Healthy Skepticism Library item: 13963

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

Metherell M.
Good drugs left behind in profit push
Sydney Morning Herald 2008 Jul 12
http://www.smh.com.au/news/national/good-drugs-left-behind-in-profit-push/2008/07/11/1215658130166.html

Full text:

MANY Australians with high blood pressure may be missing out on cheaper but often better medicine as a result of heavy promotion of more profitable alternative drugs.

The consumer organisation Choice has found that a high blood pressure drug which some experts say should be first-line treatment for many cases is prescribed at a fraction of the rate of a newer product which has been heavily advertised in medical magazines.

The finding holds significance for millions of Australians who can be prescribed a battery of different drugs to combat high blood pressure, a condition that triggers lethal heart attacks and strokes.

About 30 per cent of people aged over 25 are estimated to suffer the condition, also known as hypertension, which afflicts more than half of those over 50.

The Choice report, obtained by the Herald, found 93 per cent of advertisements aimed at doctors were for the more profitable medicines still under patent, while the newer drugs were not necessarily more effective than older treatments.

Choice’s health policy chief, Michael Johnston, said the recommended best first-line treatment for high blood pressure, chlorthalidone, was not advertised at all and was “rarely prescribed” in Australia, despite being cheaper than many more commonly prescribed treatments

Figures from the Pharmaceutical Benefits Scheme figures show that in 2005-06 there were only 35,000 prescriptions for chlorthalidone, costing $6.50 to $17, compared with 2.8 million prescriptions for the newer Coversyl drug, costing $31.40.

The study cites the independent organisation, Therapeutic Guidelines (Australia), which recommends the group of thiazide diuretic drugs, which includes chlorthalidone, stating they “should be considered first line for the majority of uncomplicated patients”.

That recommendation was supported by a big study in the United States which found that chlorthalidone was slightly superior to all other drugs and in particular was more effective at delaying strokes than other blood pressure drugs.

However a Sydney blood pressure specialist, Associate Professor Karen Duggan, said that a snag with chlorthalidone was that studies had found its use was linked to side effects including a 2 per cent increase every year in the incidence of diabetes among patients on the drug.

While such a risk in patients over 65 was less than the risk of stroke, in young patients the continued doses over the years might lift the risk of diabetes to an unacceptable level, she said.

Professor Duggan, who chairs the Heart Foundation’s national blood pressure and vascular disease advisory committee, said Choice did make valid points on the marketing of drugs and doctor education,

Choice concludes that because government contributes significantly to the cost of medicines in Australia, it should take a greater role in educating doctors.

Mr Johnston said the problem was industry-sponsored information sources on drugs, such as advertising and sales representatives, greatly outweighed independent sources of advice to doctors.

WHAT YOU GET

The five most advertised drugs

Coversyl (high blood pressure)

Norvasc (high blood pressure)

Mobic (arthritis)

Lipitor (high cholesterol)

Seretide (asthma)

SOURCE: CHOICE