Generic Copaxone? [Archive] - BrainTalk Communities

Harpist

01-07-2008, 06:32 PM

Where did you get the info that Canadians were getting "generic" Copaxone? I would be very surprised if that is true, since we do follow patent laws. I can call my neuro and pharmacy to find out for sure, if you feel confident that that is occuring. :confused:

Drugs are much cheaper here though.

Cherie

Cherie,

There are a lot of ways around patents that different countries use. Rebif and Avonex are one example. They are essentially the same medication and would not normally be allowed to be marketed in the US because of the Orphan Drug Law. As a result, I believe that Rebif was not approved in the US until 2001 or 2002 (well after other countries). It got around the Orphan Drug Law by the method of delivery and the resulting effectiveness.

I have also heard of the possibility of generic Copaxone in Canada (from two friends in Ontario). The price reduction is predicted at about 60%. Why the reduced cost? Very little research is required as it was all done by Teva.

Yes, drugs are cheaper in Canada than in the US. In the US, there is a significantly higher investment in the development of new drugs in comparison to Canada (about 3X higher on a per capita basis). Despite what people believe, the pharma industry is not a profitable sector as a whole. For example, take a look at the stock prices for BioGen or Pfizer since 2000. And a lot of smaller companies go belly up before they ever get to market.

To recoup their investment, drug companies charge more in the US (because of lower profits in other places such as Canada). They can do this because there is no central agency that regulates drug prices. It is the s***s, but this is one of the prices for innovation. While I look forward to the cost reductions associated with generics, I feel that we (as a community of people with MS) also need the innovation associated with drug research. The losers in this are those without insurance (we have discussed socialized and single insurer health care systems a number of times in the forum).

I still don't invest very much money in pharma *grin*

Good Roads

Harpist

lady_express_44

01-07-2008, 11:49 PM

I'd still be surprised if we are using generic copaxone, generally speaking.

It may be that some people are buying off the internet. I know plenty of people (in Canada and the US) buying Naltrexone (LDN), from Mexico or India, and mixing it themselves. Perhaps people who have to pay out of pocket are doing something similar with Copaxone.

The MS Society here supports Teva and Shared Solutions. I can't imagine that any insurance company is encouraging or coaching people to buy generic drugs, where there is still a patent. As far as where our pharmacists get it, I suppose that might be up to them somewhat. I will ask my pharmacist next time I am in . . .
Personally, I don't agree with generic drugs coming on the market when there is a patent. That kinda defeats the purpose, doesn't it?

As far as R&D costs, there are CONSIDERABLE tax incentives for that kind of research, at least in Canada. Also, I think a lot of money is wasted on marketing:
__________

The Cost of Pushing Pills: A New Estimate of Pharmaceutical Promotion Expenditures in the United States

Marc-André Gagnon*, Joel Lexchin

Funding: The authors received no specific funding for this article.

Competing Interests: The authors have declared that no competing interests exist.

Citation: Gagnon MA, Lexchin J (2008) The Cost of Pushing Pills: A New Estimate of Pharmaceutical Promotion Expenditures in the United States. PLoS Med 5(1): e1 doi:10.1371/journal.pmed.0050001

Published: January 3, 2008

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abbreviations: AWP, average ********* price; PhRMA, Pharmaceutical Research and Manufacturers of America; R&D, research and development

Marc-André Gagnon is with the Département de Sociologie,Université du Québec à Montréal, Montreal, Quebec, Canada. Joel Lexchin is with the School of Health Policy and Management, York University, Toronto, Ontario, Canada

* To whom correspondence should be addressed. E-mail: ma.gagnon@umontreal.ca

In the late 1950s, the late Democratic Senator Estes Kefauver, Chairman of the United States Senate's Anti-Trust and Monopoly Subcommittee, put together the first extensive indictment against the business workings of the pharmaceutical industry. He laid three charges at the door of the industry: (1) Patents sustained predatory prices and excessive margins; (2) Costs and prices were extravagantly increased by large expenditures in marketing; and (3) Most of the industry's new products were no more effective than established drugs on the market [1]. Kefauver's indictment against a marketing-driven industry created a representation of the pharmaceutical industry far different than the one offered by the industry itself. As Froud and colleagues put it, the image of life-saving “researchers in white coats” was now contested by the one of greedy “reps in cars” [2]. The outcome of the struggle over the image of the industry is crucial because of its potential to influence the regulatory environment in which the industry operates.

Fifty years later, the debate still continues between these two depictions of the industry. The absence of reliable data on the industry's cost structures allows partisans on both sides of the debate to cite figures favorable to their own positions. The amount of money spent by pharmaceutical companies on promotion compared to the amount spent on research and development is at the heart of the debate, especially in the United States. A reliable estimate of the former is needed to bridge the divide between the industry's vision of research-driven, innovative, and life-saving pharmaceutical companies and the critics' portrayal of an industry based on marketing-driven profiteering.

IMS, a firm specializing in pharmaceutical market intelligence, is usually considered to be the authority for assessing pharmaceutical promotion expenditures. The US General Accounting Office, for example, refers to IMS numbers in concluding that “pharmaceutical companies spend more on research and development initiatives than on all drug promotional activities” [3]. Based on the data provided by IMS [4], the Pharmaceutical Research and Manufacturers of America (PhRMA), an American industrial lobby group for research-based pharmaceutical companies, also contends that pharmaceutical firms spend more on research and development (R&D) than on marketing: US$29.6 billion on R&D in 2004 in the US [5] as compared to US$27.7 billion for all promotional activities.[4]

In this paper, we make the case for the need for a new estimate of promotional expenditures. We then explain how we used proprietary databases to construct a revised estimate and finally, we compare our results with those from other data sources to argue in favor of changing the priorities of the industry.

The Case for a New Estimate of Pharmaceutical Promotion

There are many concerns about the accuracy of the IMS data. First, IMS compiles its information through surveys of firms, creating the possibility that companies may systematically underestimate some of their promotional costs to enhance their public image. Second, IMS does not include the cost of meetings and talks sponsored by pharmaceutical companies featuring either doctors or sales representatives as speakers. The number of promotional meetings has increased dramatically in recent years, going from 120,000 in 1998 to 371,000 in 2004 [6]. In 2000, the top ten pharmaceutical companies were spending just under US$1.9 billion on 314,000 such events [7]. Third, IMS does not include the amount spent on phase IV “seeding” trials, trials designed to promote the prescription of new drugs rather than to generate scientific data. In 2004, 13.2% (US$4.9 billion) of R&D expenditures by American pharmaceutical firms was spent on phase IV trials [5]. Almost 75% of these trials are managed solely by the commercial, as opposed to the clinical, division of biopharmaceutical companies, strongly suggesting that the vast majority of these trials are done just for their promotional value [8].

Finally, IMS data seem inconsistent with estimates based on the information in the annual reports of pharmaceutical companies. For example, in an accounting study based on the annual reports of ten of the largest global pharmaceutical firms, Lauzon and Hasbani showed that between 1996 and 2005, these firms globally spent a total of US$739 billion on “marketing and administration.” In comparison, these same firms spent US$699 billion in manufacturing costs, US$288 billion in R&D, and had a net investment in property and equipment of US$43 billion, while receiving US$558 billion in profits [9].

To be continued . . .

lady_express_44

01-07-2008, 11:51 PM

Continued ...

nnual reports, however, have their own limitations. First, pharmaceutical firms are multinational and diversified; their annual reports provide no information on how much they spend on pharmaceutical marketing, as compared to the marketing of their non-pharmaceutical products, and they do not provide information about how much is spent on marketing specifically in the US. Second, annual reports merge the categories of “marketing” and “administration,” without delineating the relative importance of each. Finally, “marketing” is a category that includes more than just promotion; it also includes the costs of packaging and distribution. In terms of offering a more precise estimate of overall expenditures on pharmaceutical promotion in the US, annual reports are thus far from satisfactory.

In the absence of any collection of information on promotional spending by government or any other noncommercial source, the market research company IMS has long been the only source of such information, which it gains by surveying pharmaceutical firms. Since 2003, however, the market research company CAM has been providing comprehensive information on promotion expenditures by surveying doctors instead of firms. (In July 2005, CAM was merged into the Cegedim Group, another market research company.) We chose to compare IMS data to those produced by CAM in order to provide a more accurate estimate of promotional spending in the US. Other proprietary sources of data do not break down promotional expenditures into different categories and therefore were not used in our comparison.

