Napo pharmaceuticals is going a very different route to hopefully making first-world drug profits from the third-world. Their new approach means skipping the first-world entirely and going straight for those in the third-world that need it most.
The company has created a drug called Crofelemer which is used to treat chronic diarrhea. Crofelemer is unique in how it was created, and how it works. Born out of the research of Shaman Pharmaceuticals, a company which went bankrupt in 2001, Crofelemer has its roots in a South American tree called croton lechleri. Natives used an extract made from the tree to treat diarrhea. The extract itself can cause sickness if it is given in doses that are too high, but Shaman researchers isolated a compound that could be given in higher doses.
Crofelemer is unique in how it works because traditional anti-diarrhea medications like Lomotil and Loperamide decrease bowel motility, and are absorbed by the bloodstream. Crofelemer works locally, only in the gut, to stop the flow of “excess” water. (I use the term “excess” loosely because the water often lost in diarrhea cannot afford to be lost, and isn’t actually “excess” in the traditional sense of the word.)
This different mechanism of action is fantastic news for children whose immune systems haven’t fully developed, and AIDS patients whose immune systems are compromised: traditional anti-motility drugs can’t be used by either population because of their decreased immune response: allowing pathogens to linger longer in the GI tract can allow them to grow and infect the gut more than simply excreting them out. Crofelemer is unique because it doesn’t prevent bowel movements, it simply prevents diarrhea.
This drug discovered in the third world also has the greatest potential there: millions of children die every year from chronic diarrhea, and diarrhea can weaken those patients already dealing with AIDS, leading to quicker, higher mortality rates for that disease as well.
Aside from their drug being unique, Napo’s approach to making profits on Crofelemer is unique as well. The traditional model for creating profitable drugs is based on a first-world clientele: create a drug, and keep its prices high until the patent(s) expire to make up for the cost of bringing the drug to market. (Which can often reach and exceed half a billion dollars.) Napo, however, is skipping the first world and going right for the third world where the largest need and potential customer base is.
Napo, in a way, is the Henry Ford of pharmaceutical companies: they’re marketing to the huge masses of the third world, a drug that fills a very basic need, banking on moving huge quantities of the drug to create decent profit margins, as opposed to creating products with sky-high prices to sell to small, rich populations like that which exists in the United States. While Napo plans to bring Crofelemer to the US at some point, it is not its primary focus.
Should Crofelemer become profitable (and I see no great reason it shouldn’t be), I would expect some of the huge pharmaceutical companies in the US to take notice, and perhaps change their game. If drugs that fill basic needs should prove to be as profitable the ever-popular (and relatively trivial) lifestyle drugs, I could see a shift in research paradigms and a sudden focus on the huge population that makes up the third world. This can only be a good thing for those too poor to afford basic life-saving medications which are currently too costly for their governments to afford.
Napo has the potential to positively affect millions of people, and perhaps even turn the pharmaceutical industry on its head. Lifestyle drugs have their place, but currently most of the research emphasis is on these drugs because this is where the greatest profit margins are. Napo has a chance to show the world that money can be made by filling basic needs, instead of just catering to those with the deepest pockets.