Why Isn't Topical Finasteride/Dutasteride More Popular?

[Melvin-Moderator 3,710]

There was a thread started not too long ago asking why topical finasteride isn't sold by big pharmaceutical companies, but had me thinking. Why isn't topical finasteride more popular. Given how effective it has shown to be on limited studies, there should be a huge demand and a lot of outlets selling topical finasteride. What do you guys think? Would love to hear the communities input. 

Why Isn't Topical Finasteride and Dutasteride More Popular?

[Gatsby 520]

A brilliant question Melvin and I'm a little stunned as to why it's not far more readily available. Also I stagger to imagine how many hair transplant candidates would consider a transplant if it were more accessible (like finasteride). Not to mention the benefit for those who have had a hair transplant.

[shami26 9]

I agree. Topical fin should be more accessible and affordable. It shouldn't cost $70 a month either.

[Melvin-Moderator 3,710]

11 hours ago, Gatsby said:

A brilliant question Melvin and I'm a little stunned as to why it's not far more readily available. Also I stagger to imagine how many hair transplant candidates would consider a transplant if it were more accessible (like finasteride). Not to mention the benefit for those who have had a hair transplant.

If only there were a legit pharmacy willing to compound it for cheap. 

[Melvin-Moderator 3,710]

2 hours ago, shami26 said:

I agree. Topical fin should be more accessible and affordable. It shouldn't cost $70 a month either.

0.25 costs $100 which is insane.

[Rocketman1 5]

In Europe - I think it's because it is not a "free" medication which you can simply buy in the pharmacy like Ibuprofen. You need to go to a DOC and get a receipt for it in order to get it. That's why there is no possibility to make commercial advertisement for it like regaine/rogaine and so on...

[ciaus 280]

11 hours ago, Gatsby said:

A brilliant question Melvin and I'm a little stunned as to why it's not far more readily available. Also I stagger to imagine how many hair transplant candidates would consider a transplant if it were more accessible (like finasteride). Not to mention the benefit for those who have had a hair transplant.

 

We can't underestimate how a loud minority, mingled with some trolls, can make problems, and financial opportunities, appear orders of magnitude larger than they actually are. Its true in real life and even more so online. The problem right out of the gate for anyone to make a business of this is trying to develop strategy and allocate resources based on online forums and other anti-finasteride rabbit holes.

 

The reasons I think the topicals will never go mainstream is

-the very low incidence of side effects with the oral pill

-millions already taking the pill year after year

-the pill is very cheap

-human behavior/psychology: we crave convenience, tend toward being lazy, and would thus prefer to pop a pill rather than mess with slathering a liquid all over our heads every day.

 

I think topical formula operations can be successful, but they'll be small and have to continually calibrate their resources to stay profitable, accounting for variables like guys just 'easing' their way into taking the pill.

 

https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/020788s020s021s023lbl.pdf

 

https://clincalc.com/DrugStats/Drugs/Finasteride

 

[bald-and-bearded 1]

Good article @Melvin-Moderator.

Speaking of business opportunity, if it's too tiny for big pharma, I think this is something transplant surgeons should take interest in. If it means they have a greater adherence rate from their patients and therefore better results and potentially lesser real or nocebo side effects, then it would mean better business for surgeons. My doctor told me how frequently he has to refuse to operate on young patients who refuse to take oral Finasteride, so that is a business opportunity for sure.

I only hope there is agreement between reputed surgeons and an established protocol to administer and monitor such a topical product.

[Melvin-Moderator 3,710]

2 hours ago, bald-and-bearded said:

Good article @Melvin-Moderator.

Speaking of business opportunity, if it's too tiny for big pharma, I think this is something transplant surgeons should take interest in. If it means they have a greater adherence rate from their patients and therefore better results and potentially lesser real or nocebo side effects, then it would mean better business for surgeons. My doctor told me how frequently he has to refuse to operate on young patients who refuse to take oral Finasteride, so that is a business opportunity for sure.

I only hope there is agreement between reputed surgeons and an established protocol to administer and monitor such a topical product.

