Monday, 15 July 2013

Phenytoin Bad Pharma Fleecing the NHS

#MSResearch #MSBlog. Bad pharma fleecing the NHS

Whilst we are talking about phenytoninin optic neuritis today we got the news of Bad Pharma from The Independent.

Drugs companies have been accused of “highway robbery” of the NHS by using a legal loophole to push up the price of medicines in some cases by up to 2,000 per cent – at a cost to the taxpayer of tens of millions a year.

Drugs are being “flipped” from one firm to another with a price hike in between.

The Government attempts to hold down the price of drugs bought by the NHS through the Pharmaceutical Price Regulation Scheme (PPRS), under which the Department of Health negotiates what it considers a fair price for a patented medicine.

The legal “scam”  involves big-pharma firms selling on medicines commonly used by the NHS to businesses acting outside the Government’s price-regulation scheme. The purchasing firms are then free to mark up the prices they charge the NHS.  They sell the marketing rights to a treatment when its patent expires. The buyer is then able to rebrand the drug under a new name and sell it back to the NHS in a generic form at a vastly inflated price because it no longer falls under the PPRS agreement.

The drug Epanutin was sold by its manufacturer Pfizer to another business, Flynn Pharma. The medication, which is used by around 100,000 people across Britain, originally cost about 67p per 50mg. But after the sale this price shot up to almost £16 for the same amount, representing a 2,385 per cent increase. It was estimated that this mark-up will force the NHS to spend an extra £50m per year on Epanutin – now renamed Phenytoin.

                     
For Pharma the pot is filled with Cash

What next? 

6 comments:

  1. Wow, you were quick off the line there MD!
    This is scandalous. I really do wonder if there are no depths to which pharma will not stoop to make a buck. As pheytoin will be used for the optic neuritis trial, this could have implications for MSers.

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  2. see Lemtrada a.k.a alemtuzumab, campath. Re-labelled from B-cell CLL to MS. Then a miraculous transformation in pricing http://articles.chicagotribune.com/2012-10-31/lifestyle/sns-rt-us-sanofi-lemtrada-lancetbre8a0005-20121031_1_lemtrada-campath-sanofi

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  3. My guess is that this is particularly prevalent in anticonvulsant medications. Even when generic (i.e. off patent) these are usually prescribed as branded. The clinical reason for this is the different bioavailability between preparations, which, whilst not so important in drugs for things like high blood pressure, can have a pretty devastating effect in epilepsy.

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  4. It seems the pharma companies will try to exploit every loophole available. Their goal is squeezing every last dollar out of the system. Seems to me that the incentive system needs to be radically changed.

    How about this for a solution: Take the total money spent on MS (or whatever disease) in a two year period by the NHS, and insurance companies in the US, and declare it a prize for curing the disease. Not a DMD, but an actual cause and cure. The NHS or insurance companies still pay out the same amount they would have for that two year period so they don't lose anything, but the money goes to the person/company/team who found the cure. The NHS and insurance companies then don't have the expense after the two years. Everyone wins. As part of the deal, the patent holder for the cure has to offer it from then on at a very reasonable rate.

    Of course there are many problems with this solution. Who defines a cure, etc. But, this or something similar would create competition because if a pharma knows if they don't find the cure, someone else will.

    Bottom line: As long as the incentive is to develop drugs that manage the disease and therefore create a money stream, that is what will happen. Change the money flow, and you change the pharma companies.

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  5. world market for 2015 about a few billion dollars.

    But If I found the cure today, then it will be 20 years before you believe it, maybe we have found a cure?

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    Replies
    1. Yes, I admit it isn't as simple as this. However, as long as the incentive is to get and keep people taking drugs for the long term, that is where the big money (pharma) will be spent. Then how best to create an incentive for an actual cure?

      Perhaps require a percentage of drug profits above a certain amount be given to a third party non-profit foundation looking for a cure, managed by people with MS? That'll never happen...

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