Pasireotide/Signafor

Discussion in 'Acromegaly / IAA / Cushings Cats' started by MJW, Feb 6, 2018.

  1. MJW

    MJW Well-Known Member

    Joined:
    Mar 29, 2017
    I thought I would put some links and other information here for Signafor/Pasireotide.

    RVC short acting pasireotide paper: PMC4895359

    RVC long acting pasireotide paper: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5354018

    Signafor (short acting) package insert:
    https://www.pharma.us.novartis.com/sites/www.pharma.us.novartis.com/files/signifor.pdf

    Signafor LAR (long acting) package insert:
    https://www.pharma.us.novartis.com/sites/www.pharma.us.novartis.com/files/signifor_lar.pdf

    Signafor (short acting) comes in human packages of 60 1ml single use glass ampules: 0.3mg or 0.6mg or 0.9mg.
    (Short acting RVC paper dosed .03mg/kg twice a day)
    Signafor LAR comes for humans as a powder plus a syringe containing diluent to be mixed at time of injection: 20mg or 40mg or 60mg.
    (Long acting RVC paper dosed 8mg/kg once a month or 28 days)
    The posted price is not a function of the #mg.
    For humans, these packages are a month's dose (28 days).

    I called my local CVS pharmacy for information. They gave me the number of the CVS Specialty pharmacy, which gave me the number of Accredo.com.

    Accredo would not give me pricing information without a prescription.
    GoodRx.com lists the cheapest discounted Signifor price for a month's human dose at Walmart as $12,567.45 or $13,421.90.
    (It's a bit confusing because I don't think CVS or Walmart etc. actually carry either drug.)
    It lists a 1 month human dose of Signifor LAR without pharmacy reference at $12,858.95.
    There are some special deals for US residents who can't afford it. I doubt cats are eligible, but I haven't yet asked.

    The short acting Signafor feline test used .03mg/kg, or .03mg*.45kg/lb*10lbs=.135mg twice a day for a 10lb cat.
    If the glass ampules can be drawn from more than once, a package of the .90mg/ml ampules would last:
    60*.90/2/.135=200 days
    Using the lowest price, that would be 12,567.45/200=$62.84 a day or $22,935 a year or $1911 a month.

    The long acting Signafor LAR feline test used 8mg/kg, or 8mg*.45kg/lb*10lbs=36mg once a month for a 10lb cat.
    If the powder and diluent can be divided up for a cat, a package of the 60mg powder would last
    60/36=1.7 months or $7715 a month. What???

    A median human dose of the short acting Signafor would be 2*.60mg=1.20mg per day.
    A 10 lb cat's dose would be 2*.03*.45*10=.27mg a day.
    Ratio human dose to cat dose=4.44.

    A median human dose of the long acting Signafor LAR would be 40mg a month.
    A 10 lb cat's dose would be 8*.45*10=36mg a month.
    Ratio human to cat=1.11.

    How could a cat need almost as much as a human?
    @Wendy&Neko suggested maybe this is due to the high metabolic rate of felines.
    I'd prefer to believe there is a dosing typo in the paper, but that seems unlikely.
     
    Wendy&Neko likes this.
  2. JeffJ

    JeffJ Well-Known Member

    Joined:
    Jul 7, 2016
    Good writeup. Apparently this is only for people who are rich!
     
  3. MJW

    MJW Well-Known Member

    Joined:
    Mar 29, 2017
    I contacted the special Signafor (Pasireotide) team at accredo.com at 888-454-8860.
    The prices they quoted to me were slightly higher than what I posted above.
    They told me I would get the best price by having my vet purchase it wholesale.
     
  4. MJW

    MJW Well-Known Member

    Joined:
    Mar 29, 2017
    I got an update from RVC about dosing for short acting pasireotide.
    See post #163 in the cabergoline discussion.

    "Pasireotide is a very effective treatment in the patients I have used it in, and I used a dose of 0.03mg/kg once daily by subcutaneous injection of the short-acting preparation of pasireotide."

    Since it is once daily instead of twice daily as in the published abstract, it cuts the estimated price of pasireotide treatment I posted above in half.
    Maybe it would be about $1000 a month.
     
    Wendy&Neko and JeffJ like this.

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