Methods

According to its Web site (http://www.imshealth.com/), IMS provides business intelligence and strategic consulting services for the pharmaceutical and health care industries. It is a global company established in more than 100 countries. IMS gathers data from 29,000 data suppliers at 225,000 supplier sites worldwide. It monitors 75% of prescription drug sales in over 100 countries, and 90% of US prescription drug sales. It tracks more than 1 million products from more than 3,000 active drug manufacturers. IMS data for 2004 were obtained from its Web site for the amount spent on: visits by sales representatives (detailing), samples, direct-to-consumer advertising, and journal advertising.

The Cegedim Web site (http://www.cegedim-crm.com/index.php?id=12) describes CAM as a global company dedicated to auditing promotional activities of the pharmaceutical industry, established in 36 countries worldwide. CAM annually surveys a representative sample of 2,000 primary care physicians and 4,800 specialists in a variety of specialties in selected locations in the US. From CAM's newsletter [10], we obtained access to data from CAM for the same promotion categories as from IMS. In addition, CAM provided figures for the amount of spending on company-sponsored meetings, e-promotion, mailings, and clinical trials.

We used 2004 as the comparison year because it was the latest year for which information was available from both organizations. We focused on the US because it is the only country for which information is available for all important promotional categories. The US is also, by far, the largest market for pharmaceuticals in the world, representing around 43% of global sales [11,12] and global promotion expenditures [10,13].

We asked both CAM and IMS about the procedures that they used to collect information on different aspects of promotion. Based on the answers we received, we determined the relevant figures for expenditures for samples and detailing. Each author independently decided on which values should be used, based on an understanding of the methods that the companies used to collect the information and the limitations of those methods. Differences were resolved by consensus.

We queried CAM and IMS about the estimated value of unmonitored promotional expenditures. IMS did not provide an answer to this question. In order to validate its estimates, CAM relies on a validation committee that includes representatives from various pharmaceutical firms, including Merck, Pfizer, Bristol-Myers Squibb, Eli Lilly, Aventis, Sanofi-Synthelabo, AstraZeneca, and Wyeth. Under a confidentiality agreement, the firms supply CAM with internal data related to their detailing activity and promotional costs in the US. Through the validation committee, CAM can thus compare totals obtained through its own audits with the firms' internal data about their promotional budgets in order to evaluate if all promotion has been properly audited through its physician surveys. As a result of this comparison, CAM's validation committee considers that about 30% of promotional spending is not accounted for in its figures. CAM is unable to provide an exact breakdown of unmonitored promotion, but it believes that around 10% is due to incomplete disclosure and omissions by surveyed physicians and the remaining 20% comes from a combination of promotion directed at categories of physicians that are not surveyed, unmonitored journals in which pharmaceutical promotion appears, and possibly unethical forms of promotion. We adjusted total expenditures to account for this unreported 30%.

Results

For 2004, CAM reported total promotional spending in the US of US$33.5 billion [10], while IMS gave the figure of US$27.7 billion for the same year [4]. Both CAM and IMS cited the media intelligence company CMR as the source for the amount spent on direct-to-consumer advertising (US$4 billion), and they also gave the same figure for journal advertising (US$0.5 billion).

There were two major differences between the two sets of figures: the amounts spent on detailing and the amounts spent on samples. IMS estimated the amount spent on detailing at US$7.3 billion [4] versus US$20.4 billion for CAM [10], and while IMS gave a retail value of US$15.9 billion for samples [14], CAM estimated a ********* value of US$6.3 billion [10].

Using the IMS figure of US$15.9 billion for the retail value of samples, and adding the CAM figures for detailing and other marketing expenses after correcting for the 30% estimate of unaccounted promotion, we arrived at US$57.5 billion for the total amount spent in the US in 2004, more than twice what IMS reported (see Table 1).

To be continued . . .

lady_express_44

01-07-2008, 11:52 PM

Continued . . .

**Table 1. Pharmaceutical Marketing Expenditures in the United States in 2004: Data from IMS, CAM, and Our New Estimate

Discussion

Our revised estimate for promotional spending in the US is more than twice that from IMS. This number compares to US$31.5 billion for domestic industrial pharmaceutical R&D (including public funds for industrial R&D) in 2004 as reported by the National Science Foundation [15].

However, even our revised figure is likely to be incomplete. There are other avenues for promotion that would not be captured by either IMS or CAM, such as ghostwriting [16] and illegal off-label promotion [17]. Furthermore, items with promotional potential such as “seeding trials” or educational grants might be included in other budgets and would not be seen in the confidential material provided to CAM's validation committee.

IMS and CAM data were used for comparison purposes for a number of reasons: data from both were publicly available, both operate on a global scale and are well regarded by the pharmaceutical industry, both break down their information by different categories of promotion, and, most importantly, they use different methods for gathering their data, thereby allowing us to triangulate on a more accurate figure for each category.

Methodological differences between the ways that IMS and CAM collect data will affect the values for promotional spending depending on the category being considered. Because of the problematic nature of some data from each firm, we believe that the most precise picture of industry spending can be obtained by selectively using both sets of figures.

CAM compiles its data on the value of detailing and samples through systematic surveys of primary care providers and specialists and by estimating an average cost for each visit by a sales representative according to the type of physician. By contrast, IMS compiles its data on the value of detailing through surveys of firms, while its data on samples are obtained by monitoring products directly from manufacturers.

There is a significant discrepancy between the two sets of data in the cost of detailing: US$7.3 billion for IMS and US$20.4 billion for CAM. This difference can be explained by the fact that CAM offers a more complete data set since it includes in the average cost of a call (a sales representative's visit to a physician) not only the “cost to field the rep” (salary and benefits of the representative and the transportation cost) but also the costs for the area and regional managers, the cost of the training, and the cost of detail aids such as brochures and advertising material. By contrast, in reporting the cost of detailing IMS only considers the “cost to field the rep.” Furthermore, relying on physician-generated data to estimate the amount spent on detailing is likely to give a more accurate figure than using figures generated by surveying firms. Companies may not report some types of detailing, for example, the use of sales representatives for illegal off-label promotion, whereas doctors are not likely to distinguish between on- and off-label promotion and would report all encounters with sales representatives.

In the case of samples, there is also a large difference between the IMS (US$15.9 billion) and CAM (US$6.3 billion) estimates. CAM estimates the amount spent on samples by multiplying the number of samples declared by physicians with their ********* value. The latter is determined by using the average ********* price (AWP), which is the amount set by manufacturers and used by Medicare in the US to determine reimbursement. CAM then divides that amount in half to account for the fact that samples are frequently given out in small dosage forms. CAM admits, however, that the amount for samples is understated because, when physicians fill out their survey, any quantity of samples of the same product left during a call is considered to be only one sample unit. CAM's calculations also rely on the AWP, which has been criticized for not taking into account the various discounts and rebates that are negotiated between manufacturers and purchasers [18].

IMS provides exact figures for the retail value for samples by monitoring 90% of all pharmaceutical transactions and by tracking products directly from manufacturers. This method for calculating the value of samples is much more direct than CAM's and therefore is likely to be subject to less error.

Using the ********* value for samples, the CAM figure would be appropriate if we were arguing that the money spent on samples should go to another activity such as R&D. However, we have used the retail value of samples because this is consistent with companies' reporting of drugs they donate [19]. As these are both categories of products that are being distributed without a charge to the user, it is inconsistent for donations to be reported in terms of retail value and samples in terms of ********* value.

We believe that it is appropriate to correct for unmonitored promotion and that the figure we used is a reliable estimate. The 30% correction factor is based on a direct comparison that CAM is able to make between the data it collects through its surveys and the amount reported by companies.

There are other ways of combining the data that we have presented, but with the exception of choosing the lower amounts for detailing and samples and ignoring the 30% for unmonitored promotion, all of them yield a higher figure than the one from IMS. Some examples of alternative estimates follow: using the CAM estimate for the ********* value of samples and the 30% adjustment, the total amount would be US$47.9 billion; without the 30% adjustment CAM's estimate is US$33.5 billion. Adding the figures for the categories that IMS does not cover (meetings, e-promotion, mailing, clinical trials) boosts its estimate to US$31 billion; using the lower figures for detailing and samples plus the CAM amounts for the other categories and applying the 30% adjustment gives an amount of US$29.1 billion. Therefore, the actual amount could range from a low of US$27.7 billion to a high of US$57.5 billion. Our analysis shows, however, that the figure of US$57.5 billion is the most appropriate one when using the most relevant figures for each category of promotional spending.

