E-drug: Alan Maynard and Karen Bloor on pharma expenditures
-------------------------------------------------------------------------
This article by Maynard and Bloor has an interesting discussion of the
social value (cost) of pharmaceutical marketing expenses. It raises I
think an important policy issue. Should we seek a new way of funding
R&D that does not require these 20 year marketing monopolies, given
the well known problems this creates? Jamie
--
James Love, Director, Consumer Project on Technology
http://www.cptech.org, mailto:james.love@cptech.org
tel. +1.202.387.8030, mobile +1.202.361.3040
Information to physicians and clinical guidelines.
Marketing of pharmaceuticals is often vigorous and superficial, and it
continues to develop, for example, into product endorsement by
celebrities in the media.14 Commercial pressures lead companies to
influence or even corrupt the evidence base for reimbursement and
clinical decisions, and they compound the choices of prescribers.15
Pressure from patient and industry lobbies create incentives for
doctors to prescribe and systems to reimburse products that do not
ensure the most efficient use of society's resources.
It is necessary to distinguish between the hype of drug industry
advocates and the evidence of increased effectiveness and cost. A
small number of major new products have come to the market in
recent decades. The U.S. Food and Drug Administration (FDA)
approved more than 1,000 drugs during 1989�2000, of which 361
were new molecular entities (others contained active ingredients
already approved) and 153 were selected for priority review.16
Molecular manipulation is providing products that show marginal
improvements in effectiveness, often at a high cost.17 The industry
spends more time and resources to generate and disseminate
medical information than it does to produce medicines, and such
information can greatly influence clinical practice.18 Industry's
legitimate commercial imperatives and the changes in practice they
create can be extremely costly and may undermine the best interests
of patients and society. On the other hand, many proven therapies
are now off patent, and relatively cheap, but underused because of
inadequate incentives that fail to induce appropriate provider
behavior.
http://www.healthaffairs.org/1130_abstract_c.php?ID=http://www.heal
thaffairs.org/Library/v22n3/s9.pdf
Dilemmas In Regulation Of The Market For Pharmaceuticals
Alan Maynard , Karen Bloor
Volume 22 / Number 3
What can be learned from international experience of efforts to
control spending and to improve efficiency and access in
pharmaceutical markets? Policymakers tend to reinvent many policies
to control the behaviour of patients, doctors, and industry, despite a
lack of evidence of those policies' cost-effectiveness. There is an
emerging consensus that reimbursement in public and private health
care systems should be informed by evidence of the
cost-effectiveness of treatments and that utilization should be
constrained by budget caps and information systems. Whatever the
policy chosen, evaluation is as essential as it is rare.
--
To send a message to E-Drug, write to: e-drug@healthnet.org
To subscribe or unsubscribe, write to: majordomo@healthnet.org
in the body of the message type: subscribe e-drug OR unsubscribe e-drug
To contact a person, send a message to: e-drug-help@healthnet.org
Information and archives: http://www.essentialdrugs.org/edrug