What's happening to money?

[L00b]

How dare they push their drugs into doctors surgeries and manipulate their practice and amount of perceptions they issue, all for profit!

Any evidence for that sort of defamatory allegation?

[milquetoast1]

Any evidence for that sort of defamatory allegation?

 

Well there was that documentary where a doctor had to go on the run after his wife was killed by that one-armed man working for big-pharma, and he then uncovered precisely the sort of malpractice Bonzo77 is talking about.

[El Cid]

To save a little girl's life, one 12 month course of readily available treatment (medication) will cost £353,000.

 

 

Without reading any details, I would guess that the girl is getting treatment almost as good, that costs less than £353k

[Anna B]

Interesting story in today's DM. It regards the Royal National Institute for the Blind, (RNIB) backing of a drug for Macular Degeneration, (an eye disease which leads to blindness) called Lucentis, and opposes the use of a new drug called Avastin, which is considerably cheaper, but does the same job.

 

The RNIB receives an annual payment of £166,000 from Novartis, the drug company which makes Lucentis.

 

'Avastin has been shown to be as safe and as effective as Lucentis against MD. Crucially it is far cheaper. If it were used instead it would save the NHS £100 million a year. It's already widely used by private patients in the UK, and in other parts of the world.'

 

'The RNIB said it had been campaigning hard against the use of Avastin. The relationship between Novartis and the RNIB was especially close as the head of external affairs and acting head of market access at Novartis UK, was until 2011 the RNIB's policy and campaign manager.'

 

This is the sort of thing that confuses the issues and gives drug companies a bad name.

[Obelix]

Interesting story in today's DM. It regards the Royal National Institute for the Blind, (RNIB) backing of a drug for Macular Degeneration, (an eye disease which leads to blindness) called Lucentis, and opposes the use of a new drug called Avastin, which is considerably cheaper, but does the same job.

 

The RNIB receives an annual payment of £166,000 from Novartis, the drug company which makes Lucentis.

 

'Avastin has been shown to be as safe and as effective as Lucentis against MD. Crucially it is far cheaper. If it were used instead it would save the NHS £100 million a year. It's already widely used by private patients in the UK, and in other parts of the world.'

 

'The RNIB said it had been campaigning hard against the use of Avastin. The relationship between Novartis and the RNIB was especially close as the head of external affairs and acting head of market access at Novartis UK, was until 2011 the RNIB's policy and campaign manager.'

 

This is the sort of thing that confuses the issues and gives drug companies a bad name.

 

It doesn't confuse the issue when you look into why.

 

Lucentis was developed for dealing with wet age related MD and it does a very good job of that. It was tested in appropriate cohorts for side effects, and it's dosage and know side effects and contrindications are known when treated MD.

 

Lucentis cost a certain amount to develop, and the cost of the drug is priced accordingly. It is expected to be a low volume, hence a high cost drug to recoup the R&D costs.

 

Avastin is an anticancer and antibiotic drug. It's had a different testing regime. It's been tested for cancers and it does well at them. It is expected to be a high volume drug as cancer patients will take it for a very long time compared to Lucentis, and so it is a lower cost per dose.

 

Some doctors spot that cancer patients on Avastin have healed MD. Hardly surprising when you look at the mode of action.

 

So they want to prescribe it for MD. The manufacter are not going to allow this for two reasons.

 

1. It means that the R&D costs of Lucentis are not going to be recouped. This directly harms the viability of the business and means that new drugs may not get researched

 

2. The testing regime for Avastin hasn't covered MD. If the maufacturer approves it - and then someone ends up convicing a jury that they were negligent then the manufacterer gets to pay lots of compensation. Hardly sensible if they go bankrupt.

 

They can of course guard against 2 by doing the testing. That'll push the drug price up immensly of course, delay usage for a long time, and mean that the cancer patients are paying much more for their drug - for no reason because they don't have MD.

 

Far better to use the drugs for what they were intended.

