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Biotech / Medical : Texas Biotech (TXB)

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To: scaram(o)uche who wrote (79)	3/3/1997 12:25:00 AM
From: Bharat H. Barai	of 834

Dear Richard and Nvestor I am not sure that it would be accurate to call Heparin induced Thrombocytopenia an allergic reaction. It is immune mediated reaction, generally seen in 2-5 days after Heparin and in graduated fashion. Since it is not an acute drop, doctor always has time to recognize the drop in platelet count and stop Heparin. In these days of managed care, it would be difficult to justify using Argatroban in every patient needing Heparin. I doubt that the company can put it in market at or near the price of regular Heparin, which is a generic product now. They can't recover their research and investment at that level. The FDA rule is little different than you stated on your post. FDA states that, once a drug is approved for interstate shipment, a physician may as part of his practice, prescribe the drug in a manner and dosage diffrent than the package insert, as long as he has scientific basis to support such use. THIS INFORMATION IS PRINTED IN PDR IN FRONT PAGES. Using Argatroban in everydoy would not be wrong except on cost basis. Argatroban does everything that Heparin does, with less side effects but more cost. Bharat H. Barai MD Hematologist

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