AstraZeneca, and every physician for the last 10 years knows about it, because it was heralded as the nail in the coffin of Coumadin. Coumadin, derived from rotten sweet clover silage, used for decades as rat poison, is the bane of every physician. Drug interactions, a narrow therapeutic range, side effects, there are so many reasons to hate Coumadin.

So, when the initial trials came out for Ximelagatran, we collectively wet ourselves. This was going to be a whole new world for anticoagulation. As trial after trial came out, we became more and more excited. A lot of us bought AstraZeneca stock because if this was true, this drug would be the biggest thing since sliced bread. Every doctor would be prescribing it.

It came out in Europe, but as usual, the FDA took their time, and their caution paid off. Ximelagatran caused a lot of liver toxicity, and it was withdrawn from market and is now a historical footnote. From development to testing to marketing to commercial sale, I can only guess that AstraZeneca spent close to a billion on this drug. And the result? Nothing.

The real crime is that it's still probably safer than coumadin.