Category: Pharmaceutical Industry

Implications of UPMC’s ethics policy far-reaching:

“As he delivered a typical $120 lunch order to a doctor’s office last week — three chicken or salmon entrees, three appetizers, a chicken sandwich and four salads — Robert Bishop was mindful that his business, Mobile Menus, soon would be filling fewer orders.

On Friday, he expects to lose the deliveries he makes to doctors affiliated with the University of Pittsburgh Medical Center.

A new UPMC conflicts-of-interest policy will take effect that day aimed at making doctors’ decisions free from influence created by gifts or improper relationships with the drug or medical device industries.
Among other provisions, the policy bans gifts such as pens, note pads and food provided by industry representatives as they work to present information about their products at doctors’ offices.

Losing that food business for the UPMC doctors he visits, Mr. Bishop said, will cut his $5,000 weekly sales by about 20 percent. He said nearly all the lunches he provides to doctors’ offices are paid for by drug industry representatives.”

Good on UPMC…

NEJM — Efficacy and Safety of Epoetin Alfa in Critically Ill Patients

Results: As compared with the use of placebo, epoetin alfa therapy did not result in a decrease in either the number of patients who received a red-cell transfusion or the mean number of red-cell units transfused.

Conclusions: The use of epoetin alfa does not reduce the incidence of red-cell transfusion among critically ill patients, but it may reduce mortality in patients with trauma. Treatment with epoetin alfa is associated with an increase in the incidence of thrombotic events

Then, in the discussion:

In contrast, [to trauma patients] no significant reduction in mortality was seen among surgical and medical patients receiving epoetin alfa.

and

The use of epoetin alfa is not supported for patients admitted to the ICU with a nontraumatic surgical or medical diagnosis, unless they have an approved indication for epoetin alfa.

^{The only reason I post this is because of the extraordinary amount of money I saw spent on promoting the use of this very expensive drug in the critically ill patient population over the past five or ten years. And, mea culpa, I fell for it, too. It will now, hopefully, dry up as yet another revenue source for these companies as word (slowly) filters out to the critical care community. I’m betting there won’t be a full court press to get the word out about this particular article.}

NEJM — A Decade of Direct-to-Consumer Advertising of Prescription Drugs:

“Results Total spending on pharmaceutical promotion grew from $11.4 billion in 1996 to $29.9 billion in 2005. Although during that time spending on direct-to-consumer advertising increased by 330%, it made up only 14% of total promotional expenditures in 2005. Direct-to-consumer campaigns generally begin within a year after the approval of a product by the FDA. In the context of regulatory changes requiring legal review before issuing letters, the number of letters sent by the FDA to pharmaceutical manufacturers regarding violations of drug-advertising regulations fell from 142 in 1997 to only 21 in 2006. “

From the discussion:

“Our study has some key limitations. We obtained data on industry sales from PhRMA, which includes in its annual reports sales data only for its members. Ideally, we would include sales of all branded drugs sold by prescription, including pharmaceutical and biologic agents, and exclude sales of generic drugs (because generic drugs typically are not promoted). PhRMA sales data may include some generic sales (if a member reports both branded and generic sales) and typically exclude sales of biologic agents, which are manufactured by companies that belong to another trade group (Biotechnology Industry Organization). As a result, the sales figures may underestimate total dollar sales for the industry. We provide data on spending on free samples valued at their approximate retail price, which is how they typically are valued in industry promotional audits. Thus, the value of free samples we present probably overstates the opportunity cost to manufacturers, which would lie somewhere between the marginal cost of production and the retail value.”

A billion here, a billion there, pretty soon you’re talking serious money…

FDA Delay In Cancer Therapy Is Attacked – washingtonpost.com:
“Oncologists do not usually need bodyguards when they present scientific data at a medical symposium.”

Gimme an Rx! Cheerleaders Pep Up Drug Sales – New York Times

Too funny or too sad?

The Truth About Drug Companies:
“News: The author calls the pharmaceutical industry a “vast marketing machine” that thrives on monopoly rights and public-sponsored research but produces few innovative drugs. “

From Mother Jones Magazine, an interview with Marcia Angell, author of
The Truth About Drug Companies: How They Deceive Us and What to Do About It