BLOG: AzaSite lives! Thea revives a critical medicine
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Key takeaways:
- AzaSite is available again for meibomian gland dysfunction and MGD-associated evaporative dry eye disease.
- Thea has capped the cost of AzaSite at $60 per bottle.
Thar she blows! My name is Dr. Ahab, and my personal Moby Dick has finally surfaced off the port bow. After many, many months in a purgatory brought on by abysmal care and feeding provided by its prior owner, AzaSite is now available.
The good folks at Thea have plowed through the bureaucratic morass that is the FDA, and we can once again prescribe AzaSite for our patients who suffer from meibomian gland dysfunction (MGD) and MGD-associated evaporative dry eye disease (DED).
Phew!
It’s too painful to recount the Ulyssean journey my poor AzaSite has been on or my own quixotic quests to bring it to shore. Suffice it to say that it’s been the road trip from hell. Things are looking up, though. Not since Inspire, the original stewards of our noble beast, have we had a team as dedicated to making AzaSite available as the crew at Thea. I know, wouldn’t it be great if we could just send in a script and call it a day, but that’s not how our world works anymore. Realizing and accepting this, Thea has obtained the services of a newer specialty pharmacy to do much of the prior authorization grunt work. More importantly, if you take just a moment or two to work through Eagle Pharmacy, Thea has capped the cost of AzaSite at $60 per bottle.
For those of you too young or too traumatized to remember, AzaSite is a highly effective treatment for MGD/posterior blepharitis/evaporative DED. It is topical azithromycin in the DuraSite vehicle. The vehicle dramatically increases contact time with the ocular surface and lids. We start off with a loading dose every night at bedtime for 2 weeks and then slowly decrease the frequency. Once absorbed, azithromycin has an incredibly long retention time in the meibomian glands, which allows most patients to dose as infrequently as twice per week.
Azithromycin raises the melting point of the meibum and returns the altered lipids to their original, proper carbon chain structure. Cool science; pretty sure it was Gary Foulks’ work. These effects are due to the anti-inflammatory effects of the drug; MMP-9 levels typically go down after effective tissue levels are achieved. At the slit lamp, we see decreased telangiectasia on the lid margins, secretions that become clearer over time, and an increase in tear breakup times. All of which typically lead to happier patients. And for as long as it may last this time, a happier me!
So, if you’re looking for me, I’m off to find Ishmael. I hear he’s looking for a great white whale story with a happy ending.
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