Category: Pharma

Why Do “Ancient Drugs” Cost So Much?

Once again, our friend the “Country Doctor” poses an interesting question. Check this out. If the line of reasoning supporting high prices for drugs is the cost of their development, why the heck do drugs that have been around forever cost so much?  Insulin, albuterol inhalers, and epinephrine are offered as examples of such apparent malfeasance. BUT. Scroll down and check the response offered by one reader. Dr. JKH notes that “designer” delivery systems for old drugs are modern inventions that permit new patents and raise prices. Another explanation. The impact of “Big Government” and its policies.

Bottom Line. This is an interesting discussion when you dig into the details. BUT. Most people don’t dig this deeply, and “old drugs at new prices” is bad optics to the general public. AND. Likely no amount of rational argument can make this perceptive go away.

Anyone Out There Not See This One Coming???

Check this out. What you will see are recent Harris Poll results indicating that the pharmaceutical industry’s image seems to have its “halo slipping.” More quantitatively, we see that positive ratings have slid from 62% positive several months ago to 56% now. And what might that mean? Maybe lots of things, or maybe nothing!

In the “nothing” category, it should be noted that while across the year we see a gradual trend downward, the majority rating is still one of positivity. The bottom is not falling out. 

Relatedly, the statisticians among our readers may interpret this as nothing more or less than a “regression toward the mean.” Translated, that means that the perception of pharmaceutical companies jumped up significantly, as we have previously discussed, when the rapid development of effective COVID-19 vaccines made us heroes.  Maybe the blush is just coming off that rose a little bit. 

On the other hand, pharmaceutical companies are once again being excoriated in the news. The introduction of an Alzheimer’s drug that may or may not work, and costs over $50,000 a year per patient, doesn’t help. And then the indications for using that drug getting “walked back” by the manufacturer makes matters worse.  AND. The fact that the FDA is now calling for an investigation of their own doctors involved in the approval process for this drug is likely to crank our rating down yet another few notches in the eyes of the public.

Bottom Line. We said several months ago that the pharmaceutical industry had an opportunity to build on the fleeting vaccine positivity and establish a pathway to a more permanent positive public image. 

Nonetheless, here we are!

The Sound of Silence

Check this out.  Spend a couple of minutes and watch the video. What you will see is a fascinating story of Pfizer, sort of accidently, discovering that its arthritis drug appeared also to be effective as a preventative against Alzheimer’s. BUT. After several years of internal discussion, they decided not to publish the data or do the clinical trials necessary to pursue the indication. Why? You be the judge. This report offers up two diverse reasons. One, the “science” of the data, obtained by analyzing insurance claims, wasn’t strong enough. OR. Maybe the drug’s upcoming patent expiry didn’t make further investments in further indications a prudent business decision. 

Bottom Line. Frankly, I find this story a little creepy. How many potentially significant clinical discoveries never get to see the light of day for whatever reason. And, more importantly, what should have been done here that should be done in similar cases in the future?

Think about it!

Will Anything Stick???

Check this out. What you will see is a report that the Trump Administration is working on a plan that would allow Americans to import drugs legally from Canada. Why? To permit our patients to “get the benefit of the deals” that our pharmaceutical companies have struck with other countries. Wow! Think of everything that would possibly be affected by this move. Do patient safety concerns arise as drug companies are asserting? How do patients get reimbursed for their drug spends? What happens to pharmaceutical companies profits and stock prices?

BUT. How likely is this bill to pass. I am going with “not very.” Several Trump drug price reduction initiatives have tanked recently. Remember my post on the absurdity of requiring drug companies to include drug prices in DTC advertisements? Waste of time. This errant move got trashed in Federal Court.  

The bill that would have cut out drug rebates paid by drug companies to PBM’s? Withdrawn by the White House.  

Bottom Line. And so it goes. Cockeyed notion after cockeyed notion of how to reduce drug costs to Americans biting the dust. Will that happen with this Canadian import notion? Probably!

All causing me to ask again. What kind of drug pricing approach would the American government, and the American people, find reasonable,  while still permitting drug companies to make appropriate risk adjusted profits, and what is thebest way to get there?  

The “pot shot” fixes don’t seem to be working. What will?

The Cost Of Insulin Is “Through The Roof”

Why do people feel compelled to add editorial comments when describing the price of drugs?  Check this out.

I always scratch my head when I see inflammatory terminology being used to describe the price of drugs in the U.S.  Phrases like “through the roof” and “we have to do better.” My strong sense here is that the comparative prices in different countries should be allowed to speak for themselves. Where is the threshold in drug pricing where such terminology kicks in? Do patients in the U.S. subsidize other countries’ drug pricing in 2019? Sure. So what else is news? I have been hearing this same theme for the 40 years+ I have worked in the healthcare vertical. BUT. Are the inequalities being resolved? 

Bottom Line. The kicker here, folks, is this blogging physician’s assertion that these are the problems that you get “when health care is for profit.” This just in. Pharmaceutical products are made by private companies with shareholders who do, indeed, expect the companies to make a profit. Apparently lots of people don’t understand that. While what they say they are seeking is price reduction, what they are actually seeking is a fundamental change in the business model of the pharmaceutical industry.  

