Why are Britain's health charities bent on sucking the blood from the NHS? The very same organisations that do such sterling work funding research, supporting patients and promoting awareness appear to have a blind spot when it comes to assessing what treatments are worth. We see it each time the National Institute for Health and Clinical Excellence (Nice) reaches an unpopular decision to ban a drug on the NHS because it is too expensive, as it did yesterday with the new prostate cancer medicine abiraterone. Cue uproar from charities.
"This decision is a bitter blow to thousands of men and their families and must be overturned," said Owen Sharp, the chief executive of the Prostate Cancer Charity. It was the same last month, when Nice ruled against three bowel cancer drugs. Mark Flannagan, the chief excecutive of Beating Bowel Cancer, said: "This is yet another blow for bowel cancer patients. All bowel cancer patients deserve the best care." Of course – how could anyone dispute that? Nice agreed that some of the drugs were effective – extending life by an average of 3.9 months in the case of prostate cancer. As Mr Sharp said, that could give a terminally ill man the chance to "walk his daughter down the aisle or see the birth of a grandchild". It is a disaster for such a man to be denied such a drug.
But we cannot provide every treatment that is effective to every patient who would benefit without regard to the cost. If we did, we would quickly bankrupt the NHS. Yet that is what the health charities are helping to do. By turning their fire on Nice, and neglecting the other player in the tragedy – the drug company involved – charities are effectively saying that protecting drug-company profits is more important than protecting the NHS.
Nice assesses each drug and calculates how much benefit it delivers for the cost. It mostly approves drugs costing up to ?30,000 per Quality Adjusted Life Year (Qaly – a measure of the benefit), or for terminal conditions, up to ?50,000. In this case, the prostate drug came in at ?63,000 per Qaly, and the bowel cancer drugs at ?110,000 per Qaly. So, in Nice's view, the drug companies Janssen and Amgen were charging more than they were worth. Did the health charities challenge the companies? No. Instead, they lambasted Nice. Do they receive drug company financial support? Perhaps we should be told.
Only Harpal Kumar, the chief executive of Cancer Research UK, struck the right note. Commenting on the prostate drug decision yesterday, he said: "We feel extremely let down that the drug's manufacturer couldn't offer Nice a price they could agree on." This is a ?500bn global industry and it is time other organistations joined Nice in holding it to account to ensure fair prices are charged to the NHS.
The decline is in sharp contrast to
the decade-long drug-industry advertising spree that began in 1997, when the
Food and Drug Administration loosened its regulations and allowed direct-to-consumer advertising of prescription drugs on TV.
Some industry analysts attribute part of the decline to
controversy over such ads. Employers and
health insurance companies have long complained that TV ads drive consumers to the latest, often most expensive, pills. And doctors complain that their patients often pressure them into prescribing these heavily advertised drugs.
Perhaps the most well-known criticism of TV advertising of pharmaceuticals arose in 2004 when Merck withdrew the once heavily advertised painkiller
Vioxx after studies showed it increased the risk of heart attacks and strokes.
can't look any worse, Ricky Santorum proves that he's an even bigger asshole than we thought.
One of the feistiest exchanges came in response to a young child's question on the cost of medical care in America. Urged on by his mother, a boy asked what Santorum would do to lower medical costs, but before he could finish his question, the candidate said such things should be left up to the market.
"We can make medicine cheaper by using markets," Santorum said. "That's how you make medicine cheaper is that you have free people going out there and competing against each other and competition drives up quality and drives down costs."
Competition? Okay, great! So we can import cheaper drugs from Canada then, have them compete in the open market?
"The only reason new drugs are developed is because Americans actually do pay for the cost of that research," Santorum said. "And so when you say oh, I'll go and get my drugs in Canada, that's great. Go get your drugs in Canada and if everybody did that, you'd have no new drugs. You have that drug and maybe you're alive today because people have a profit motive to make that drug."
Okay, so forget the open market. Really, only people who can afford to deliver profits to drug companies should be able to use them, huh?
"People have no problem going out and buying an iPad for $900," he said. "But paying $900 for a drug, they have a problem with it. It keeps you alive. Why? Because you have been conditioned to thinking that health care is something that you should get and not have to pay for. Drug companies, health care companies need to have a profit motive, because if they don't, then how are we going to regulate costs? We are gonna ration care."
iPads start at $500, by the way. And unlike life saving drugs, you buy it once. If you had to pay $900 for an iPad every month, or even every year, you better believe sales would crater.
And while iPads are a completely optional purchase, life-saving drugs are not. Unless, of course, you can't afford to deliver profits.
The mother of the original questioner tried once more to plead her case, explaining that she's paid $1.3 million a year to keep her son alive, and while she's willing to go bankrupt for her child, it pains her to see his friends die in the hospital because their parents cannot afford the treatment.
