Genzyme Corp. is working on several fronts to assure that its drug,Ceredase, with annual costs in excess of $150,000, remains availableto Gaucher's disease patients.

Genzyme is working closely with some of the 25,000 to 30,000patients with Gaucher's, a crippling bone disorder, to ensure thattheir insurers cover and reimburse Ceredase.

In addition, the Cambridge, Mass.-based company is backinglegislation in Congress that would prohibit health insurers fromimposing lifetime caps on the cost of health insurance claims. "Theproblem is that these patients are tapping out their lifetime benefits,"said Abby Myers, president of the National Organization for RareDisorders.

Myers said that Genzyme's problems may be just the first for manybiotech firms. "Biotech drug companies are going to have to dealwith managed care plans that may not want to cover a very expensivedrug that is not prevalent within the general population," she toldBioWorld Today.

Myers said the issue of consuming lifetime health insurance benefitshas driven some Gaucher's patients not to take the drug. "I haveheard of patients who refuse to take it," Myers said.

Myers also reported that several managed care plans administer lowerdosages in order to cuts costs. But Genzyme vice president BillAliski denied there has been any widespread changes in Ceredasedosing. Aliski said only 5 percent of Gaucher's patients on are thereduced regimen. He suggested that the reduction could be traced to aprotocol put forward by physicians at the Scripps Clinic, of La Jolla,Calif., who recommended that a patient be started on a lower dose ofCeredase than recommended by the manufacturer.

However, Aliski did confirm that Genzyme works closely withpatients to facilitate reimbursement.

While most companies' sales people work directly with pharmacistsand other physicians in charge of a managed care plan's formulary,Genzyme works directly with the physicians diagnosing and treatingGaucher's patients. "We call on the specialists who are involved withmanaged care networks."

"We explain the product to the physician along with details aboutdosage and other considerations. But the physician makes thedecision about whether to treat and what dose to use," said Aliski.

Genzyme representatives also work closely with a registry ofGaucher's patients, which includes about 650 patients. The companytracks each patient to make sure they receive specialized diagnostictests at tertiary care centers and follows them as they are treated bylocal physicians and hospitals.

A reimbursement hotline run by Genzyme works with patients andphysicians to navigate health insurance rules and regulations toobtain coverage and reimbursement. "We educate payers about howto over the treatment," Aliski said.

Genzyme Moves To Retire $100M In Debt

In other company news, Genzyme said it will begin redeemingconvertible subordinated notes totaling $100 million on March 21,1996.

The 6.75 percent notes were sold in October 1991 and were due infive years. In addition to saving $6.75 million in annual interestpayments, Genzyme officials said their long-term debt will bereduced to $26 million.

When the $1,000 notes were issued Genzyme's stock(NASDAQ:GENZ) was trading for $44.75 and they were convertibleto shares at $52.87.

In paying off the debt early, Genzyme offered to convert each note to18.9 shares of common stock plus 2.5 shares of Genzyme TissueRepair Division stock (NASDAQ:GENZL).

Based on the Friday closing prices of the two stocks _ GENZ at$74.50 and GENZL at $25.12 _ the holders would receive for each$1,000 note shares worth $1,437, which is how much cash they willget if they decline the stock swap.

Genzyme officials said they expect most note holders to convert toshares. If all of them did, the company would issue 1.89 millionGenzyme shares and 255,000 shares for Genzyme Tissue Repair. Theformer currently has 31 million shares outstanding and the latter 12million.

Genzyme ended the day Monday down $1 at $73.50. The TissueRepair Division stock was off 62 cents to $24.50. n

-- Michele L. Robinson, Washington Editor and Charles Craig

(c) 1997 American Health Consultants. All rights reserved.