Healthy Skepticism Library item: 10034

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: news

Goldstein J.
Anemia Drug Rebates to Docs May Spur Overuse
The Wall Street Journal Health Blog 2007 May 9
http://blogs.wsj.com/health/2007/05/09/anemia-drug-rebates-to-docs-may-spur-overuse/?mod=yahoo_hs

Full text:

In a front-page story, the New York Times connects the dots between the rebates paid to doctors who prescribe anemia drugs and the higher-than recommended doses many patients receive.

The paper got hold of records from a group of six cancer doctors in the Pacific Northwest who received rebates of $2.7 million from Amgen for prescribing $9 million worth of the company’s drugs last year. The documents were provided by the group’s former business manager, who lost his job. He told the Times the doctors made a net profit of $1.8 million on the drugs.

The rebates aren’t illegal, but they have come under scrutiny as studies have shown that many patients receive higher doses than the FDA recommends. At high doses, the drugs increase the risk of blood clots. A graphic with the Times story shows that the average dose of the drugs U.S. patients receive – 17,400 units of drug per week – is far higher than that given in many other developed countries. In Britain, for example, the average dose is 8,000 units per week; the Canadian average is 10,800.

Anemia drugs in the class include Amgen’s Epogen and Aranesp, and Johnson & Johnson’s Procrit. The drugs raise the level of the oxygen-carrying protein hemoglobin (pictured, above left) in the blood and reduce the need for transfusions. J&J told the Times the rebates don’t aim to cause doctors to prescribe more of its drug but instead “reflect intense competition” in the market. Amgen said rebates are a normal commercial practice and that the company’s promotion of its drugs has been proper.

An FDA advisory committee is meeting tomorrow to discuss the risks the drugs carry for cancer patients. For the Health Blog’s preview of that meeting, click here; our interview on anemia drugs with the CEO of a big dialysis company, is here; for a counterpoint to the CEO’s point of view, click here.