There has been a discussion in the Netherlands about expensive medicine for rare illnesses. One solution mentioned in the discussion is to allow the pharmacy to replicate the drug in question. I do not expect an in-dept explanation as my knowledge of chemistry and medicine is very basic.

The Drug in question is called "Orkambi" and costs about €170k a year for each patient.

I want to know more how you could replicate the drug. I'm familiar with electronics reverse engineering, do the same principals work for chemistry?

My question is: How hard is it to replicate a drug like Orkambi? If it is not hard or expensive to replicate, what makes the drug expensive?

Background article: https://www.nrc.nl/nieuws/2017/11/22/kamer-bekijk-of-apotheek-medicijn-zelf-kan-namaken-14155346-a1582124

Please use a online translation service as the article is in Dutch.

  • 1
    Orkambi is simply a combination of two other drugs, which would be easy to replicate by simply taking both drugs individually in the same dosage as used in Orkambi. The trouble is, one of those drugs (Ivacaftor) is extraordinarily expensive, which is why Orkambi is expensive. So no, a pharmacy can't solve this.
    – Carey Gregory
    Commented Feb 9, 2018 at 18:49
  • Thank you for the explanation, it's good enough as an answer. I was actually expecting the pharmacy to do the chemistry similar to NurdRage's Pyrimethamine videos.
    – user12909
    Commented Feb 9, 2018 at 19:15

1 Answer 1


The problem is a copyright issue for the synthesis of ivacaftor. It's an organic compound, not a biologic, so within reach of any decent pharmaceutical company. A new efficient method is described here http://onlinelibrary.wiley.com/doi/10.1002/jhet.2931/full but that's not going to help if it breaks laws. And we're talking big money.

The Cystic Fibrosis Foundation, a non-profit organization dedicated to improving healthcare for people with cystic fibrosis, provided $150 million of the funding for the development for ivacaftor in exchange for royalty rights in the event that the drug was successfully developed and commercialized. In 2014, the Foundation sold these royalty rights for $3.3 billion. The Foundation has stated that it intends to spend these funds in support of further research



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