Excluding direct-to-consumer advertising, CAM considers that around 80% of the remaining promotion is directed towards physicians, with 20% of this figure going to pharmacists. (IMS does not provide any comparable values.) With about 700,000 practicing physicians in the US in 2004 [20], we estimate that with a total expenditure of US$57.5 billion, the industry spent around US$61,000 in promotion per physician. As a percentage of US domestic sales of US$235.4 billion [21], promotion consumes 24.4% of the sales dollar versus 13.4% for R&D.

Our new estimate of total promotion costs and promotion as a percentage of sales is broadly in line with estimates of promotional or marketing spending from other sources. The annual reports of Novartis distinguish “marketing” from “administration.” Marcia Angell extrapolates from this annual report to the entire industry and calculates a figure of US$54 billion spent on pharmaceutical promotion in the US in 2001 [22]. As a proportion of sales, she estimates 33% is spent on marketing. Using similar methodology, the Office of Technology Assessment derived an estimate for marketing costs in the US by extrapolating from the cost structure of Eli Lilly. The Office of Technology Assessment considers that firms spend around 22.5% of their sales on marketing [23]. Based on United Nations Industrial Development Organization estimates, a report from the Organization for Economic Cooperation and Development estimated that, in 1989, pharmaceutical firms globally spent 24% of their sales on marketing [24], but few details of the methodology used were provided, making it impossible to verify the accuracy of the estimate. Finally, in 2006 Consumers International surveyed 20 European pharmaceutical firms to obtain more information about their exact expenditures on drug promotion. Among the 20 firms contacted, only five agreed to provide separate figures for marketing, which ranged from 31% to 50% of sales depending on the firm [25].

The results are also consistent with data on the share of revenue allocated to “marketing and administration” according to annual reports of large pharmaceutical companies, if we consider that the largest part of “marketing and administration” is devoted to promotion. Lauzon and Hasbani found that 33.1% of revenues was allocated to “marketing and administration” [9], similar to the 31% reported by the Centers for Medicare and Medicaid Services [26] and the 27% from Families USA [27].

The value of our estimate over these others is that it is not based on extrapolating from annual reports of firms that are both diversified and multinational. Our estimate is driven by quantifiable data from highly reliable sources and concerns only the promotion of pharmaceutical products in the US. The derivation of our figure is thus transparent and can form the basis for a vigorous debate.

To be continued . . .

lady_express_44

01-07-2008, 11:53 PM

Continued . . .

Conclusion

From this new estimate, it appears that pharmaceutical companies spend almost twice as much on promotion as they do on R&D. These numbers clearly show how promotion predominates over R&D in the pharmaceutical industry, contrary to the industry's claim. While the amount spent on promotion is not in itself a confirmation of Kefauver's depiction of the pharmaceutical industry, it confirms the public image of a marketing-driven industry and provides an important argument to petition in favor of transforming the workings of the industry in the direction of more research and less promotion.

Supporting Information

Abstract S1. English abstract
(20 KB DOC).

Alternative Language Abstract S1. Translation of the abstract into French by MAG
(20 KB DOC).

Appendix S1. The Web links displayed in the footnotes 4,7,10,13,14, and 21 are now defunct. In order to make accessible all data we used for this article, this appendix provides supporting information or alternative sources for the defunct Web links.
(994 KB PDF).

Acknowledgments

The authors would like to thank Jean-François Duplain from CAM Group (Canada), Sylvie Gaumond and Sue Cavallucci from IMS Health Canada, Lesley Shulenburg at Thomson CenterWatch, and Éric Pineault, Jean F. Gerbini, Marc Hasbani, and Marie Carpentier for their help and comments.

**[References omitted]

All journal content, except where otherwise noted, is licensed under a Creative Commons Attribution License.

http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0050001&ct=1
(thanks Agate)

Cherie

Jakaloke

01-08-2008, 05:34 PM

Yes, drugs are cheaper in Canada than in the US. In the US, there is a significantly higher investment in the development of new drugs in comparison to Canada (about 3X higher on a per capita basis). Despite what people believe, the pharma industry is not a profitable sector as a whole. For example, take a look at the stock prices for BioGen or Pfizer since 2000. And a lot of smaller companies go belly up before they ever get to market.

To recoup their investment, drug companies charge more in the US (because of lower profits in other places such as Canada). They can do this because there is no central agency that regulates drug prices. It is the s***s, but this is one of the prices for innovation. While I look forward to the cost reductions associated with generics, I feel that we (as a community of people with MS) also need the innovation associated with drug research.

No offense, but what a pile of BS. Did you copy and paste this from some drug company association website? Because that's what you're spouting - drug company propaganda.

Scott

Jakaloke

01-08-2008, 05:42 PM

The only thing I can come up with is that Canadians may be visiting India (there is a very large ethnic Indian population in Canada) and returning with Natco Pharma's generic version of glatiramer acetate. As I understand it, Teva is defending their patent right in India which is the only place this product is sold.

Scott

lady_express_44

01-08-2008, 07:30 PM

No offense, but what a pile of BS. Did you copy and paste this from some drug company association website? Because that's what you're spouting - drug company propaganda.

Scott

It's economics; supply and demand. Canadians won't pay it, Americans will. :cool:

Also, the US legal system causes a huge "tax" on American pharmaceuticals, due to malpractice suits, jury trials, anticipated liability costs, etc.

Cherie

fahrmar

01-08-2008, 07:42 PM

How much profit is required before medications like Copaxone are sold at a HUMANE price? With sales globally at 1.4 billion in one year, when is R & D recouped? A patent does not equate a license to price gouge and exploit the infirm.

From TEVA:

"Global in-market sales of Copaxone®, which continued to expand its global leadership position, reached $378 million, an increase of 17% over the fourth quarter of 2005. U.S. in-market sales increased by 9% to $238 million. In-market sales outside the U.S., mainly in Europe, increased by 35% to $139 million. For the full year of 2006, global in-market sales of Copaxone® increased by 20% to $1,414 million, with U.S. in-market sales increasing by 17% to $916 million and non-U.S. sales increasing by 26% to $498 million, reflecting higher sales in Teva's main Western European markets as well as in Russia and certain Latin American countries."

http://www.vcall.com/IC/GenRelease.asp?ID=113383

Harpist

01-08-2008, 10:33 PM

No offense, but what a pile of BS. Did you copy and paste this from some drug company association website? Because that's what you're spouting - drug company propaganda.

Scott

Scott,

It's easy to stand up, wave your hands and say "Drug Company Propaganda".

I don't read many of the web sites (neither the "capitalistic, pro-drug company" gang nor the "universal health care" group). These groups often skew the analysis, are disingenuous or flat out lie.

I am a data driven guy. One of my hobbies/jobs is analyzing industrial sectors for medium term profitability (primarily for the reallocation of investments for myself and about a two dozen friends, family and ex-employees). The pharma industry is one of the areas I spent some time looking at (the other was the energy sector). I started the work in 1999 and I review the analysis every three months for changes (no drug company websites/data/new releases were used in this work. Even the financial statements were mined from alternative sources).

Basically, the result of this work was that the US pharma industry was not a good investment (because of reduced profitability) and that US drug costs would increase dramatically. There were a number of reasons for this:

High research costs: Worldwide, US invests the highest amount per capita in drug research. The US accounts for about 60% of the worldwide investment in drug research and accounts for about 50% of the drugs that significantly improve the quality of life. (Just another side note - Canada invests about 2%).

Potential loss in revenue: Patent infringement is increasing worldwide as more countries/organizations are developing the technology to produce many of the popular (high proft margin) drugs. The internet becomes the mechanism of delivery. Loss in revenue - this I couldn't accurately estimate - but I SWAG'ed it at about 5-20% (up from 1-2% just 10 years ago).

Increased costs: The cost for bringing a new drug to market is increasing rapidly (presently at about 10-20% per year).

