Could Grapefruit Juice Cut Drug Costs?
An enzyme that lives in the gut, charmingly named CYP3A4, breaks down drugs before they enter the bloodstream. So people with lots of CYP3A4 may have less medicine enter their blood than people who don’t have so much. Enter the grapefruit.
Grapefruit juice has a compound that temporarily gets rid of CYP3A4 — which allows more of a drug to enter the bloodstream. That can be a bad thing in some cases. Patients shouldn’t take statins (such as Pfizer’s Lipitor or Merck’s Zocor) with grapefruit juice, because doing so can cause the drug to build up to unhealthy levels in the body.
But, the WSJ reports, some researchers are now trying to use grapefruit juice to their advantage. A University of Chicago study is pairing grapefruit juice with rapamycin, which is sold by Wyeth as an immunosuppressant and is being studied to treat cancer. Normally, only about 14% of the drug is absorbed into the blood, but give it a bit of juice and the absorption rate increases several fold.
It’s too early to tell how far this sort of thing might go, and standardizing grapefruit juice as part of a drug regimen could be tricky. But some docs think the grapefruit effect could ultimately allow patients to take lower doses of drugs.
“Oral oncology therapies are costing $3,000 to $5,000 a month. So it’s almost like a new world when it comes to drugs costs,” Ezra Cohen, the University of Chicago oncologist studying rapamycin, told the WSJ. “If we can lower the costs of those by 50%, you’re talking about hundreds of millions of dollars saved.”
Posted by Jacob Goldstein, WSJ