Healthy Skepticism Library item: 17308

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

Hirschler B
Call for UK to ditch Astra's Nexium, other drugs
Reuters 2010 Feb 26
http://uk.reuters.com/article/idUKLDE61O0EW20100226

Abstract:

• Experts want NICE to abandon old drugs not worth using

• Candidates include “me too” drugs and new formulations

• Dropping some products will free funds for new ones

Full text:

Britain’s state health service should ditch some drugs that are not worth using, including AstraZeneca’s (AZN.L) top-seller Nexium for heartburn, to provide funds for new treatments, experts said on Friday.

Dyfrig Hughes of Bangor University and Robin Ferner of Birmingham’s City Hospital said such medicines could be relegated to a blacklist of products that cannot be prescribed on the National Health Service (NHS).

Their suggestion, in an article in the British Medical Journal, underscores a growing debate over value for money in healthcare.

Britain’s National Institute for Health and Clinical Excellence (NICE) has taken a global lead by recommending which drugs should be reimbursed on the NHS, using a systemised approach that is watched closely by other countries.

But Hughes and Ferner — the latter a member of NICE’s appeal panel — believe backing new treatments is only half the story and NICE should also cull old medicines that are not cost-effective.

“There are many that have been superseded by newer, more effective medicines and others that bring only trivial benefits over existing therapies while costing much more,” they wrote.

These include some but not all “me too” drugs — the term commonly used for new entrants into existing therapeutic categories.

The authors also hit out many of the medicines developed through “evergreening” strategies, in which drugmakers patent incremental changes and new formulations for drugs whose patents are about to expire.

One example is the heartburn and ulcer drug Nexium, which is 11 times more expensive than generic omeprazole and has no additional benefits, they said. The NHS spent 42 million pounds ($64 million) on Nexium last year in England alone.

“That 42 million pounds could be much better spent elsewhere,” Hughes said in a telephone interview.

A modified release version of AstraZeneca’s schizophrenia medicine Seroquel and a film-coated dispersible form of GlaxoSmithKline’s (GSK.L) migraine treatment Imigran were also cited as drugs that might be dropped.

“Both Nexium and Seroquel XL are clinically proven treatment options that bring benefits to many patients in the NHS,” AstraZeneca spokesman Neil McCrae said in response.

Another area of saving is seen in new measures to increase rates of generic prescribing — already 83 percent — which could produce annual savings of up to 72 million pounds by 2013.