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Federal Shadow Minister for Health discusses delay in approval of a drug for the treatment of Parkinson's disease

PRU GOWARD: There are 30,000 Parkinson Disease sufferers in Australia. In the over-60s age group, one in 100 are sufferers of Parkinsons Disease. Now, the Australian Drug Evaluation Committee, according to the Federal Shadow Minister for Health, Dr Bob Woods, has delayed approval for the marketing of a new Parkinson's disease drug called L-depryl. It's most effective as an early onset, first-use drug for the treatment of Parkinson's disease, and overseas trials have shown it to be effective and safe.

Well, this morning, we're going to look at that issue with Dr Woods, and also with Collin Degotardi, who is one of the 30,000 Parkinson disease sufferers in Australia, and is also a medico. Now, L-depryl is also known as Depranyl, and Bob Woods joins me now.

Good morning. Dr Woods, what's your explanation for the delay in the release of this drug here?

BOB WOODS: I think it's inexplicable, basically. I mean, the only possible reason that I can see is that it's actually not a very cheap drug. It costs about $40 a week for patients, and that's the only possible reason because it's available in the States and the UK, in most Western European countries; in fact, in the UK, it's been available since the mid-70s. In the States, I mean, it's such a good drug that it's now .. the situation is that if you, as a neurologist, don't prescribe it for a Parkinsons patient, then you're liable to be sued. I mean, it's as cut and dried as that. In medicine, few things are that cut and dried, but this really does seem to be black and white.

PRU GOWARD: So, in other words, it's been approved and has been used in other countries for at least a decade. It was first put up for approval here, in 1984.

BOB WOODS: That's right.

PRU GOWARD: How many clinical trials have they done? What sort of assessment have the Australian Government authorities carried out?

BOB WOODS: Well, there's a whole range of clinical trials available. The best one is of 800 patients done in the United States, reported a couple of years ago, and it was used there to stop the disease from progressing. It's been used in other stages of the disease, but the important indication seems to be that if you give it to people when they first get Parkinsons, it stops the disease from getting worse as quickly as otherwise, and whereas normally you need to have other treatments for the symptoms after about a year from diagnosis, if you have the Depranyl drug, it looks like you get about two years or perhaps sometimes even more than that before you meet any symptoms. And one particular trial looked at 800 patients in the States. The difference was so conclusive that they actually had to stop the trial before it was finished.

PRU GOWARD: Right. Now, if you did have this drug release, and you've said it's an expensive one, what would the cost to the Australian Government be?

BOB WOODS: Well, it costs about $40 a week. There are about 30,000 Parkinson patients, but it's only really indicated for the patients when they first get the disease diagnosed; so, it'd be a much smaller number than that would need the drug. But against the costs of the drug, of course, you have to weigh up the savings, in as much as those people wouldn't be going into hospital. And every time you spend a day in hospital, it's $300. They wouldn't need the other drugs which are obviously not cheap as well. So, overall, the cost effectiveness of it is an arguable question, but, I mean, overwhelmingly the compassionate and humanitarian grounds of giving somebody an extra year of decent life, is basically overwhelming. There's no price you can put on that.

PRU GOWARD: Dr Bob Woods, thanks for your time this morning. The age-old debate - the price of good health. And joining me now is Dr Collin Degotardi, a former psychiatrist from Macquarie Street who's now retired, who realised he had the disease three years ago, and stopped working.

Dr Degotardi, good morning. What's your access to this drug been?

COLLIN DEGOTARDI: Well, an application had been made for it by my specialist but, in fact, it's been knocked back.

PRU GOWARD: But, do you travel overseas and get it overseas?

COLLIN DEGOTARDI: No, apparently you can't, because it's illegal to use it in Australia unless you've got approval.

PRU GOWARD: But when you go to the UK, for example, you can't stay there and use it there?

COLLIN DEGOTARDI: Oh, I could use it there, but it would be pointless unless it was continuous.

PRU GOWARD: Why do you feel that it's a drug for you?

COLLIN DEGOTARDI: Well, because it slows the progress of the disorder.

PRU GOWARD: Right. So, it's an early stage drug, as far as you're concerned?

COLLIN DEGOTARDI: Yes, that's right.

PRU GOWARD: Now, how much worse have you become in the time that you've been trying to get hold of Depranyl?

COLLIN DEGOTARDI: Well, I've only really had this disease confirmed six weeks ago. I've suspected it for some time, but I've been putting off going to .. too frightened to find out, actually.

PRU GOWARD: Yes, I guess it is alarming. So, you've only tried to get it for the last six weeks?


PRU GOWARD: And the answer at every stage has been `no'?

COLLIN DEGOTARDI: That's correct.

PRU GOWARD: What are your choices? What can you take if you don't take Depranyl? COLLIN DEGOTARDI: Well, any other drug I take has certain side-effects, and this one, I believe, has less trouble.

PRU GOWARD: And can the other drugs, the drugs that you're taking now, slow down the onset of the disease?

COLLIN DEGOTARDI: Well, I've been advised not take them. I've been advised it's better to leave it until it's more advanced for the other drugs, and it's better to use this L-depryl to stop the progress.

PRU GOWARD: Oh, I see. What a terrible dilemma for you.


PRU GOWARD: Dr Degotardi, thank you very much for joining us this morning. Well, good luck with that battle. It's a very expensive one.