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发信人: THR (HIP), 信区: Military
标 题: 08要拿医药业开刀了
发信站: BBS 未名空间站 (Sun Apr 19 23:16:59 2009)
现在药厂开始急了.
主要是学英国,要搞GENERICS和BRAND NAME的治疗比较研究,如果BRANDNAME不比
GENERICS显著提高,MEDICARE就不COVER.
举的例子就是Merck/Schering-Plough的VYTORIN.VYTORIN是BRANDNAME SIMVASTATIN(
ZOCOR)加ZETIA,价格是GENERIC的SIMVASTATIN的四倍以上(SIMVASTATIN还算新的
GENERIC,以后生产厂多了肯定更便宜). 但是研究证明没有什么差别.VYTORIN去年销量
下降很厉害.
关键是如果美国和英国一样搞严格的性价比,那很多药厂要倒霉了,
现在MERCK开始FIGHT了,最近成立了一些代表医药业的游说团体,头头都是民主党的前高
层.
希望大嘴能挺住.不过很可能半途而废.因为制药业的院外集团是资金最充足的院外集团.
Drugmakers Boost Lobbying to Police Drug Comparisons (Update1)
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By Jonathan D. Salant and Aliza Marcus
April 17 (Bloomberg) -- U.S. drugmakers are working to ensure that President
Barack Obama’s move to encourage cheaper medical care doesn’t end up
dictating treatments to doctors and insurers.
Already the biggest spender on influencing policy, the drug industry,
including Merck & Co. and Eisai Co., is relying on well-known individuals,
some with stories of personal battles against disease, to promote its views.
They include Tony Coelho, a former U.S. House Democratic leader who has
epilepsy; Andrea LaRue, counsel to Tom Daschle when he was Senate Democratic
leader; and the firm of Democratic fundraiser Tony Podesta, brother of
Obama adviser John Podesta.
Makers of drugs and other health-care products say they support side-by-side
studies of medical products as a tool for doctors and patients, not as a
way to stop medical professionals from prescribing a more expensive drug if
they’re convinced it will work better. The industry has already recorded
one victory, supporting the removal of language concerning costs from a $1.1
billion funding provision for such studies included in the Obama stimulus
package passed in February.
“The companies fear that older generic drugs might very well turn out to be
better than the newer advertised drugs, which bring in much more of a
profit,” said Julian Zelizer, a history and public affairs professor at
Princeton University in Princeton, New Jersey. “In difficult economic times
, the drug companies don’t want to take any risks, so they are bringing out
the biggest lobbyists in the business.”
Crucial Savings
Carving savings out of the health-care system is crucial to Obama’s goal of
providing health insurance to more Americans. Senate lawmakers have pledged
to have legislation ready by June to get all Americans affordable medical
coverage.
More than half of medical care may be based on insufficient evidence of
effectiveness, the Congressional Budget Office said in March. The Health and
Human Services Department says all medical spending will probably rise this
year to $2.5 trillion, or 18 percent of the economy.
Merck backs comparative effectiveness research to figure out what works best
, said Jane Horvath, senior director for public policy at Merck, based in
Whitehouse Station, New Jersey.
“We aren’t stepping up a fight with President Obama,” Horvath said in a
telephone interview today. “Merck continues to encourage Congress to pass a
more permanent comparative effectiveness research structure and process.
Presenting valid research that people can trust can be a valuable tool for
the health-care system.”
U.K. System
Opponents to the inclusion of cost as a factor in comparing the
effectiveness of treatments cite the U.K.’s National Institute for Health
and Clinical Excellence, or NICE, which looks at the cost and benefit of
medical treatments in deciding what should be covered by national health
insurance.
The U.K. agency said March 5 that Tykerb, sold by GlaxoSmithKline Plc of
London, is too expensive for routine use in women with advanced breast
cancer. Given with chemotherapy, Tykerb costs about $35,000 a year for each
patient, the agency said.
Indianapolis-based WellPoint Inc., the second-largest health insurer by
revenue, and Philadelphia-based Cigna Corp. are backing Obama with a
lobbying push of their own through their Washington-based support
organization, America’s Health Insurance Plans.