Finding himself in the unenviable position of defending oft-derided drug companies, Santorum stuck to his guns.
"He's alive today because drug companies thought that they would make money in providing that care and if the drug company didn't think they could make any money by providing that care, I hate to put it in these terms, but that drug wouldn't be here," he said, adding that he sympathized with the mother, "we either believe in markets or we don't."
And oh, he's totally in favor of allowing insurance companies to discriminate against people with pre-existing conditions, so if you're already sick, he doesn't want you to get health insurance.
So you got it? If you can afford $1.3 million every year to deliver profits to big pharma and the insurance industry, then your kid can live. If you can't, then your kid dies, and that's okay, because if it's not, then you don't believe in free markets. Unless you're Canadian. Because if you are, then your kid gets to live.
USA! USA! USA!
New heart disease, diabetes and dementia drugs could emerge from new insight into the benefits of resveratrol - a chemical contained in red grape skin that is found, in small quantities, in red wine.
Resveratrol's health-giving properties have already been studied in depth but it's only now that scientists know that, not only does it promote energy in human cells, it does so by fooling them into thinking they haven't got enough to begin with.
Armed with this knowledge, a research team based at the US National Heart, Lung and Blood Institute (NHLBI) believe drug manufacturers could draw on resveratrol to produce a new range of treatments for a whole range of conditions.
Red Wine Drugs
Details of their red wine drugs work appear in the Cell publication and, separate to this, a UK-based source described its benefits to The Telegraph.
"Although you can get resveratrol from red wine, you would need to drink about 700 bottles to get a meaningful dose", Cambridge University's Doctor Andrew Murray explained, adding: "This study is important because the effects of resveratrol on the cell were identified, so that more potent drugs could be developed to mimic its effects."
The basis of the new study were tests carried out with mice but it emphasises that animal-based research doesn't necessarily yield results that will be mirrored in humans.
Wine Drug Treatments
Therefore, further research will be required, probably involving human subjects, before the advent of market-ready wine-based drug treatments.
"Resveratrol has potential as a therapy for diverse diseases such as type 2 diabetes, Alzheimer's disease and heart disease", Doctor Jay Chung, from the NHLBI's Laboratory of Obesity and Aging Research explained in a press statement. "However, before researchers can transform resveratrol into a safe and effective medicine, they need to know exactly what it targets in cells."
"This result underscores the need for careful, well-controlled studies to illuminate how these natural products operate", his colleague Robert Balaban added. "As Dr. Chung's work suggests, the effects of resveratrol seem to be more complicated than originally thought.
"However, this new insight into the phosphodiesterases might prove an interesting avenue to pursue."
By Phil Serafino
Feb. 2 (Bloomberg) -- A Johnson & Johnson prostate-cancer medicine discovered in England and developed with funds from U.K. charities is too expensive for the country’s National Health Service.
The NHS shouldn’t pay for Zytiga because the drug’s benefits don’t justify the cost even after the manufacturer agreed to cut the price, the National Institute for Health and Clinical Excellence said in a statement today. The agency, known as NICE, advises the state-run medical system on which treatments it should pay for. J&J and the public have a chance to comment on the decision, which is preliminary, NICE said.
Advocates for cancer patients criticized the ruling, saying the drug helps keep men alive after chemotherapy has failed to stop their cancer. Zytiga, which costs 2,930 pounds ($4,640) for a 30-day supply, may extend life by more than three months compared with a placebo, and can be taken orally at home, London-based NICE said. The agency isn’t disclosing the discount that New Brunswick, New Jersey-based J&J agreed to provide.
Feb. 2 (Bloomberg) -- Johnson & Johnson hid studies showing its Risperdal anti-psychotic drug caused diabetes to protect billions of dollars in sales, a lawyer said in the first personal-injury claim over the medication to go to trial.
Researchers at J&J’s Janssen unit knew as early as 1999 that a study found Risperdal caused diabetes at a higher rate than a competing drug and failed to hand over the results to regulators probing links between the disease and anti-psychotic medicines, Fletch Trammell, a lawyer for a former Risperdal user, told a New Jersey jury today in opening statements.
“The evidence will show Janssen buried studies for a competitive advantage,” Trammell told jurors in state court in New Brunswick, New Jersey. J&J, the world’s second-largest health-products maker, is based in the city.
The trial of Gary Skala’s claims that his 14 years’ worth of Risperdal use caused his diabetes began two weeks after J&J agreed to pay $158 million to settle Texas officials’ claims that it fraudulently marketed the drug.
British drug maker AstraZeneca is the latest multinational to uproot from Montreal's once-thriving pharmaceutical sector.
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