[Ip-health] France: Prescription drugs mean big money

[michelle.childs@keionline.org]

Consumers International is running a campaign on drug promotion. One of
its members in France (UFC-QUE CHOISIR)has estimated that between 2002 and
2006 =801 billion has been wasted as a result of GPs prescribing branded
rather than generic drugs.

<snip>

In particular the study analysed the sharp rise - an increase of 88%
between 2002 to 2006 - in the spending on anticoagulants and antiplatelet
agents.

It argued that in France this is mainly due to the prescription of one
particular drug called Plavix =96 the second most prescribed drug worldwide=
.

It was found that in a significant number of cases, the cheaper low-dose
generic aspirin version called Protect could have been prescribed rather
than Plavix.


UFC-QUE CHOISIR pointed out that in 2002 alone, the health authorities
have found that 50% of prescriptions for Plavix were unnecessary or
mis-prescribed. This means that =8070 million per year or =80350 million fo=
r
the period spanning 2002 to 2006 could have been saved.



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&int1stParentNodeID=3D89655&int2ndParentNodeID=3D97504

Prescription drugs mean big money
Research by the French consumer group Union F=E9d=E9rale des Consommateurs-=
Que
Choisir (UFC-QUE CHOISIR) has estimated that between 2002 and 2006 =801
billion has been wasted as a result of GPs prescribing branded rather than
generic drugs.

The group claims that this colossal misappropriation is a result of drug
industry pressure on doctors.

Irresponsible drug promotion has been a concern for the consumer movement
for many years and recent reports from Consumers International such as
Branding the Cure and Drugs, doctors and dinners have sought to highlight
the tactics drug companies are using to influence doctors prescribing
habits and =96 increasingly =96 exploit loopholes in the regulations that m=
ost
countries use to prevent drug companies advertising directly to consumers.

However, whilst the practices are increasingly well known, it will be a
shock to many to discover the impact that this promotion can have on
health budgets.


UFC-QUE CHOISIR has been looking more closely at this issue and studying
spending on prescription drugs in France.


The financial impact
The first phase of the study by UFC-QUE CHOISIR was released in September
2007 and showed that the systematic prescription of new, branded drugs
rather than generic drugs to treat three conditions, gastro-oesophageal
disorders, arthritis and blood pressure cost the healthcare system in
France =80660 million.


More recently a second phase of the study focused on another set of drugs,
namely anticoagulants and antiplatelet agents that are used in the
prevention of cardiovascular attacks.


Taken together, the two phases of the study suggest that over the period
of four years, from 2002 to 2006, a total of =801 billion could have been
saved. This figure relates to just the five kinds of drugs included in the
study which represent 14% of all prescriptions made by general
practitioners.


Facts and figures
In particular the study analysed the sharp rise - an increase of 88%
between 2002 to 2006 - in the spending on anticoagulants and antiplatelet
agents.

It argued that in France this is mainly due to the prescription of one
particular drug called Plavix =96 the second most prescribed drug worldwide=
.

It was found that in a significant number of cases, the cheaper low-dose
generic aspirin version called Protect could have been prescribed rather
than Plavix.


UFC-QUE CHOISIR pointed out that in 2002 alone, the health authorities
have found that 50% of prescriptions for Plavix were unnecessary or
mis-prescribed. This means that =8070 million per year or =80350 million fo=
r
the period spanning 2002 to 2006 could have been saved.


Industry influences and prescription behaviour
In their study UFC-QUE CHOISIR also highlighted the findings of two
recently published independent reports by the Court of Auditors and the
General Inspection of Social Affairs (IGAS), and found that the results of
phases one and two of their own study were consistent with those of the
other two reports.

These findings underpin UFC-QUE CHOISIR=92s claims that doctors=92
prescription methods are heavily influenced by the pharmaceutical industry
and that the pharmaceutical industry influences these prescription
behaviours particularly through sales reps visiting doctors.

UFC-QUE CHOISIR argues that the information given to doctors during these
sales rep visits can never be objective and points to research by the
independent health network/magazine Prescrire and its Observatory for
Medical Visits in the period stretching from 1991 to 2006.

This research had revealed that the pressure exerted by the drug industry
in France is higher than anywhere else in Europe. The IGAS report
highlighted the fact that France had an incredible 22,702 sales reps in
2005 or one pharma sales representative for every nine doctors. This is
twice as many as in England or Germany and four times more than in the
Netherlands. IGAS estimated that the annual cost born by the industry is
the equivalent of =8025,000 per doctor.

In France, all of this sales power is directed at doctors as industry
sales reps are only allowed to visit doctors and not pharmacists nor drug
wholesalers or drug distributors. However UFC-QUE CHOISIR also noted a new
and worrying trend whereby the pharma industry is now seeking to bypass
doctors and reach out to consumers and patients directly.


UFC-QUE CHOISIR=92s campaign aims
UFC-QUE CHOISIR is calling on the Ministry of Health to undertake a
radical reform of France=92s drug policy and provision of information to
doctors. It regrets the Ministry of Health=92s lack of reaction or response
to these recently published reports.

They also question the effectiveness and credibility of doctors receiving
training and/or continuing education which is 90% funded by the pharma
industry as provided for under new public health legislation.

UFC-QUE CHOISIR is also concerned about the lack of pharmacology training
French doctors receive. With only 80 hours of study dedicated to
pharmacology, France ranks last in Europe for education in this field.

UFC-QUE CHOISIR proposes to rebalance information to doctors through an
initiative, which requires the combination of government authorities
providing more objective information and curbing the =91blanket marketing=
=92
practices of pharmaceutical companies.


What does UFC-QUE CHOISIR want to happen?
UFC-QUE CHOISIR wants the pharma industry sales reps to be replaced with
the establishment of a body of 1,700 public medical visitors under the
authority of the High Authority for Health (HAS).

The annual cost for maintaining this measure is estimated at =80200 million
and could be funded through taxing pharma marketing.

In the mean time, until these measures are adopted, UFC-QUE CHOISIR has
called for an =91immediate drug promotion disarmament=92. This refers to th=
e
strengthening of the following two measures already in existence:

increasing taxes on drug promotion, and
a reduction in the number of visits to doctors by sales reps in the case
of the most problematic types of drugs.

In France, the study has attracted a lot of media attention with Le Monde
publishing a summary of the findings. However, it remains to be seen
whether the measures suggested by UFC-QUE CHOISIR will be adopted and
whether they will be sufficient to withstand the onslaught of the
pharmaceutical industry in its ever-increasing quest to make more money
from prescription drugs.


Consumers International is working with its global membership to monitor
drug promotion and campaign for effective rules to curb irresponsible drug
marketing. More information about the campaign including CI reports, an
online blog and spoof video showing the tactics that drug companies use to
promote their drugs is available at www.marketingoverdose.org/


Read the UFC-QUE CHOISIR reports
The UFC-QUE CHOISIR reports and their findings can be viewed on
www.quechoisir.org/ at the links below:

Comment les labos et les m=E9decins creusent le trou...
Prescription des m=E9dicaments : Analyse des d=E9penses de m=E9dicaments
remboursables suite =E0 une prescription de ville
Prescriptions de m=E9dicaments : Des prescriptions irrationnelles, un
constat confirm=E9 par la Cour des Comptes


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