Decreased international profits: Increasing pressures for cost control overseas would drive international profits down. Countries like Canada, UK, etc... set the price of the drug independently from supply and demand.

In 1999, I had two conclusions (and if you looked into the MGH archives from 1999, you will find these):

Since drug prices in the US are largely unregulated, the drug companies would dramatically increase the cost of drugs sold in the US (as much as they could get away with) in attempt to maintain high profit margins

The increase in US drug costs would not offset the loss in international revenue and/or increased development costs. Thus, the profitability of pharma companies would decrease significantly from 2000 - 2010.

It didn't take a rocket scientist to see these things coming. And it has been confirmed over the first seven years as the performance of the pharma industry underperformed the DOW by over 50% (as opposed to profit margins for 1990-2000 that were about 150% of the DOW).

I'm the first one to understand that - just because the predictions turned out to be correct - it doesn't prove that the assumptions are right. I welcome constructive criticism of these conclusions/assumptions/data. I may be totally off base on my conclusions. But it is my conclusion - not the drug companys'.

Would I like to see changes? Certainly!!! My wife (a nursing professor) rails about drug marketing (both to the doctors and the general public). Would I like to see better focus in drug research? Absolutely! Can we get rid of these excessive lawsuits? Let's give it a shot.

I'm just not sure we can lose all the bad things about this system without sacrificing some of the good things.

But what I would really like to see both sides ramp down the rhetoric. Unfortunately, that is the nature of the US. It seems we can only see things in black or white - gray is not allowed.

Good Roads

Harpist

fahrmar - a response to your later post. I wish there was a good answer to what constitutes an acceptable profit margin. The pure capitalist will say that all of this money is put back into research for new drugs. We all know that it doesn't always work this way.

However, I do know that it is the lure of these type of profits that brings investment money into these companies. I have to admit that Teva was one of the few drug companies that I invested in directly (rather than through some mutual fund). At least some of my small investment goes to researching new drugs. I just wish it was a higher percentage.

I think there are strong arguments on all sides of this issue.

lady_express_44

01-09-2008, 12:08 AM

Decreased international profits: Increasing pressures for cost control overseas would drive international profits down. Countries like Canada, UK, etc... set the price of the drug independently from supply and demand.

Our standard of living, on average, is lower then the US. Pricing for the drug reflects what our market will bear, as well as our government's policy on pricing. If the prices are raised, there will be less product sold here, ultimately impacting their profit.

Why are drugs cheaper in Canada:

http://www.aims.ca/library/MPPI_pharma-revised_.pdf

Cherie

Harpist

01-09-2008, 01:41 AM

Our standard of living, on average, is lower then the US. Pricing for the drug reflects what our market will bear, as well as our government's policy on pricing. If the prices are raised, there will be less product sold here, ultimately impacting their profit.

Why are drugs cheaper in Canada:

http://www.aims.ca/library/MPPI_pharma-revised_.pdf

Cherie

Hi Cherie,

I enjoyed the transcript you referenced by the health economist at the University of Guelph on Canadian pharmaceutical pricing. The talked seemed to be balanced and I agreed with most everything I saw in the conclusions:

To wrap this all up, if you want Canadian pharmaceutical prices in the US, the steps you must follow are clear. You must cut your standard of living by 20-30%. You must reform your ludicrous product liability laws. And you must squeeze pharmaceutical industry profits through price controls and dominant purchaser policies, thus causing lower levels of pharmaceutical investment and innovation, getting cheaper prices for medicines already discovered at the cost of prolonged pain and suffering for victims of diseases we cannot yet cure or control. And you must restrict patient access to the latest and best
medicines in order to keep costs low.

I leave you with this final thought: suppose the difference in prices between Canada and the US is, as I’ve suggested, primarily market driven. Suppose also that the US government allows reimportation of drugs from Canada, eliminating market separation. In that case, prices in Canada can be expected to rise to US levels, with the result that Canadian consumers lose out and US consumers are no better off. In addition, drug companies are worse off since any price discrimination which occurred was profit maximizing. And those in need of pharmaceutical innovation (i.e. the sick and potentially sick) are worse off because the stream of future innovations will be reduced.

Basically, everybody loses, or at the very least nobody wins.

One of the things that I disagreed with is that an increased price of drugs in Canada would result in a reduced profit for the US pharma industry. If one side or the other has a bigger hammer in the negotiation, chances are that price is either too low or too high. I believe that the Canadian government had the bigger hammer when it set up the guidelines for drug prices.

I count on the fact that the customer always wants the lowest cost and the supplier wants the highest price. It is rare when both parties say ask "what is the best for both of us in a long term symbiotic relationship". I've seen it happen, but it is as rare as hen teeth.

Just in case anyone missed the reference in the conclusions regarding diseases like MS:

...And you must squeeze pharmaceutical industry profits through price controls and dominant purchaser policies, thus causing lower levels of pharmaceutical investment and innovation, getting cheaper prices for medicines already discovered at the cost of prolonged pain and suffering for victims of diseases we cannot yet cure or control...

Thanks again for an interesting reference.

Good Roads

Harpist

lady_express_44

01-09-2008, 02:35 AM

"The outcome is that Canada produces pharmaceutical inventions at half the rate of the US industry, per capita investment in R&D is one of the lowest in the developed world"

Seems like an odd statistic, doesn't it? Our country is 1/10th the population of the US . . . yet we still produce 50% of the number of inventions the US does, with the lowest R&D per capita investments in the world . . .?

What's up with that? :cool:

As far as our standard of living, perhaps our gaps between the rich and poor aren't so big either. "If the mean value increases over time, but at the same time the rich become richer and the poor poorer, the group may not be collectively better off."

Cherie

actx

01-09-2008, 11:52 AM

As I posted earlier, MS is close to being an "orphan disease" in the US as so few people have it relative to other diseases. There aren't enough of us around for the price to every be very low. Copaxone was identified in 1967 and took 25 years or so to make it to market. That is a very expensive process and if companies don't think they can recoup their investments + a lot of profit to cover their risks, they won't develop drugs.

Take a look at Pfizer, Merck, etc and the recent 'blockbuster' failures they have had. . .drugs that they spent decades working on that they cancelled after P2/P3 trials. ALL the money they invested, hundreds of millions of dollars is gone.

Developing drugs is expensive and risky. Both drive the costs of drugs.

Compare net income for Teva with Apple Computer. While I love Apple, their contribution to my well being doesn't come close to what Teva/Copaxone gives me:

Teva $ 546M
Apple $3,496M (or $3.4B)

While I wish Copaxone were cheaper. . .I don't wish it to the point that they stop developing new drugs.

lady_express_44

01-09-2008, 12:14 PM

if companies don't think they can recoup their investments + a lot of profit to cover their risks, they won't develop drugs.

"The main point about excess in the pharmaceutical industry is how much there is of it. . . .

Although the pharmaceutical industry claims to be a high-risk business, year after year drug companies enjoy higher profits than any other industry. In 2002, for example, the top 10 drug companies in the United States had a median profit margin of 17%, compared with only 3.1% for all the other industries on the Fortune 500 list. Indeed, subtracting losses from gains, those 10 companies made more in profits that year than the other 490 companies put together."

http://www.cmaj.ca/cgi/content/full/171/12/1451

As I posted earlier, MS is close to being an "orphan disease" in the US as so few people have it relative to other diseases. There aren't enough of us around for the price to every be very low.

J Manag Care Pharm. 2007 Nov;13(9):799-806.

Utilization, cost trends, and member cost-share for self-injectable multiple sclerosis drugs--pharmacy and medical benefit spending from 2004 through 2007

Kunze AM, Gunderson BW, Gleason PP, Heaton AH, Johnson SV.
Prime Therapeutics, 1305 Corporate Center Drive, Eagan, MN 55121, USA. akunze@primetherapeutics.com.

BACKGROUND:

In 1993, interferon beta-1b became the first of 4 self-injectable multiple sclerosis (MS) drugs to be approved by the U.S. Food and Drug Administration. Initially covered as a medical expense, self-injectable MS drugs are increasingly considered specialty pharmaceuticals and are often covered under the pharmacy benefit. Self-injectable MS drugs are expensive, costing approximately $2,000 per month per patient in 2007.

