# Synthesis cost of Fomepizole

Fomepizole is essential drug for methanol poisoning, I observed it cost too much like in 1000's of dollar for couple of ml. Is cost due to patents, or due to synthesis cost,structure of molecule looks very small and easy, then why so much difficulty in synthesizing molecule ?

• It's not a matter of synthesis, so it seems borderline off-topic as it's about economics of pharmacy. Sep 29 '20 at 21:27
• its also about synthesis cost with purity enough for human use also. If someone make clear that it is relatively cheap to get high purity product, i guess one will get it in black market Sep 29 '20 at 21:46

## 1 Answer

Interesting that the cost in the US for the USDA-approved form is US$900 per 1.5 ml IV ampule. (Specific gravity is given as ~1, i.e. 1.5 g per ampule). That chemical, 4-methylpyrazole, "For Research Use Only. Not Intended for Diagnostic or Therapeutic Use.", is available for US$74 per g .

So if standard use is 1.5 ml, then the research-grade chemical would cost ~US\$130 per dose. Is the difference in cost due to difficulty in removing toxic substances from the research grade drug? Is the cost due to licensing fees, set to make a profit and to recover the cost of testing efficacy and safety?

As a side note, ethanol therapy is often used for alcohol dehydrogenase inhibition, to slow metabolism of methanol to formaldehyde, because, "fomepizole is more expensive than ethanol, and its use in pediatrics is off-label." Твоё здоровье!

• How many companies hold a product licence for it? I suspect that the answer may be as low as 1. What are worldwide sales of the therapeutic material? I suspect not enough to support several companies holding a licence. Sep 29 '20 at 21:16
• The WHO list (page 10) mentions it as sulfate (5 mg/mL á 20 mL) so it is not the pure stuff used (4 injections with 10 mg/kg body weight, apparently) while the German edition mentions as disadvantage the high price, 945 € for 5 × 20 mL). Among the 250 hits on EPO's esp@cenet with «fomepizole» as key, some try to improve the original formulation by Jazz Inc. (USA) already freezing around 20...24 C. Sep 29 '20 at 22:01
• as described in patent WO2009117166A2, for example. Sep 29 '20 at 22:04