‘Need More Information’
“We need more information about which drugs, treatments and technology are
more effective and we need to put that information in the hands of consumers
and providers,” said Robert Zirkelbach, a spokesman for the trade group.
“That will go a long way to improve the quality of care and bring down
health-care costs across the board.”
Merck and Schering-Plough Corp.’s cholesterol pill Vytorin may face tougher
competition from generic simvastatin if federally funded studies show it no
more effective at unclogging arteries. Vytorin prescriptions dropped by a
third last year after a study found the pill, a combination of simvastatin
and Kenilworth, New Jersey-based Schering-Plough’s Zetia, worked no better
than the generic pill alone. Vytorin costs about four times as much as
simvastatin.
The president’s Federal Coordinating Council for Comparative Effectiveness
Research, formed last month, includes Ezekiel Emanuel, brother of White
House Chief of Staff Rahm Emanuel, to oversee the studies. The council’s
first report to Obama and Congress, containing recommendations of what
treatments should be studied, is due June 30.
Advancing Cost?
“We need to compare whether some of these new ideas are really advances or
more costly alternatives to what we know will work,” said Henry Waxman, a
California Democrat and chairman of the House Energy and Commerce Committee,
in an interview.
Soon after Obama won November’s election, the Pharmaceutical Research and
Manufacturers of America, the trade group known as Phrma, helped create the
Partnership to Improve Patient Care, which last month hired Coelho, 66, who
was chairman of Al Gore’s unsuccessful presidential bid and helped win
passage of the 1990 Americans With Disabilities Act.
Coelho’s group also includes the American College of Cardiology, a
Washington-based trade group for heart doctors, and Easter Seals, the 90-
year-old advocacy group for disabled people. The organization, based in
Chicago, claims a million members.
“I have no problem with research determining what is bad, what is good,”
Coelho said. “But all of us have different bodies and all of us react
differently to different types of medication. Don’t make it into a cookie-
cutter process.”
Easter Seals
Easter Seals will use its newsletter, Web site and annual convention in
October to mobilize supporters, said Katy Neas, a lobbyist for the
organization.
“As the debate goes forward, and after this much- anticipated research,
things are going to start heating up,” Neas said.
Another Coelho ally is Phrma President Billy Tauzin, 65, a former Republican
chairman of the House Energy and Commerce Committee.
Tauzin had intestinal cancer. He and Coelho use personal stories to argue
that Obama’s plan runs the risk of stopping government health plans and
insurers from paying for lifesaving treatments deemed more expensive than
alternatives that may not work as well for everyone.
Coelho said he’s worried that government studies will lead to restrictions
on antiseizure drugs. He said he needed four drugs, though some plans would
only pay for two. And substituting lower-cost generics can hurt patients,
Coelho said.
‘Criticism’
“On a lot of us, if you do that switch, you can cause me to have seizures,
” Coelho said. “It’s criticism from my point of view as a patient.”
Tauzin said he used an experimental drug to cure his cancer, a medicine he
might not have gotten if insurers consider cost to determine coverage.
“They’ll show medicines work better for some people on average,” Tauzin
said. “You may not be average. Suppose you’re the patient for whom Drug B
doesn’t work.
“The irony is science is taking us in the direction of precision medicine,
where we can figure out from your genetic code exactly what medicine works
for you.”
Backers of comparative research say there’s no conflict.
Where It’s Working
“It’s not whether it works or not, but in whom it is working or not,”
said Marcus Wilson, president of HealthCore, a WellPoint subsidiary that
conducts comparisons and is seeking federal money for research, in an
interview. “We look at it as helping us get much closer to personalized
medicine than we are today.”
Individual drug companies, which have said they support comparative
effectiveness as a concept, have been keeping watch in Washington. Tokyo-
based Eisai, which developed the Alzheimer’s drug Aricept, hired the
Podesta Group in January.
Comparative effectiveness “should not be used by the public or private
payers as a reason to deny access to specific therapies to specific patients
,” said Lynn Kenney, an Eisai spokeswoman.
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狗仔卡
发表于 2009-4-21 12:06 PM
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