Many pets with Lyme disease are not getting adequate treatment because of a persistent, but unnecessary, doxycycline price hike. The US Food and Drug Administration declared a shortage of the Lyme disease antibiotic last year after a number of manufacturers were forced to cut production.
Those drugmakers with products still on the market took the chance to increase prices, some by over 6,000% but prices haven’t gone down now the shortage has ended, leaving dogs, cats, and other animals priced out of treatment.
Doxycyline is a first-line antibiotic used to treat infection with Lyme disease bacteria. It is considered safe for humans and animals and is often used for management of canine borreliosis (i.e. dogs with Lyme disease). Doxycycline is also used to treat malaria and some sexually transmitted infections, as well as for anaplasmosis, another tick-borne infection.
Why Doxycycline Prices are High
The rise in Lyme disease cases last year as well as an increase in anaplasmosis cases in people and their pets, combined with the sudden cut in production from several drugmakers led to the generic antibiotic being in short supply but high demand. Drug manufacturers like Jordan-based Hikma took the opportunity to raise prices and increase their revenue. The price of a 100mg dose went up some 6,351% between November 2012 and November 2013, while the 50mg capsules increased in price by 2,138%. Prices remain high even though many manufacturers are once again producing doxycycline.
Those without pet insurance were particularly hard hit and those with animals such as horses, who require around 50 times the dose needed by humans, are finding it impossible to justify the expense. For some horses six bottles or more of the antibiotic (at $400 each) may be needed for a month-long treatment regime. Less expensive antibiotics are available but the price difference is negligible and they may be needed for longer as they are not always as effective as doxycycline.
Compounding Pharmacy Horse Deaths
In addition to concerns over pricing, there have also been a number of deaths of animals who have been treated with drugs from compounding pharmacies. This cheaper option which involves the pharmacy making the drug themselves from raw materials has, therefore, become less attractive due to safety concerns. Doxycycline is no longer on the FDA’s list of drug shortages but remains on the shortage list produced by the American Society of Health-System Pharmacists.
It is unclear why drugmakers are not producing as much doxycycline as before but some suspect problems obtaining raw materials or adhering to regulations regarding drug manufacture. In the meantime, humans and their companion animals may be offered treatment for Lyme disease and co-infections with tetracycline (also in short supply), minocycline, or another generic antibiotic.