Have you seen the film Dallas Buyers Club? It is one of the movies that haunt me and keeps coming back to me in my thoughts and dreams. I now know why.
Dallas Buyers Club is a 2013 American biographical drama about a patient diagnosed with AIDS in the mid-1980s when there were no licensed treatments for HIV. It was in an era when HIV infection was highly stigmatizing. Out of desperation, the main character Ron Woodroof, brilliantly played by an anorexic-looking Matthew McConaughey, establishes the Dallas Buyers Club, to smuggle unapproved pharmaceutical drugs into Texas for treating his symptoms and starts distributing them to fellow people with AIDS. As a result, he faces massive opposition from the Food and Drug Administration (FDA) and most sectors of the medical establishment. The movie is a monument to the human spirit and our desire to live and be treated as equals.
McConaughey and Jared Leto, who played Rayon a transgender AIDS patient, received the Academy awards for Best Actor and for Best Supporting Actor, respectively in the film. The film also won the Academy Award for Best Makeup and Hairstyling and was nominated for Best Picture, Best Original Screenplay, and Best Editing.
If you haven’t seen the film it is a must, but be warned you won’t finish seeing the movie without shedding a tear.
So what has it got to do with MS? In the latest BMJ, there is an article on Buyers Clubs in general. They are now quite common in the UK and have evolved out of the desperation of patients and their families to access treatments for many conditions where there is a current lack of access to specific medications under the NHS. Interestingly, the London gay community have set-up a buyers club to purchase pre-exposure prophylaxis or PREP to prevent themselves from becoming infected with HIV. There is nothing like the gay community to show us how health activism should be done.
Could buyers clubs be the solution for people with MS to access high-cost DMTs in resource-poor countries? Are there any local MS Champions in Kenya, Tanzania, Uganda, Zambia, etc. who are interested in setting-up a buyers club? We could explore the logistics and cost of purchasing generic equivalents of high-cost DMTs and biosimilars and shipping them into areas of greatest need. I am sure we could find some philanthropic neurologists in these areas who we be able to screen, monitor and look after these people with MS who need treatment? One successful buyer’s club could become a template on how to clone and reproduce them across the world.
Buyers clubs could even become a way of improving access to DMTs in middle-income countries with inadequate socialist healthcare systems; for example, many people with MS in Eastern Europe can’t access DMTs or have limited access to newer generation high-efficacy DMTs.
Do you think buyers clubs will address the problem of access to DMTs in resource-poor environments? Let us know your thoughts.
If you are interested in helping address the issue of lack of access to MS DMTs in resource-poor countries and environments post please sign-up to our Grass Roots Off-Label DMT Initiative (GROLDI).