OBJECTIVES:

To (1) determine the trends for price and utilization of self-injectable MS drugs, (2) meld medical and pharmacy claims data to capture total health care spending on self-injectable MS drugs, and (3) calculate the out-of-pocket cost-share for members with pharmacy benefits.

METHODS:

A pharmacy benefits manager with integrated medical claims for approximately 1.8 million commercial members, about 20% of its total of 9 million commercial members, analyzed self-injectable MS pharmacy claims for a 45-month period beginning in January 2004 and ending in September 2007 and integrated medical and pharmacy claims for a 42-month period beginning in January 2004 and ending in June 2007. The 9 million members are beneficiaries of 10 Blue Cross Blue Shield (BCBS) health plans distributed throughout the United States, and the subset of 1.8 million members are enrolled in 1 BCBS health plan in the Northern Plains states.

Self-injectable MS drugs were identified using Generic Product Identifier (GPI) codes for the National Drug Code (NDC) numbers on pharmacy claims. Mail-order pharmacy claims with up to a 90-day supply were counted as 3 claims, and community pharmacy claims dispensed with up to a 34-day supply were counted as 1 claim. Self-injectable MS drugs were identified from medical claims using Healthcare Common Procedure Coding System (HCPCS) codes: J1595 for glatiramer, J1830 for subcutaneous interferon beta-1b, Q3026 for subcutaneous interferon beta-1a, and Q3025 and J1825 for intramuscular interferon beta-1a.

RESULTS:

For the approximately 9 million members with data from pharmacy claims only, these 4 self-injectable MS drugs accounted for approximately 1.8% of total pharmacy benefit spending in 2004, 1.9% in 2005, 2.3% in 2006, and 2.4% in 2007. The mean average ********* price (AWP) per member per month (PMPM) increased by 56.8%, from $1.11 PMPM in the first quarter of 2004 to $1.74 PMPM in the third quarter of 2007. Utilization was flat at about 82-83 claims per 100,000 members per month during the 45-month measurement period. The average annual price increase per unit ranged from 8.9% for interferon beta-1a to 13.3% per year for interferon beta-1b. Members paid a median out-of-pocket cost per pharmacy claim of $15 in 2004, $20 in 2005 and 2006, and $25 in the first 9 months of 2007. For the 1.8 million members with both pharmacy and medical benefit claims, the medical benefit accounted for 2.5% of total spending on MS self-injectables in 2004, 2.0% in 2005 and 2006, and 1.2% in 2007.

CONCLUSION:

The percentage of all pharmacy expenditures that was attributable to self-injectable MS drugs increased from 1.8% in 2004 to 2.5% in 2007. Nearly all of the increase in spending on self-injectable MS drugs over the nearly 4-year period was attributable to drug price increases because PMPM utilization was essentially unchanged. The median member cost-share was approximately 1% of the total cost of self-injectable MS drugs.

PMID: 18062731

http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=18062731&itool=iconabstr&itool=pubmed_DocSum

Cherie

Harpist

01-09-2008, 12:41 PM

"The outcome is that Canada produces pharmaceutical inventions at half the rate of the US industry, per capita investment in R&D is one of the lowest in the developed world"

Seems like an odd statistic, doesn't it? Our country is 1/10th the population of the US . . . yet we still produce 50% of the number of inventions the US does, with the lowest R&D per capita investments in the world . . .?

What's up with that? :cool:

What he says is that rate of pharma inventions is half - not the total amount (the rate is per capita). The total number of pharma inventions in Canada compared to the US is 0.5*0.1 = 5% of the number of pharma inventions of the US. This is largely because of the 3x lower per capita pharma investment in Canada.

Good Roads

Harpist

Harpist

01-09-2008, 01:43 PM

J Manag Care Pharm. 2007 Nov;13(9):799-806.

Utilization, cost trends, and member cost-share for self-injectable multiple sclerosis drugs--pharmacy and medical benefit spending from 2004 through 2007

Kunze AM, Gunderson BW, Gleason PP, Heaton AH, Johnson SV.
Prime Therapeutics, 1305 Corporate Center Drive, Eagan, MN 55121, USA. akunze@primetherapeutics.com.

Cherie

Cherie,

If I read this right it says that since 2004 that injectible drugs costs:

Have increased by about 12% per year (56.8% over four years
Have increased faster than other meds (as seen by the increased % of total pharmacy cost.
Have increased slower than other medical costs (as seen by the decreased % of total patient cost.

Good Roads

Harpist

lady_express_44

01-09-2008, 02:05 PM

What he says is that rate of pharma inventions is half - not the total amount (the rate is per capita). The total number of pharma inventions in Canada compared to the US is 0.5*0.1 = 5% of the number of pharma inventions of the US. This is largely because of the 3x lower per capita pharma investment in Canada.

Good Roads

Harpist

Ok, that makes more sense!

Still, if the population of Canada was 10X what it is (the same as the US), theoretically we would be contributing 50% of the inventions. Considering we spend the least in the world (per capita) on R&D, that's probably quite an accomplishment. :D

Cherie,

If I read this right it says that since 2004 that injectible drugs costs:

Have increased by about 12% per year (56.8% over four years
Have increased faster than other meds (as seen by the increased % of total pharmacy cost.
Have increased slower than other medical costs (as seen by the decreased % of total patient cost.

Good Roads

Harpist

I'm missing your point, I think.

My points were:

1. Pharma companies ARE making a lot of profit (link 1)
2. Even though relatively few people have MS, the cost for injectibles alone represent a large % of spending for our insurers (link 2)

PwMS are a good investment for them, even though there are so few of us.

Cherie

actx

01-09-2008, 02:07 PM

"The main point about excess in the pharmaceutical industry is how much there is of it. . . .

Although the pharmaceutical industry claims to be a high-risk business, year after year drug companies enjoy higher profits than any other industry. In 2002, for example, the top 10 drug companies in the United States had a median profit margin of 17%, compared with only 3.1% for all the other industries on the Fortune 500 list. Indeed, subtracting losses from gains, those 10 companies made more in profits that year than the other 490 companies put together."

http://www.cmaj.ca/cgi/content/full/171/12/1451

J Manag Care Pharm. 2007 Nov;13(9):799-806.

Utilization, cost trends, and member cost-share for self-injectable multiple sclerosis drugs--pharmacy and medical benefit spending from 2004 through 2007

Kunze AM, Gunderson BW, Gleason PP, Heaton AH, Johnson SV.
Prime Therapeutics, 1305 Corporate Center Drive, Eagan, MN 55121, USA. akunze@primetherapeutics.com.

BACKGROUND:

In 1993, interferon beta-1b became the first of 4 self-injectable multiple sclerosis (MS) drugs to be approved by the U.S. Food and Drug Administration. Initially covered as a medical expense, self-injectable MS drugs are increasingly considered specialty pharmaceuticals and are often covered under the pharmacy benefit. Self-injectable MS drugs are expensive, costing approximately $2,000 per month per patient in 2007.

OBJECTIVES:

To (1) determine the trends for price and utilization of self-injectable MS drugs, (2) meld medical and pharmacy claims data to capture total health care spending on self-injectable MS drugs, and (3) calculate the out-of-pocket cost-share for members with pharmacy benefits.

METHODS:

A pharmacy benefits manager with integrated medical claims for approximately 1.8 million commercial members, about 20% of its total of 9 million commercial members, analyzed self-injectable MS pharmacy claims for a 45-month period beginning in January 2004 and ending in September 2007 and integrated medical and pharmacy claims for a 42-month period beginning in January 2004 and ending in June 2007. The 9 million members are beneficiaries of 10 Blue Cross Blue Shield (BCBS) health plans distributed throughout the United States, and the subset of 1.8 million members are enrolled in 1 BCBS health plan in the Northern Plains states.

Self-injectable MS drugs were identified using Generic Product Identifier (GPI) codes for the National Drug Code (NDC) numbers on pharmacy claims. Mail-order pharmacy claims with up to a 90-day supply were counted as 3 claims, and community pharmacy claims dispensed with up to a 34-day supply were counted as 1 claim. Self-injectable MS drugs were identified from medical claims using Healthcare Common Procedure Coding System (HCPCS) codes: J1595 for glatiramer, J1830 for subcutaneous interferon beta-1b, Q3026 for subcutaneous interferon beta-1a, and Q3025 and J1825 for intramuscular interferon beta-1a.

