Pharmaceutical Technologist - September/October 2008 - (Page 17)

Pharmaceutical advertising of Gleevec in both early- and late-phase chronic leukemia patients.2 While Gleevec was originally designed to treat leukemia, it soon became apparent that it was also effective in treating a rare form of stomach cancer called gastrointestinal stromal tumours (GIST). In 2002, Gleevec was approved in the US for the treatment of GIST. It was quickly deemed a miracle drug, but it wasn’t until 21 months later that NICE finally authorized the use of Gleevec for UK victims of the disease. IQWiG appears to be similarly set on keeping costs down. The German agency has promoted an “efficiency frontier” as its governing methodology for evaluating treatments, but this seems to be nothing but smoke and mirrors designed to cover the government’s preference for established — and generally less expensive — treatments. For example, through its system of reference pricing, the German government has demonstrated bias against innovative — and often more expensive — drugs. German health officials divide drugs into classes based on the conditions they treat and then set the reimbursement rate for all drugs in a particular class at the average price of those drugs. Naturally, such an average price means that generic drugs are more expensive than they otherwise would be, while innovative new drugs in a class that may be more effective are less expensive than the market would ordinarily dictate. If IqWIG gains the authority to use cost-benefit analyses — as the “efficiency frontier” principle does — in its evaluate of drugs, the agency would effectively control which drugs are prescribed by doctors. If the government will only reimburse patients for certain, “cost-effective” drugs, prescribing habits will quickly fall in line. And patients’ individual needs will be shoved aside. By decreeing the most cost-effective option in a given treatment category, these agencies effectively determine what a doctor must prescribe, irrespective of a patient’s individual characteristics. By allowing pharmaceutical companies to provide Europeans with medical information, they could serve as a counterbalance to state-run comparative effectiveness agencies. Indeed, a great deal of evidence demonstrates that consumers benefit when drug manufacturers participate in healthcare decision-making. In the US, for example, a 2002 study by FDA found that direct-to-consumer advertising of pharmaceuticals improved both patient–doctor discussions and compliance with physician recommendations. The study also found that 88% of patients who asked about a specific drug were afflicted with the condition in question.3 A 2003 study in Health Affairs, (a US health policy journal) arrived at a similar conclusion. According to the study, ad-inspired doctor visits resulted in the advertised medicine being prescribed only 47% of the time.4 Put another way, patients didn’t receive a prescription for the medicine they came in to discuss on more than half their visits. So even with advertising, doctors exert an appropriate level of judgment when they prescribe drugs. On other occasions, according to the study, previously undiagnosed medical conditions were treated. For European bureaucrats, there is reason for concern. If consumers are able to gain additional information on pharmaceutical options thanks to direct-to-consumer efforts, there’s a good chance they’ll start asking their state-run health systems why they don’t have access to certain treatments. However, European Parliament member Jorgo Chatzimarkakis recently argued: “Citizens cannot be deprived of information by their own governments on such crucial issues as one’s health.”5 Government-run systems have demonstrated that they’re not interested in spending more money.6–8 Armed with new information on their medical options, consumers may be able to make the case with their leaders that the healthcare status quo of rationed, controlled care will no longer suffice. PT these agencies effectively determine what a doctor must prescribe, irrespective of a patient’s individual characteristics. References 1. www.cmpi.org/PDFs/Reports/ healthinformation.pdf 2. www.oncolink.upenn.edu/resources/ article.cfm?c=3&s=8&ss=23&id=8397& month=05&year=2002 3. www.fda.gov/cder/ddmac/ Final%20Report/FRfinal111904.pdf 4. http://content.healthaffairs.org/cgi/ content/full/hlthaff.w3.104v1/DC1 5. www.euractiv.com/en/health/ governments-right-cut-patientsinformation/article-158177 6. www.fda.gov/cder/ddmac/ Final%20Report/FRfinal111904.pdf 7. www.walesonline.co.uk/news/ health-news/2008/09/10/daughter-sdesperate-plea-for-dad-s-cancer-drug91466-21715733 8. - http://news.bbc.co.uk/nolpda/ifs_news/ hi/newsid_7362000/7362989.stm Peter Pitts is President of the Center for Medicine in the Public Interest (NY, USA). On the go ● ● ● The European Commission has decided to allow pharmaceutical companies to provide information regarding their products on the internet, in print and over the airways. Comparative effectiveness agencies operated by the government appear to have an interest in keeping costs down and generally prefer cheaper treatments. Direct-to-consumer advertising could provide patients with alternative treatment options and encourage them to question state-run health systems as to why they don’t have access to certain treatments. www.ptemagazine.com 17 http://www.cmpi.org/PDFs/Reports/healthinformation.pdf http://www.cmpi.org/PDFs/Reports/healthinformation.pdf http://www.oncolink.upenn.edu/resources/article.cfm?c=3&s=8&ss=23&id=8397&month=05&year=2002 http://www.oncolink.upenn.edu/resources/article.cfm?c=3&s=8&ss=23&id=8397&month=05&year=2002 http://www.oncolink.upenn.edu/resources/article.cfm?c=3&s=8&ss=23&id=8397&month=05&year=2002 http://www.fda.gov/cder/ddmac/Final%20Report/FRfinal111904.pdf http://www.fda.gov/cder/ddmac/Final%20Report/FRfinal111904.pdf http://content.healthaffairs.org/cgi/content/full/hlthaff.w3.104v1/DC1 http://content.healthaffairs.org/cgi/content/full/hlthaff.w3.104v1/DC1 http://www.euractiv.com/en/health/governments-right-cut-patients-information/article-158177 http://www.euractiv.com/en/health/governments-right-cut-patients-information/article-158177 http://www.euractiv.com/en/health/governments-right-cut-patients-information/article-158177 http://www.fda.gov/cder/ddmac/Final%20Report/FRfinal111904.pdf http://www.fda.gov/cder/ddmac/Final%20Report/FRfinal111904.pdf http://www.walesonline.co.uk/news/health-news/2008/09/10/daughter-s-desperate-plea-for-dad-s-cancer-drug-91466-21715733 http://www.walesonline.co.uk/news/health-news/2008/09/10/daughter-s-desperate-plea-for-dad-s-cancer-drug-91466-21715733 http://www.walesonline.co.uk/news/health-news/2008/09/10/daughter-s-desperate-plea-for-dad-s-cancer-drug-91466-21715733 http://www.walesonline.co.uk/news/health-news/2008/09/10/daughter-s-desperate-plea-for-dad-s-cancer-drug-91466-21715733 http://news.bbc.co.uk/nolpda/ifs_news/hi/newsid_7362000/7362989.stm http://news.bbc.co.uk/nolpda/ifs_news/hi/newsid_7362000/7362989.stm http://www.ptemagazine.com

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Pharmaceutical Technologist - September/October 2008 Contents Industry Highlights Morpheus Market Watch Smoke and Mirrors Reducing Data Burdens Keeping it Simple Bringing Pharma Up to Date

Pharmaceutical Technologist - September/October 2008

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