[Ip-health] NY Times op-ed defending me-too drugs (industry funded)

[Mike Palmedo]

http://www.nytimes.com/2007/10/18/opinion/18pitts.html?n=3DTop/Opinion/Edit=
orials%20and%20Op-Ed/Op-Ed/Contributors&_r=3D1&oref=3Dslogin&pagewanted=3Dp=
rint

A Test of Bad Health

By PETER PITTS
October 18, 2007
New York Times

IF Congress overrides President Bush=92s veto of the State Children=92s
Health Insurance Program, a little-known provision of the original House
bill could be revived.

As written, the provision would allocate $300 million to create a Center
for Comparative Effectiveness that would test whether newer, more
expensive drugs work better than their older and cheaper counterparts.
Medicare would use the center=92s findings to help decide which drugs to
cover. If the center found that a newer, pricier pill was no more
effective than the older, cheaper version, Medicare would probably
refuse to pay for it.

This sounds reasonable. But it will most likely result in Medicare
covering fewer breakthrough medicines, which would, in turn, force
doctors to prescribe only the drugs that Medicare will pay for =97 not the
ones that are best for the patient.

Why? Drugs must be tested on large, representative populations that must
be monitored for years. Because conducting these studies is so tricky,
their findings are regularly overturned or modified by further research.
In fact, some are so off the mark that doctors ignore them.

But if Medicare starts using flawed studies like these to determine its
list of covered drugs, doctors will have to give them respect they
probably don=92t deserve. There=92s also an inherent conflict of interest
when the government conducts comparative-effectiveness studies and then
uses those studies to determine which pills are worth buying. The more
drugs the government classifies as =93wasteful,=94 the more money it saves.

Look what happened in Britain. In 2001, contrary to expert findings by
licensing authorities around the world, the British
comparative-effectiveness agency cited =93insufficient evidence=94 for
recommending the use of Gleevec in both early- and late-phase chronic
leukemia patients.

In 2002, the United States approved Gleevec for another purpose: to
treat a rare stomach cancer. It wasn=92t until 21 months later that
Britain approved the use of Gleevec for victims of the disease.

What aside from cost concerns could explain such restrictions? And what
could stop something like this from happening here? The center=92s
supporters say it will be financed through an independent =93trust fund.=94
But this won=92t solve the problem. The center would still be part of the
government =97 and still get in the way of medical innovation.

Peter Pitts is president of the Center for Medicine in the Public
Interest, a nonprofit organization that receives financing from the
pharmaceutical industry.

--
Mike Palmedo
Research Coordinator
Program on Information Justice and Intellectual Property
American University, Washington College of Law
4910 Massachutsetts Ave., NW Washington, DC 20016
T - 202-274-4442 | F 202-274-0659
mpalmedo@wcl.american.edu