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BLOG: AzaSite: AWOL again
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Man, I’m thinking it’s time for an intervention. Or some kind of therapy. You know, “Hi, I’m Darrell, and I prescribe AzaSite.” Something has to change. It’s as if I’m in some sort of really bad relationship. Every time it seems like we’ve worked out our issues and figured out how we can live together, something comes between us.
To review, AzaSite is topical azithromycin delivered in a DuraSite vehicle. It is FDA approved for the treatment of bacterial conjunctivitis (for which it is highly effective and very convenient for the patient), an indication that comprises roughly, oh, 5% of prescriptions written. After Foulks published data showing that AzaSite reduced the melting point of meibomian gland secretion and normalized the carbon chain structure of the lipids in meibum, the dry eye community started to prescribe AzaSite for the treatment of meibomian gland disease and evaporative dry eye. Unless your patient is allergic to the preservative, it actually works very, very well.
Then things got interesting.
AzaSite was brought to market by the late, sorely missed Inspire. Edgy only begins to describe the marketing of AzaSite, but it definitely got the word out that it worked for many cases of evaporative DED and posterior blepharitis. Sadly, Inspire’s next drug missed its phase 3 endpoints, resulting in the fire sale of the company to Merck. You remember Merck, right? It changed the world with the introduction of Timoptic in the 80s, followed by Trusopt, Cosopt and later Zioptan. It added AzaSite to its quiver (along with some residual Inspire ill will with the FDA), then sold the whole shebang to Akorn as it exited eye care.
Still with me? I have lauded Akorn for stepping to the plate and eventually supporting AzaSite (Eagle specialty pharmacy, bigger bottle, etc). Just when I got comfortable and started prescribing more, the German company Fresenius bought Akorn. Fresenius has now unearthed some sort of manufacturing issue with AzaSite that will effectively take it off the market until mid-July at the earliest. To make matters even worse, after taking control of Akorn and jettisoning approximately 80% of Akorn’s employees Fresenius is now trying to back out of the takeover deal! Once again I will be forced to a) make due with inferior treatment and b) fall on my sword and explain that it’s not my fault.
You know that perfect restaurant spot in your city where you loved every restaurant ever opened there right up until the minute each one of them failed? Yah, it’s like that with AzaSite.
Disclosure: White reports he is a consultant to Allergan, Shire, Sun, Kala, Ocular Science, Rendia, TearLab, Eyevance and Omeros; is a speaker for Shire, Allergan, Omeros and Sun; and has an ownership interest in Ocular Science and Eyevance.