RESULTS:

For the approximately 9 million members with data from pharmacy claims only, these 4 self-injectable MS drugs accounted for approximately 1.8% of total pharmacy benefit spending in 2004, 1.9% in 2005, 2.3% in 2006, and 2.4% in 2007. The mean average ********* price (AWP) per member per month (PMPM) increased by 56.8%, from $1.11 PMPM in the first quarter of 2004 to $1.74 PMPM in the third quarter of 2007. Utilization was flat at about 82-83 claims per 100,000 members per month during the 45-month measurement period. The average annual price increase per unit ranged from 8.9% for interferon beta-1a to 13.3% per year for interferon beta-1b. Members paid a median out-of-pocket cost per pharmacy claim of $15 in 2004, $20 in 2005 and 2006, and $25 in the first 9 months of 2007. For the 1.8 million members with both pharmacy and medical benefit claims, the medical benefit accounted for 2.5% of total spending on MS self-injectables in 2004, 2.0% in 2005 and 2006, and 1.2% in 2007.

CONCLUSION:

The percentage of all pharmacy expenditures that was attributable to self-injectable MS drugs increased from 1.8% in 2004 to 2.5% in 2007. Nearly all of the increase in spending on self-injectable MS drugs over the nearly 4-year period was attributable to drug price increases because PMPM utilization was essentially unchanged. The median member cost-share was approximately 1% of the total cost of self-injectable MS drugs.

PMID: 18062731

http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=18062731&itool=iconabstr&itool=pubmed_DocSum

Cherie

I have no clue what your point is. . .

Harpist

01-09-2008, 02:56 PM

Ok, that makes more sense!
Still, if the population of Canada was 10X what it is (the same as the US), theoretically we would be contributing 50% of the inventions. Considering we spend the least in the world (per capita) on R&D, that's probably quite an accomplishment. :D
Cherie

Cherie,

The 50% is not of worldwide pharma inventions. It is just in comparison to the US. So a comparison to worldwide per capita investment is an apples to oranges comparison.

However, you are correct in saying that Canada is more cost effective than the US since Canada's investment is 33% of the US (on a per capita basis) and creates 50% less pharma inventions (on a per capita basis). As these references noted this most likely coming from three areas:

Product liability
Product focus
Marketing

Ok, that makes more sense!

I'm missing your point, I think.

My points were:

1. Pharma companies ARE making a lot of profit (link 1)
2. Even though relatively few people have MS, the cost for injectibles alone represent a large % of spending for our insurers (link 2)

PwMS are a good investment for them, even though there are so few of us.

Cherie

Regarding the article about injectible cost - my response was simply a condensation of the article. There were a lot of numbers presented and their conclusions were selective towards one set of those. I looked at some of the other results. Injectible costs are increasing slower than medical costs as a whole. The authors showed this in their results but neglected to put that in their conclusions.

You and I have a different way of making a point. You tend to post a lot of articles without much in the way of critical analysis or interpretation of the numbers, analysis methods or data sampling. I tend to look behind the numbers a lot.

The other reference you gave was a good example. It reported that in 2002 the pharma industry had profits of 14% (and used Pfizer as its example). This is correct that in 2002 Pfized had a good year. But if you look from 2000 to 2008, Pfizer stock price dropped by almost 50% - with a rise in Q2 2002 through Q2 2003. So the authors of that paper picked the one period in since 2000 that proved his point (as many people do).

The authors' generalizations are also dangerous for our community. Do you realize that Rebif and Avonex fall into what the authors call the "Me too" category of drugs (a category that the authors are very critical of). So if we followed what they are promoting, possibily Avonex and certainly Rebif would not have been developed or approved. So let's have a show of hands - should we stick with only Beta and not have Avonex or Rebis?

When one reads the article there is an obvious tone that indicates a bias - they did not present anything from the "other side". It is like listening to the US Congress argue about the Iraq War. And when you look behind the numbers you see that more clearly. Numbers can deceive just as much as they enlghten.

My approach for transferring information to others is what we are taught (and what I taught) as part of engineering ethics. When I pass on information it is my resposibility to consider the validity and reliability of what I pass on. Otherwise, I just become an information gossip.

Good Roads

Harpist

Jakaloke

01-09-2008, 04:49 PM

Scott,

It's easy to stand up, wave your hands and say "Drug Company Propaganda".

I don't read many of the web sites (neither the "capitalistic, pro-drug company" gang nor the "universal health care" group). These groups often skew the analysis, are disingenuous or flat out lie.

I am a data driven guy. One of my hobbies/jobs is analyzing industrial sectors for medium term profitability (primarily for the reallocation of investments for myself and about a two dozen friends, family and ex-employees). The pharma industry is one of the areas I spent some time looking at (the other was the energy sector). I started the work in 1999 and I review the analysis every three months for changes (no drug company websites/data/new releases were used in this work. Even the financial statements were mined from alternative sources).

Basically, the result of this work was that the US pharma industry was not a good investment (because of reduced profitability) and that US drug costs would increase dramatically. There were a number of reasons for this:

High research costs: Worldwide, US invests the highest amount per capita in drug research. The US accounts for about 60% of the worldwide investment in drug research and accounts for about 50% of the drugs that significantly improve the quality of life. (Just another side note - Canada invests about 2%).

The US also accounts for over 50% of the global drug market, and Canada about 1.75% (with ten times Canada's population, the US consumes 30 times the drugs). American R&D is about 18% of sales (a little below average for developed nations), Canada's is about 10% (embarrassingly low, I admit).

Potential loss in revenue: Patent infringement is increasing worldwide as more countries/organizations are developing the technology to produce many of the popular (high proft margin) drugs. The internet becomes the mechanism of delivery. Loss in revenue - this I couldn't accurately estimate - but I SWAG'ed it at about 5-20% (up from 1-2% just 10 years ago).

The majority of drug patent infringement came from India, who recently instituted drug patent protection. Infringement as a result should be declining markedly.

Increased costs: The cost for bringing a new drug to market is increasing rapidly (presently at about 10-20% per year).

The widely quoted figure of $800 million is double the actual figure, to include lost investment revenue on the $400 million spent. It also only represents new chemical entities, which account for less than a third of new drugs. The majority of new drugs are basic alterations or new uses for old drugs and cost very little to produce.

By far the largest expense in the industry is marketing and administration.

Decreased international profits: Increasing pressures for cost control overseas would drive international profits down. Countries like Canada, UK, etc... set the price of the drug independently from supply and demand.
Drug prices are rising relative to inflation in almost all major markets. There is less profit outside the US, but it isn't decreasing.

In 1999, I had two conclusions (and if you looked into the MGH archives from 1999, you will find these):

[LIST]
Since drug prices in the US are largely unregulated, the drug companies would dramatically increase the cost of drugs sold in the US (as much as they could get away with) in attempt to maintain high profit margins

The increase in US drug costs would not offset the loss in international revenue and/or increased development costs. Thus, the profitability of pharma companies would decrease significantly from 2000 - 2010.

According to Fortune 500, the top 5 drug makers in 2007 in terms of revenue, had profit as a % of revenue of:
Johnson & Johnson - 21%
Pfizer - 37%
Merck - 20%
Abbott - 8%
Wyeth - 21%

It didn't take a rocket scientist to see these things coming. And it has been confirmed over the first seven years as the performance of the pharma industry underperformed the DOW by over 50% (as opposed to profit margins for 1990-2000 that were about 150% of the DOW).

I'm not sure how the above numbers compare to the Dow, but they look pretty healthy.

I'm the first one to understand that - just because the predictions turned out to be correct - it doesn't prove that the assumptions are right. I welcome constructive criticism of these conclusions/assumptions/data. I may be totally off base on my conclusions. But it is my conclusion - not the drug companys'.

I disagree with your assertion of correctness, but I apologise if I gave the impression you were quoting the drug companies. I meant to imply it looked similar to what they would publish.

But what I would really like to see both sides ramp down the rhetoric. Unfortunately, that is the nature of the US. It seems we can only see things in black or white - gray is not allowed.

Agreed.

Scott

lady_express_44

01-09-2008, 08:35 PM

Cherie,

The 50% is not of worldwide pharma inventions. It is just in comparison to the US. So a comparison to worldwide per capita investment is an apples to oranges comparison.

