Glaxo chief: Most of our drugs don't work as advertised

BaliBabyDoc

Lifer
Jan 20, 2001
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Independent
It is an open secret within the drugs industry that most of its products are ineffective in most patients but this is the first time that such a senior drugs boss has gone public. His comments come days after it emerged that the NHS drugs bill has soared by nearly 50 per cent in three years, rising by £2.3bn a year to an annual cost to the taxpayer of £7.2bn. GSK announced last week that it had 20 or more new drugs under development that could each earn the company up to $1bn (£600m) a year.

Thank goodness for the new legislation Bush signed. It guarantees higher industry profits for years. Of particular note is that as a class . . . psychiatric drugs (antidepressants/antipsychotics) . . . are more effective than most of their somatic counterparts. Yet many insurance companies . . . and Medicare/Medicaid . . . discriminate against people with mental illness.

 

Fencer128

Platinum Member
Jun 18, 2001
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Originally posted by: BaliBabyDoc
Independent
It is an open secret within the drugs industry that most of its products are ineffective in most patients but this is the first time that such a senior drugs boss has gone public. His comments come days after it emerged that the NHS drugs bill has soared by nearly 50 per cent in three years, rising by £2.3bn a year to an annual cost to the taxpayer of £7.2bn. GSK announced last week that it had 20 or more new drugs under development that could each earn the company up to $1bn (£600m) a year.

Thank goodness for the new legislation Bush signed. It guarantees higher industry profits for years. Of particular note is that as a class . . . psychiatric drugs (antidepressants/antipsychotics) . . . are more effective than most of their somatic counterparts. Yet many insurance companies . . . and Medicare/Medicaid . . . discriminate against people with mental illness.

I fail to see the link between drugs only working for a subset of patients and the fact that because more drugs are licensed under the NHS, the drug bill has gone up.

Sounds to me as if the author of the article would like to find an arguement to say "the NHS costs too much" - but this is the best they can do even though you cannot make that arguement from these facts. Furthermore I'm GLAD it costs more now. It means a greater variety of drugs are on offer - as compared to a few years ago. That means there'll be a greater chance of me getting a better, effective treatment if I need it.

Cheers,

Andy
 

BaliBabyDoc

Lifer
Jan 20, 2001
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Glaxo, Pfizer, BMS, etc NEVER advertise to get you to buy the MOST effective drug for you. They advertise for you to buy their drug . . . regardless of whether or not it will be a benefit to you. I'm not sure you actually read the article or understand what Roses (the GSK exec) was trying to say. More money must go into R&D but it should not go into the current "me too" process which has generated a myriad of statins. It should go into characterizing the interaction between pharmacotherapy and genetics to determine profiles of drug efficacy and possibly even rational drug design to improve efficacy/decrease side effects.

There's a poor overall correlation between producing MORE drugs and increasing the odds a drug will work for a particular person. If the determining factors are truly genetic (pharmacogenetics) it's the equivalent of buying 10 lottery tickets instead of one and then claiming you've got a much better chance of winning.

It's beyond the scope of the article, but pharmacogenetics is the distant future (probably). In the near term, physicians, drug companies, and funding authorities need to work together to improve the quality of care while reducing costs. Predictable adverse drug events (giving a multiple cytochrome 3A4 drugs to a slow metabolizer) costs millions if not billions each year. You can screen for slow metabolizers (cheap test) or just not give multiple 3A4 drugs. In either case, prevention easily pays for itself. Even if you ignore adverse events, it costs a lot to deal with excess utilization that comes from ineffective treatment. Physicians lack the time (and often initiative) to change the standard of care. Drug companies clearly lack the initiative b/c they are collecting handsome sums based on the status quo. Governments and insurance companies should eagerly embrace reform but instead they've taken three other routes:

1) producing preferred pharmacy lists: essentially choosing one or two agents from a class as 1st line therapy while requiring extensive hoop-jumping for a clinician to prescribe anything else . . . (naturally this obliterates the argument that more drugs increase the opportunity of finding an effective therapy).