The issue is that the cost to compound it is expensive. Plus shipping costs, customer service. It’s not worth it in my opinion. Unless, it can be compounded at a reasonable cost.

[Dr. Suhail Khokhar 244]

2 hours ago, bald-and-bearded said:

Good article @Melvin-Moderator.

Speaking of business opportunity, if it's too tiny for big pharma, I think this is something transplant surgeons should take interest in. If it means they have a greater adherence rate from their patients and therefore better results and potentially lesser real or nocebo side effects, then it would mean better business for surgeons. My doctor told me how frequently he has to refuse to operate on young patients who refuse to take oral Finasteride, so that is a business opportunity for sure.

I only hope there is agreement between reputed surgeons and an established protocol to administer and monitor such a topical product.

It's a LOT of work that goes into finding a trustworthy compounding pharmacy that can do this for a reasonable price. The other issue is you need to have a critical mass of patients who would want to buy this product in order for it to be fruitful for the surgeon to invest so much time/money into this endeavor. This isn't to mention the shipping/handling, storage costs, customer service issues, dealing with fraud from vendors and patients, etc.

 I am currently trying to find a trustworthy compounding pharmacy to do this. The compounding pharmacies in the US charge so much that it's not even worth it. I can give you the fee schedule that they sent me to give you guys an idea, if you're interested.

[Melvin-Moderator 3,710]

43 minutes ago, Dr. Suhail Khokhar said:

It's a LOT of work that goes into finding a trustworthy compounding pharmacy that can do this for a reasonable price. The other issue is you need to have a critical mass of patients who would want to buy this product in order for it to be fruitful for the surgeon to invest so much time/money into this endeavor. This isn't to mention the shipping/handling, storage costs, customer service issues, dealing with fraud from vendors and patients, etc.

 I am currently trying to find a trustworthy compounding pharmacy to do this. The compounding pharmacies in the US charge so much that it's not even worth it. I can give you the fee schedule that they sent me to give you guys an idea, if you're interested.

Yes please post it. I was going to, but didn’t since I thought it would come from you. In my opinion, you’d have to get it compounded out of the US. Perhaps, Europe or South America. 

[Deanomag 16]

Is it not possible do crush the pills and mix with a cream/oil that absorbs into skin ?? 
I stopped taking fin not long ago but would be interested in topical as the side effects would be minimised ? 

[Dr. Suhail Khokhar 244]

7 hours ago, Melvin-Moderator said:

Yes please post it. I was going to, but didn’t since I thought it would come from you. In my opinion, you’d have to get it compounded out of the US. Perhaps, Europe or South America. 

Here is the fee schedule for different compositions of finasteride/minoxidil that I received from a very reputable US compounding pharmacy. As you can see, it's cost prohibitive to do this in the US. I'm looking at some reputable foreign compounding pharmacies to see if they have better pricing. Before I give these to my patients, I would obviously check to see if the composition is legit by working with a US based biochemistry group. 

[Melvin-Moderator 3,710]

5 hours ago, Deanomag said:

Is it not possible do crush the pills and mix with a cream/oil that absorbs into skin ?? 
I stopped taking fin not long ago but would be interested in topical as the side effects would be minimised ? 

I don’t think it works that way, it needs to be synthesized with a good vehicle for absorption. But I’m no doctor lol. @Dr. Suhail Khokhar? 

[bald-and-bearded 1]

There was another thread on a similar topic about some topical product from India. I tagged Dr. Suhail on there. Is it necessary to have minoxidil mixed with Finasteride?

[Dr. Suhail Khokhar 244]

5 hours ago, bald-and-bearded said:

There was another thread on a similar topic about some topical product from India. I tagged Dr. Suhail on there. Is it necessary to have minoxidil mixed with Finasteride?

No, you don't need both in the same solution. It just makes it easier and more convenient though to have both 

[bald-and-bearded 1]

6 hours ago, Dr. Suhail Khokhar said:

No, you don't need both in the same solution. It just makes it easier and more convenient though to have both 

If not minoxidil, what is the simplest thing to mix Finasteride with so that it gets absorbed through the skin?