 

The drugs were developed this way not to make the MD drug more expensive but to make the cancer drug CHEAPER!

 

But that's not convenient is it when you want to engage in a bit of anti pharma bashing.....

[Bonzo77]

Any evidence for that sort of defamatory allegation?

 

You don't have to look hard to find it

[Longcol]

You don't have to look hard to find it

 

Just post a link. Easy peasy.

[Cyclone]

It doesn't confuse the issue when you look into why.

 

Lucentis was developed for dealing with wet age related MD and it does a very good job of that. It was tested in appropriate cohorts for side effects, and it's dosage and know side effects and contrindications are known when treated MD.

 

Lucentis cost a certain amount to develop, and the cost of the drug is priced accordingly. It is expected to be a low volume, hence a high cost drug to recoup the R&D costs.

 

Avastin is an anticancer and antibiotic drug. It's had a different testing regime. It's been tested for cancers and it does well at them. It is expected to be a high volume drug as cancer patients will take it for a very long time compared to Lucentis, and so it is a lower cost per dose.

 

Some doctors spot that cancer patients on Avastin have healed MD. Hardly surprising when you look at the mode of action.

 

So they want to prescribe it for MD. The manufacter are not going to allow this for two reasons.

 

1. It means that the R&D costs of Lucentis are not going to be recouped. This directly harms the viability of the business and means that new drugs may not get researched

 

2. The testing regime for Avastin hasn't covered MD. If the maufacturer approves it - and then someone ends up convicing a jury that they were negligent then the manufacterer gets to pay lots of compensation. Hardly sensible if they go bankrupt.

 

They can of course guard against 2 by doing the testing. That'll push the drug price up immensly of course, delay usage for a long time, and mean that the cancer patients are paying much more for their drug - for no reason because they don't have MD.

 

Far better to use the drugs for what they were intended.

 

The drugs were developed this way not to make the MD drug more expensive but to make the cancer drug CHEAPER!

 

But that's not convenient is it when you want to engage in a bit of anti pharma bashing.....

 

The best interests of the public in this case would be for the testing to be done independently (maybe by the NHS) and then the cheaper drug to be used. It will still be cheap, and an older more expensive drug can be dropped. Tough for the capitalists who lose this time, good for everyone else.

[I1L2T3]

The best interests of the public in this case would be for the testing to be done independently (maybe by the NHS) and then the cheaper drug to be used. It will still be cheap, and an older more expensive drug can be dropped. Tough for the capitalists who lose this time, good for everyone else.

 

Very good point. Big pharma are capitalist risk-taking companies. If they develop drugs that turn out to have other uses that is kind of part of the risk but the discovery of new uses can also have significant upsides for them.

 

There's no conspiracy though. Its a case of reconciling the work pharma companies do (and their profit motives) with the greater good for society. We all know that sometimes the two things on the face of it don't always reconcile very well. Sometimes the criticism is warranted, sometimes not.

[L00b]

The best interests of the public in this case would be for the testing to be done independently (maybe by the NHS) and then the cheaper drug to be used. It will still be cheap, and an older more expensive drug can be dropped. Tough for the capitalists who lose this time, good for everyone else.

Are you familiar with the amount (and cost) of testing required for UK regulatory approval? I'm not intimately familiar, but I have seen enough real life figures. They are scary. Really scary.

 

Independent testing still needs to be paid for and, as with most regulatory approval schemes, will need to be paid for by the generic manufacturer (not the NHS, thankfully - their annual budget is haemorrhaging enough as it is, without their having to subsidise generics manufacturers' entry into the British market as well).

 

The cost of which generic product will then increase in proportion, and unsurprisingly be passed to the NHS.

 

The independently-tested generic will most probably end up still cheaper than the old big pharma product, of course...but cutting into the old big pharma product life cycle in this way will just disincentivise big pharma from researching more new drugs.

 

Lose-lose, methinks.

Edited June 3, 2015 by L00b