And then what?

A Drug Company Just Sent This Guy A Big Check!!!

Check this out.  What you will see is a Time Magazine story that reports on techniques that pharmaceutical companies use to “hook people on their costly drugs.” We are all obviously familiar with co-pay cards and similar tactics. But I must confess that I was not aware that drug companies are actually sending out checks to patients who could not otherwise pay the cost of their drugs. The psychologist pictured above, for example, just received a check for almost $3,000 to help him to cover the cost of Enbrel. Reportedly, Amgen will send a patient up to $12,000 a year to help to defray the cost of the drug. Interestingly, even in a world where the propriety of virtually everything is being questioned, such payments are perfectly legal as long as the patient is not on a Federal Government health plan that covers prescriptions. Not surprisingly, however, these cash-based assistance plans are now coming under increasing scrutiny. Bottom Line. The headline of this piece is the head scratcher. It clearly suggests that drug companies that use cash reimbursement techniques are doing something that is, well, wrong.  Are they? 

Controlling Drug Prices – A “Work in Progress”

Check this out.  What you will see is the Trump administration’s “plan” for lowering and controlling drug prices. I find several things of interest here. First, most of the interventions identified are more tweaks than significant moves. Second, the discussion focuses more on drug “middlemen” than on drug companies themselves. Third, the fact that there were 136 question marks in the document reveals that the plan is more a “work in progress” than it is a done deal. Bottom Line. The fact that drug stock prices rose significantly immediately after the announcement is a good indicator that the market saw the plan as being largely without teeth as it relates to the pharmaceutical industry. Will the next steps be the same? Different? Stay tuned!

Who Holds Up Experimental Drug Access for Dying Patients?

Drug companies, that’s who. Check this out. What you will see is a New York Times article reporting that while pieces of “right to try” and “compassionate use” legislation are being actively pursued, they won’t matter much if drug companies refuse to provide access to the drugs. All the legislation does is set aside the need for FDA approval in critical cases. It does NOT guarantee that the drug will make it into the patients’ hands. You see, given the millions of dollars required to bring a new product to market, many companies don’t want to take the risk of getting a product out into the marketplace too soon. Bottom Line. This issue obviously has a lot of moving parts, and reasonable minds can disagree. What would you do if you were a pharmaceutical executive who had to decide whether a dying patient could get access to your investigational new drug?

Friend Or Foe???

Check this out. What you will see is an interesting story about a drug anti-addiction advocate who showed up as Minnesota lawmakers prepared to push a bill that would charge a tax on opioid sales. While purportedly there to offer her group’s resources, and also purportedly taking no position on the proposed tax, Jessica was viewed askance when she arrived with five representatives from PhRMA. The fact that she later admitted that her organization had accepted funding from the pharmaceutical industry, but refused to disclose the amount, sort of fanned this flame. Clearly, the pharmaceutical industry is trying to position itself as being on the right side of the opioid crisis issue. Trying to be seen as helping to deal with the problem rather than being seen as the cause of it. Not only is this good PR, it is also an important defense strategy which will likely be trotted out in the lawsuits that communities are filing against drug companies for handing them the opioid crisis. Bottom Line.  In my mind, there is no question that the harmaceutical industry needs to be adopted as a partner in dealing with the opioid crisis, even if it is done reluctantly. The resources of the industry are obviously huge, and should be brought to the table in dealing with this “epidemic.”  This is going to require open mindedness on the part of legislators, and forthrightness on the part of the drug companies. Any slip on either side can quickly queer the deal. And that would be a real shame!

The Role of The Pharmaceutical Sales Representatives In 2017

Sales rep We haven’t done a riff on PSR’s in a while, so today is as good a day as any to examine their role in pharmaceutical marketing in 2017 and beyond. Or is it? Check out this article. What you will see is a report that the majority of physicians get bored when they are presented with the “stale detail,” i.e., a personal meeting with a PSR that provides them with no new information. BUT. The article ends with a report that most physicians are still claiming that they are meeting with PSR’s, and want to do so in the future. Huh? More information from this study shows that one of the major reasons PSR’s are increasingly seen as redundant is that physicians have become increasingly adept at using digital media to obtain the information they require. AND. Pharmaceutical companies seem to have failed to integrate their sales representatives’ presentations with the digital media. Even the digital media in the PSRs’ hands, the “tablet,” is inexplicably being used less frequently over time. Bottom Line. Ah-Hah! It seems that the formulation of the correct role of the PSR in the new age should focus on helping physicians to get better value out of information available in the digital media, and to do so with greater efficiency. How to do that might well be the subject of a very interesting, forward looking study.   BTW, given all of the above and such increasingly important considerations as political correctness, is it not perhaps the time to rename the field force? Put another way, do we really still want the word “sales” included in the title of the pharmaceutical industry’s customer facing professionals?  Think about it!