However, you are correct in saying that Canada is more cost effective than the US since Canada's investment is 33% of the US (on a per capita basis) and creates 50% less pharma inventions (on a per capita basis). As these references noted this most likely coming from three areas:

Product liability
Product focus
Marketing

Regarding the article about injectible cost - my response was simply a condensation of the article. There were a lot of numbers presented and their conclusions were selective towards one set of those. I looked at some of the other results. Injectible costs are increasing slower than medical costs as a whole. The authors showed this in their results but neglected to put that in their conclusions.

You and I have a different way of making a point. You tend to post a lot of articles without much in the way of critical analysis or interpretation of the numbers, analysis methods or data sampling. I tend to look behind the numbers a lot.

The other reference you gave was a good example. It reported that in 2002 the pharma industry had profits of 14% (and used Pfizer as its example). This is correct that in 2002 Pfized had a good year. But if you look from 2000 to 2008, Pfizer stock price dropped by almost 50% - with a rise in Q2 2002 through Q2 2003. So the authors of that paper picked the one period in since 2000 that proved his point (as many people do).

The authors' generalizations are also dangerous for our community. Do you realize that Rebif and Avonex fall into what the authors call the "Me too" category of drugs (a category that the authors are very critical of). So if we followed what they are promoting, possibily Avonex and certainly Rebif would not have been developed or approved. So let's have a show of hands - should we stick with only Beta and not have Avonex or Rebis?

When one reads the article there is an obvious tone that indicates a bias - they did not present anything from the "other side". It is like listening to the US Congress argue about the Iraq War. And when you look behind the numbers you see that more clearly. Numbers can deceive just as much as they enlghten.

My approach for transferring information to others is what we are taught (and what I taught) as part of engineering ethics. When I pass on information it is my resposibility to consider the validity and reliability of what I pass on. Otherwise, I just become an information gossip.

Good Roads

Harpist

Harpist

Awe c’mon Harpist . . . just think of how much of the color gray would be missing out of your life if it wasn’t for my postings? You know you love me . . .

http://www.youtube.com/watch?v=WGwxUOqyXNM&feature=related

As I've told you before, sometimes I post articles for discussion, which may or may not be indicative of my personal point of view. Other times I have quoted something, and am just posting a link to give credit for the quote. That doesn’t mean I agree with all the information that is presented in each article, or that I expect you to waste your precious time offering input into each of the author’s points.

My personal opinion on this topic, for what it’s worth, is that several of the large pharmaceutical companies are making unnecessary profit margins at the expense of the people. If they weren’t, they simply could not afford to spend as much as they do on such things as marketing.

Obviously, all of the costs incurred while operating a business, including; executive salaries, bonuses, profit shares, benefits, off-site meetings, marketing, R&D, etc. are expensed before profits are calculated (and share value influenced). If, after all that sometimes EXCESSIVE!! spending there is still considerable profit, you know they are grossing a LOT of money. Yes, it’s often justified by choosing to incur totally unnecessary expenditure in the process . . . but how much is “wasted” in that regard is anyone’s guess, and THEIR choice.

Like in most businesses, the decision about which products to pursue/offer is often based on which will likely generate the most profit. This isn’t about helping “us” unhealthy people (HA!). . . it is about how much money they can make for their firm ... for increased salaries & bonuses ... for growth (more money) ... and for share-holders. If it wasn’t, why not reconcile profits every ten years and give some of it back to the people or industry? This is done by some businesses here, believe it or not.

I think the question comes down to what is an acceptable amount of profit? Should they be able to gouge the market because they CAN? Should “public health” be a government responsibility or can/should some controls be implemented that restrict their expense policies & profits?

As far as Rebif and Avonex being “me too” drugs . . . from what I recall, Betaseron (Beta 1-b) was the first interferon the market patented for MS. Avonex is a slightly different type of interferon (Beta 1-a), but as I understand things, Rebif is basically just Avonex (Beta 1-a) at a higher dosage. If that is correct, Biogen (?) was on the ball for testing a “me too” drug (at a higher dosage), in order to get around the Avonex patent . . . but they DID have to trial it and prove it more effective (in some obscure way), even though we now know that it is not necessarily more effective. Someone at Biogen was definitely on the ball and probably got a GREAT bonus for that idea!

Cherie

BTW, you might just not be hanging with the right crowd if you are concerned about investing money in the large pharmaceutical companies. If you knew people "in the know", you could just cash out when the going gets good . . . just as the Biogen Execs did just prior to announcing the deaths due to Tysabri.

Harpist

01-10-2008, 12:27 AM

According to Fortune 500, the top 5 drug makers in 2007 in terms of revenue, had profit as a % of revenue of:

Johnson & Johnson - 21%
Pfizer - 37%
Merck - 20%
Abbott - 8%
Wyeth - 21%

I'm not sure how the above numbers compare to the Dow, but they look pretty healthy.

Scott,

First, I assume you mean the net profit margins for 2006 as I haven't seen any 2007 annual financials.

Second, at the risk of wandering into a a financial discussion, using net margin to indicate the company profit is one of the tricks that is used to make drug companies look bad (i.e. taking excessive profits). The true profitability is indicated by return on equity (ROE) which measures a firm's efficiency at generating profits from every dollar of net assets not just this year's expenses. Otherwise you are getting just a quick snapshot of the company and have no idea of its history.

I did a quick check on ROE of a couple of DOW 30 companies for 2006 (no order as I just picked a few out of memory):

Dupont - 35.3%
Dow Chemical - 23.0%
IBM - 30.8 %
Microsoft - 39.9%
3M - 38.4%
Home Depot - 22.2%
McDonalds - 23.2%

Now here are the drug companies you mentioned:

Merck - 26.0%
Abbott - 12.1%
Pfizer - 28.3%
Wyeth - 31.5 %
J&J - 28.6 %

The drug companies barely outperformed McDonalds in 2006. This is why they have only averaged a 5% annual yield since 2000 (Pfizer was actually negative). They were underperformers when compared to the rest of the stocks that comprise the Dow Jones Industrial Average. If you believe they outperformed the rest of the market, you are mistaken.

One other point. You stated that drug company profits weren't decreasing. Take a look at some these companies using ROE. Merck started this decade at a 49% ROE and has been steadily dropping to 25% in 2006. Other drug companies have been showing similar behavior.

As I stand back and take a deep breath, I have to say that - despite what it may seem - I am a big proponent of changes in the US health care system as well as the drug industry. I think in most gatherings of people I would sit somewhere in the middle. Here at MGH what seems to drive me to the side of the drug companies is the (I believe) biased opinion that DRUG COMPANIES = GREEDY = BAD = MONSTERS.

I have to ask when the last time that something GOOD was said on this forum about the drug companies that are involved with the advancement of our treatment options for slowing MS development and treating its symptoms? How about the drug companies that are looking for a cure? And other technologies are right in that mix. Few of us remember the days before MRIs. Despite the high cost of MRIs, who wants to be back in the days of testing for MS by taking a hot bath?

I realize that we are marginalized group - low on funds and high on expenses. But the drug companies are trying in their own business oriented way to help us. And they have a responsibility to their shareholders to make a profit that exceeds the risks. Remember, most all of us are primary or secondary stockholders (through pension plans, IRAs, mutual funds, etc... even foreign governments rely on these types of investments to pay the bills).

Again, I point to the rhetoric on both sides of this argument. It is not a perfect system and it needs lots of improvement. But let's aim at the right target before we shoot.

Good Roads

Harpist

Scott - I have responses to other portions of your reply, but it will have to wait for another day. North Idaho received another six inches of snow (to go with the three feet we already have) and I have to get it off the driveway before the ice rink expands (and there is more snow on its way). Luckily, I have more energy during the cold temperatures of winter. But even with a snow blower it will still be the last task before going to bed. Where are those adolescent slaves when I need them?

I want to thank you for your most recent response and the numbers it includes. It gives a true starting point for a discussion.

Jen C

01-10-2008, 01:50 PM

lady_express_44

01-10-2008, 01:55 PM

Yeah, an internet ordering site . . . .

I don't even know if we have "Canadian Pharmacy" up here, but I know they are in the US. I'll check it out, thanks.

Cherie

Jakaloke

01-10-2008, 04:45 PM

Scott,

First, I assume you mean the net profit margins for 2006 as I haven't seen any 2007 annual financials.

