This is estimated to cost the country over A$470 million for 4–5 years supply of the drug.Roche has agreed with Emcure in India to make an affordable version of this cancer drug available to the Indian market.Roche has changed the brand name of the drug and has re-introduced an affordable version of the same in the Indian market. The new drug named Herclon would cost approximately RS75,000 INR (US$1,200) in the Indian market.On September 16, 2014, Genentech notified hospitals in the United States that, as of October, trastuzumab could only be purchased through their selected specialty drugs distributors not through the usual general line wholesalers. By being forced to purchase through specialty pharmacies, hospitals lost rebates from the big wholesalers and the ability to negotiate cost-minus discounts with their wholesalers. Biosimilars
By 2014, around 20 companies, particularly from emerging markets, were developing biosimilar versions of trastuzumab
after Roche/Genentechs patents expired in 2014 in Europe, and in 2019 in the United States. In 2013, Roche/Genentech relinquished its patent right for the drug in India because of the difficult IP environment there.In January 2015, BIOCAD announced the first trastuzumab biosimilar approved by the Ministry of Health of the Russian Federation.
Cryoglobulinemic vasculitis is a form of inflammation affecting the blood vessels caused by the deposition of abnormal proteins called cryoglobulins in the blood vessels, in patients affected by mixed cryoglobulinemia (type 2 and 3), since simple or type 1 cryoglobulinemia does not cause complement activation (but a hyperviscosity syndrome only). Cryoglobulinemic vasculitis affects the skin and causes a rash in roughly 15% of people with detectable circulating cryoglobulin proteins. : 835  Additionally, the kidneys may be affected by this form of vasculitis resulting in membranoproliferative glomerulonephritis. Fevers, painful muscles and joints, and peripheral nerve damage are other common manifestations of cryoglobulinemic vasculitis. Due to deposition of complement (in particular, C4), low levels of circulating complement factors may be seen. See also
Cryoglobulinemia
Cutaneous small-vessel vasculitis
Skin lesion

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