Run on nicotine patches leaves smokers desperate Pharmacists forced to turn many away

April 13, 1992|By Jonathan Bor | Jonathan Bor,Staff Writer

In an article Monday about nicotine patches, The Sun #F incorrectly identified the makers of two of the patches. The article should have said Marion Merrell Dow makes Nicoderm and Ciba-Geigy makes Habitrol.

The Sun regrets the errors.

Pharmacists say they can't remember anything like the consumer clamor that has greeted the nicotine patch -- the latest hope for smokers desperate to quit.

So why isn't your neighborhood druggist smiling?

It's simple. A nationwide shortage of skin patches has forced many pharmacists to turn away customers who are quite willing to pay the hefty asking price, about $120 a month.


Many smokers eager to start therapy are trekking from one pharmacy to another in search of the patch. Imagine the frustration of the tobacco addict who stays smoke-free after going on the patch -- then cannot get resupplied when the original prescription runs out.

"I backslid," said Mrs. Terry Bacon, 66, of Baltimore County.

A smoker for 41 years, Mrs. Bacon said she stayed off cigarettes fora month after beginning therapy with Nicoderm, one of three brands on the market. When her pharmacist couldn't fill her next prescription, she found her craving too powerful too resist.

She smoked for four days until her drugstore was able to supply her with another brand, Habitrol. She admitted that after going back on the patch she "cheated" a cigarette or three before settling back into abstinence.

A West Coast wholesaler said the shortage is striking would-be quitters from California to Maryland. "It's terrible," he said. "They underestimated the market. They hit the newspapers, hit the TV with ads, and people just decided they wanted to quit smoking. The American people were looking for a convenient way to quit smoking, and now they can't make them [the patches] fast enough," he said.

Apparently chains are faring no better than corner drugstores: A pharmacist with the Giant Pharmacy chain reported last week that she had received no shipments of Nicoderm and Habitrol and only a paltry allotment of ProStep.

Some observers believe the shortage will ease when ProStep, the latest brand to be introduced, makes its mark. Pharmacists say they have plenty of ProStep in reserve, but many physicians are unfamiliar with the product because it was introduced just six weeks ago.

The nicotine patch works on a simple principle: It delivers the same addictive agent found in tobacco, freeing the smoker from the need to light up. By not smoking, the person doesn't inhale the cancer-causing agents that can kill.

Worn on the skin, the patch delivers a slow trickle of nicotine through the pores, ultimately satisfying the brain's craving for stimulation. The smoker -- in truth, an addict -- can gradually withdraw from nicotine by steadily tapering the dosage over the course of three months.

Mrs. Bacon said that so far, the patch has satisfied her craving for tobacco. While it has caused some minor skin irritation, her solution has been to put each day's patch in a different place on her arm or back.

Long-term success probably cannot be judged for years, most authorities agree. But a study of Nicoderm published in the Journal of the American Medical Association reported that one in four patients using the patch was still a non-smoker six months after starting therapy, compared with one in nine patients using a placebo.

The nicotine patch could qualify as the pharmaceutical success story of the year. Analysts estimate that the product could reap $1 billion in sales this year.

Trouble is, the demand is much higher than companies ever expected. Consequently, factories were not prepared to produce the patches fast enough.

"We're selling two to three times more than we expected," said Doug Arbesfeld, a spokesman for Ciba-Geigy of Summit, N.J., the maker of Nicoderm. "And we can sell even more, but we don't have enough." So far, he said, the company has sold $170 million worth of patches to wholesalers since December.

Recently, he said, the company ordered its plant in Basel, Switzerland, to increase production.

Likewise, Marion Merrell Dow of Kansas City, Mo., which estimates sales of $60 million so far from its sales of Habitrol, recently ordered its California plant to start turning out patches 24 hours a day, seven days a week. "Right after the New Year, there was almost an instantaneous influx of people wanting this product," said Tom Heapes, spokesman for Marion Merrell Dow. "This really started steamrolling."

While obviously pleased with the patch's popularity, Mr. Heapes said the company is well aware of consumer frustration.

"This time, the research came up short," he said. "We're most concerned with any people with interrupted therapy. We're asking pharmacists to be careful with their allotments to first fill // prescriptions of patients who are already on therapy."

Pharmacists say they often find themselves so strapped for thepatches that they cannot allocate them fairly.

Pat Finke, owner of the Medicine Shoppe in Parkville, said her most recent shipment last Tuesday contained no Nicoderm whatsoever, and only enough Habitrol to satisfy three patients with a two-week supply. "I will order six boxes on a given day, and I'll get one box in maybe two or three days," she said. "It's frustrating."

Spokesmen for Ciba-Geigy and Merrell Dow said they expect the shortage to ease in a few weeks, once the faster production schedule takes hold and more customers move to lower doses as they progress through therapy.

A fourth patch, by Parke-Davis of Mount Plains, N.J., awaits federal approval.

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