Economic impact of tetracyclines
Tetracyclines are antibiotics which are produced by the pharmaceutical industry. Ultimately, any profit made by the industry results in indirect revenue for the country. So it follows that the greater the sale, the greater the tax revenue. Furthermore, in producing drugs that would keep a population healthy, the number of man hours lost to illness is reduced. In producing new and established drugs, the pharmaceutical industry creates opportunities for a great number of highly skilled workers. In the process of producing these drugs, the pharmaceutical industry must consider the most cost efficient means available.
There are many economic factors that pharmaceutical industries must address when formulating a new drug. Antibiotics such as tetracyclines can be used to treat a wide range of infections, meaning there is high demand for them and a lot money invested in their development and production. The production of antibiotics is worth millions of pounds and continues to expand each year. Over 10,000 antibiotic substances have been discovered and this number is increasing as new antibiotics are being created and developed synthetically.
The discovery of new antibiotics is a very complex process which takes years and furthermore is very costly. Microorganisms are cultured and then tested for their therapeutic index by allowing them to diffuse onto a range of different products such as bacterial cultures. This is to observe the effectiveness of their antibacterial properties. However, most of these antibiotics produced in this way have already been discovered. Therefore these new compounds may be modified to fulfil different roles and target different bacteria. Pfizer were the original producers of the first tetracyclines and are the main choice when the proprietary band is prescribed. However, the non-proprietary is most commonly prescribed - most likely due to cost for the NHS.
The production of antibiotics is said to be a batch process, as contamination would be more likely within a continuous process. Although a continuous process is quicker, the wastage caused by contamination means it isn't a cost effective process. Fermentation is used to allow the selected microorganisms to multiply and produce the antibiotic on a large scale. The selected organism which produces the antibiotic is isolated and a starter culture is made to increase the numbers of available organisms. Next, the medium is transferred to fermentation tanks where the microorganisms are able to grow and multiply, so large amounts of the antibiotic are produced. After a number of days a maximum level of antibiotic will have been produced by the microorganisms and separation of the products can begin. Various different purification methods can be used e.g. organic chemicals, leaving a purified powder. This whole process takes a few days meaning huge quantities can be manufactured each year worth millions of pounds to the producers.
Different formulations are then produced such as tables, capsules, intravenous drips. The type of formulation will affect how much the drug will cost the customer. For example tablets are the cheapest as they are the easiest to produce and they are combined with cheap materials/ chemicals in formulation. Conversely, an intravenous preparation will be more expensive as a solvent is used to dissolve the drug. Packaging and transport costs also affect the economic factors related to the drug. Tablet formulations are cheap as they are packed tightly in boxes and are not easily damaged. This contrasts to the high cost required to transport other formulations in suitable conditions. Environmental factors can affect the drug such as temperature and suitable transportation methods are needed to deliver the product safely without damage.
It is important to consider Quality Assurance throughout the production process. As mentioned earlier it is very easy for contamination to occur during the manufacture. So Quality Assurance is completed by checking the product on a regular basis. This is very time consuming and requires staff, however, if contamination were to occur there would be a greater loss of money through wastage and time. It is also very important to ensure the highest quality of product is produced as patients' health is dependent on the drug and if errors were to occur, the company in fault could be fined and acquire a bad reputation.
In the manufacture process the major costs of the materials is in the production of the fermentation culture. It contains essential ingredients that the microorganisms need for growth and reproduction. Most importantly there will be a carbon source (molasses/ sugars). Nitrogen is also essential mostly in metabolic pathways which take place in the organism. Other elements are also necessary: phosphorus, iron, and copper. These are added as salts. Also, foaming is prevented during the fermentation process by adding anti-foaming agents such as octadecanol.
The majority of the materials used in production would be sourced locally however more specific materials may need to be imported from other countries. Importing the materials will introduce greater costs in the production due to transportation and workers' wages. However, it would benefit the overall economy as more jobs would be produced in the country of origin and the money would ultimately be returned, with a profit to the producers, through the sale of the product.
Another area that requires a certain amount of economic consideration is the energy requirements in the production and distribution stages. Certain temperatures need to be produced to enable the fastest rate of reaction, and many pieces of equipment will be used which require electricity to power them. A lot of energy will also be required for transportation like petrol for lorries.
When a customer is prescribed tetracyclines, they are required to pay the standard NHS prescription cost of 7.20 pounds due to it being a Prescription only medicine. However the tablets themselves are relatively cheap; according to the BNF 1 tablet costs approx 20p therefore the real cost of a pack for a complete course may be cheaper than the standard NHS charge. But the fact that the cost is relatively high may prevent overuse/misuse. Another problem the NHS may consider is whether its use outweighs its higher cost of production/purchase. However, since tetracyclines are so cheap to manufacture, there is no issue with distributing this drug on the NHS with the usual levy charge.
The maximum shelf life for tetracyclines is 1 year after which it can deteriorate into a toxic compound. This time is relatively long and so is an advantage to the manufacturer. To save further costs it may be kept in a powder form to prevent hydrolysis in solution, which could decrease the shelf life further still. Once taken, their half life is 6-11 hours (Paracetamol 1-4 hrs) meaning they will be fully functional for a long time. Therefore a lower dosage is required hence lowering the cost of production even further. The type of formulation will also affect the antibiotic's strength/effectiveness; if they are injected they will be even more effective as they will reach the target area more quickly, through the blood stream. However the cost of production would be much higher and therefore this formulation may only be chosen in preference of the cheaper tablets in certain circumstances.
There are other similar competitive drugs on the market for example penicillins. However tetracyclines are normally chosen by preference. This may be due to the fact that fewer people are allergic to them, they have fewer side effects or because they are very broad spectrum antibiotics. Other pharmaceutical companies create competition for each other as they may produce the same drugs as each other or may produce cheaper alternatives that are just as effective. This creates lowering prices and can affect the economy of the companies. This can be prevented by patenting laws. When new drugs are discovered the pharmaceutical company will obtain a patent for this drug allowing them sole production rights. However, after a certain length of time these run out.
Development of new drugs is a very costly process but due to bacterial resistance, new antibiotics are always required. This may mean discovering new antibiotics or modifying existing ones to allow them to remain in use for longer. Antibiotics are an essential part of medicine and therefore play a major part in the economy.
有其他类似的竞争药物如青霉素类市场。然而，四环素类抗生素通常选择偏好。这可能是由于这样的事实，更少的人对他们过敏，他们有较少的副作用，或因为他们是非常广谱抗生素。其他制药公司为彼此创造竞争，因为他们可能会产生相同的药物，或可能会产生更便宜的替代品，是有效的。这造成了降低价格，并会影响公司的经济。这可以通过专利的法律阻止了。当新药被发现时，制药公司将获得这种药物的专利权，允许他们单独生产权利。然而，在一定的时间长度后，这些耗尽。
开发新的药物是一个非常昂贵的过程，但由于细菌耐药性，新的抗生素是必需的。这可能意味着发现新的抗生素或修改现有的，让他们保持在使用更长的时间。抗生素是医学的重要组成部分，因此在经济中起着重要的作用。