2) In the UK, US insurance companies (and other single payer nations): negotiate lower drug costs while ignoring efficacy issues

3) In the US: recent legislation to prohibit negotiating for lower drug costs
 

alchemize

Lifer
Mar 24, 2000
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BBD,

The Medical Profession/Industry has some serious complicity with the rampant overprescription/misprescription of these often ineffective drugs.

Don't blame the government unless you are willing to take on some of the blame yourself. Where was your lobby fighting against it?
 

BaliBabyDoc

Lifer
Jan 20, 2001
10,737
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The Medical Profession/Industry has some serious complicity with the rampant overprescription/misprescription of these often ineffective drugs.
Don't blame the government unless you are willing to take on some of the blame yourself. Where was your lobby fighting against it?
I left the AMA b/c the organization is FOS. The American Psychiatric Association (APA), American Academy of Pediatrics(AAP), and the American Academy of Child and Adolescent Psychiatry (AACAP)all have somewhat responsible policies about reform in prescription drug use.

The complication for the AAP is that the US government does NOT require drugs to be tested in children. At the moment less than 15% of all drugs prescribed for children have been tested in children. By definition, pediatric treatment is more likely to fail since these drugs were not adequately tested in clinical trials. Fortunately, children have outrageous placebo responses. Granted, that's also another reason why few people want to test drugs in children.

The APA (not to be confused with the American Psychological Association) has more stringent rules about what gifts are acceptable from drug companies than the AMA. Unfortunately, the explosion in psychiatric drug costs has led drug companies to lavish speaker bureau, advisory board positions, and research grants to clinicians. Admittedly, some people are motivated by money.

The AACAP has all the liabilities of the AAP and APA.

An older project but similar to what I do now . . . notice the funding source.
 

alchemize

Lifer
Mar 24, 2000
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Excellent BBD you've restored some of my faith in you ;)

I think we both agree that the AMA is in bed with the pharmacy companies. But I think that relationship is the greater long-term threat to the general health of our country, not government intervention such as the bill you referenced.

Change comes best from within...the democrats haven't substantially supported revolution in healthcare anymore than the Dems have. Both sides are clambering over each other to see who can pay for more, yet insert their own pork in, and get the most votes out of it.
 

glenn1

Lifer
Sep 6, 2000
25,383
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BBD, i'd add increasing the number of mandatory C.E. hours for physicans on your list of potential improvement areas. I know for VA the requirement is only 30 hours C.E. per year, and for some states it's only 10. For a good number of docs (especially ones who have been out of medical school for a while), i'd say that's not nearly enough. Hell, i could self-diagnose with a Merck Medical Guide better than some of the docs i've had could do on their own.

I agree, pharma companies seem to be hitting the wall in regards to what new miracles can be accomplished with traditional chemical pharmacology. Hopefully biotech and genetic engineering pharmacology techniques will step up to the plate with some singificant contributions to the doctor's arsenal before long.
 

charrison

Lifer
Oct 13, 1999
17,033
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Since glaxo cant make all their drugs 100% effective in all patients, they should only release a drug when it reaches such capabilties. There is no need to help those 30-60% who do benefit from the substandard drugs that are being produced.
 
Feb 24, 2001
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Yet many insurance companies . . . and Medicare/Medicaid . . . discriminate against people with mental illness.

I think the whole idea about mental "illness" is out of whack. It's not a medical problem. It's great that some folks have coverage for it, but it should be completely seperate from major medical insurance. I tend to think that only hurts people more than it helps. It turns them into patients instead of clients. It's not a disease or anything, it's just someone getting help. Why add to their problems and make it some medical illness?

Tough call on what to do. Let it continue like it is and have insurance pay some of it, which would help people financially, or class it as non-medical and have them feel like a customer and not a patient, but having to pay more. Unforunately, I think it has to come down to the almighty dollar. Too expensive for any sort of long-term therapy without assistance.