Second, at the risk of wandering into a a financial discussion, using net margin to indicate the company profit is one of the tricks that is used to make drug companies look bad (i.e. taking excessive profits). The true profitability is indicated by return on equity (ROE) which measures a firm's efficiency at generating profits from every dollar of net assets not just this year's expenses. Otherwise you are getting just a quick snapshot of the company and have no idea of its history.

I did a quick check on ROE of a couple of DOW 30 companies for 2006 (no order as I just picked a few out of memory):

Dupont - 35.3%
Dow Chemical - 23.0%
IBM - 30.8 %
Microsoft - 39.9%
3M - 38.4%
Home Depot - 22.2%
McDonalds - 23.2%

Now here are the drug companies you mentioned:

Merck - 26.0%
Abbott - 12.1%
Pfizer - 28.3%
Wyeth - 31.5 %
J&J - 28.6 %

The drug companies barely outperformed McDonalds in 2006. This is why they have only averaged a 5% annual yield since 2000 (Pfizer was actually negative). They were underperformers when compared to the rest of the stocks that comprise the Dow Jones Industrial Average. If you believe they outperformed the rest of the market, you are mistaken.

One other point. You stated that drug company profits weren't decreasing. Take a look at some these companies using ROE. Merck started this decade at a 49% ROE and has been steadily dropping to 25% in 2006. Other drug companies have been showing similar behavior.

As I stand back and take a deep breath, I have to say that - despite what it may seem - I am a big proponent of changes in the US health care system as well as the drug industry. I think in most gatherings of people I would sit somewhere in the middle. Here at MGH what seems to drive me to the side of the drug companies is the (I believe) biased opinion that DRUG COMPANIES = GREEDY = BAD = MONSTERS.

I have to ask when the last time that something GOOD was said on this forum about the drug companies that are involved with the advancement of our treatment options for slowing MS development and treating its symptoms? How about the drug companies that are looking for a cure? And other technologies are right in that mix. Few of us remember the days before MRIs. Despite the high cost of MRIs, who wants to be back in the days of testing for MS by taking a hot bath?

I realize that we are marginalized group - low on funds and high on expenses. But the drug companies are trying in their own business oriented way to help us. And they have a responsibility to their shareholders to make a profit that exceeds the risks. Remember, most all of us are primary or secondary stockholders (through pension plans, IRAs, mutual funds, etc... even foreign governments rely on these types of investments to pay the bills).

Again, I point to the rhetoric on both sides of this argument. It is not a perfect system and it needs lots of improvement. But let's aim at the right target before we shoot.

Good Roads

Harpist

Scott - I have responses to other portions of your reply, but it will have to wait for another day. North Idaho received another six inches of snow (to go with the three feet we already have) and I have to get it off the driveway before the ice rink expands (and there is more snow on its way). Luckily, I have more energy during the cold temperatures of winter. But even with a snow blower it will still be the last task before going to bed. Where are those adolescent slaves when I need them?

I want to thank you for your most recent response and the numbers it includes. It gives a true starting point for a discussion.

Yes, of course I meant 2006, sorry. I'm by no means a financial analyst, so I'll defer to your wisdom, but consistently high net profit margins seem to me like a pretty good measure of a company's health.

I'd probably be sitting somewhere nearby you in the middle. I obviously (as a user of their products), appreciate the vigour of a healthy pharmaceutical industry. They might just find a cure for what ails me if they keep making money and spending at least some of it on R&D.

The drug industry is unique in that it deals with people's health. When a price tag gets put on that it tends to cause emotions to flare, especially when there's so much misinformation and dishonesty floating about. When I read the AstraZeneca Prilosec/Nexium story (there's a version of it here (http://www.msnbc.msn.com/id/20249591/)) I became a little bit jaded towards the industry in general. When it appears that corporate profits are coming at the expense of people's health, rather than by way of it, I think most people become distrustful and begin to view the industry as "GREEDY BAD MONSTERS".

I'm guessing direct-to-consumer marketing, while increasing sales phenomenally, is probably responsible for much of the ill-will towards the industry. Perhaps if marketing budgets were trimmed to something less than double R&D budgets there might be a little less rancour.

Scott

P.S. - I grew up in the West Kootenays of BC , just across the border from Northern Idaho. I hated all that snow when I was there, but I sure miss it while putting up with this endless rain and sleet here on the coast.

lady_express_44

01-10-2008, 06:51 PM

The drug industry is unique in that it deals with people's health. When a price tag gets put on that it tends to cause emotions to flare . . .

This is the issue . . . where they make huge profits BECAUSE of human suffering.

They are not "McDonalds", where people have a CHOICE on purchasing the product. :mad: Is it right that they can charge enough to even make it into the "Fortune 500" company list? Oh yeah, there's the stock holders to think about . . . :rolleyes:

http://oversight.house.gov/documents/20060919115623-70677.pdf

Cherie

Harpist

01-10-2008, 07:31 PM

This is the issue . . . where they make huge profits BECAUSE of human suffering.

They are not "McDonalds", where people have a CHOICE on purchasing the product. :mad: Is it right that they can charge enough to even make it into the "Fortune 500" company list? Oh yeah, there's the stock holders to think about . . . :rolleyes:

http://oversight.house.gov/documents/20060919115623-70677.pdf

Cherie

Cherie,

Before I go any further on this, I have to ask - do you believe that the document you referenced supports the fact that drug companies brought in huge profits since the start of the new Medicare drug plan? I'd like to know if you have read through this in a critical fashion and come to the conclusion it is a valid, unbiased and accurate report.

I'd really like to hear what you actually think. Because I'm not throwing away good time watching "Doogie Hauser M.D." on a piece of beef jerky being thrown in the middle of a pack of hungry coyotes (one of my Dad's expressions).

Good Roads

Harpist

agate

01-10-2008, 07:58 PM

Harpist, excuse me for barging in here, but have you found evidence that the article by Representative Henry Waxman that Cherie gave a link to is unbiased and inaccurate? If so, where?

lady_express_44

01-10-2008, 08:55 PM

Cherie,

Before I go any further on this, I have to ask - do you believe that the document you referenced supports the fact that drug companies brought in huge profits since the start of the new Medicare drug plan? I'd like to know if you have read through this in a critical fashion and come to the conclusion it is a valid, unbiased and accurate report.

I'd really like to hear what you actually think. Because I'm not throwing away good time watching "Doogie Hauser M.D." on a piece of beef jerky being thrown in the middle of a pack of hungry coyotes (one of my Dad's expressions).

Good Roads

Harpist

I don't think that report "proves" anything. What I do know is that there are so many smoke screens in business practices, it would be impossible to know how healthy the company really is. You know that too, Harpist . . . they can paint whatever picture they want.

Whether we are using "net margin", "profit", "ROE" figures, or if we are comparing "McDonalds" to "Merck" . . . we are talking in the 10's to 100's of billions of dollars!!

How about you prove to us the industry is in hardship, without linking a potentially biased source? :rolleyes:

Cherie

Harpist

01-10-2008, 09:07 PM

Harpist, excuse me for barging in here, but have you found evidence that the article by Senator Henry Waxman that Cherie gave a link to is unbiased and inaccurate? If so, where?

Agate,

There are several areas that could show bias in a report like this:

Selective sampling (In this report 6 months in 2005 and 6 months in 2006)
Selective key indicator (Is net profit the correct indicator? Are the companies that were chosen representative?)
Analysis (Are the comparisons being made an apples to apples comparison? Is the correct basis calculation used?)
Partisanship (political, special interest, etc...?)
Correlation or causation in the conclusions (Increased drug company net profits come from increased drug prices due to change in Medicare plan?)
References (Where does the information come from? Partisan sources?)

The only obvious possible bias from the outset is that this is a Democrat attacking a Republican Congress and President (first line of the Background section).

It seemed that Cherie posted this URL as a response to my post that I felt that the profit numbers for drug companies were not as high as what were being thrown around. Is that the point Cherie, or are you just stirring the pot?

Good Roads

Harpist

Harpist

01-10-2008, 09:18 PM

How about you prove to us the industry is in hardship, without linking a potentially biased source? :rolleyes:

Cherie

Cherie,

First, I am not trying to prove the drug industry is in hardship - only that it is not neccesarily the gouger that it is represented as (and possibly the need for innovation incentive).

Second, I rarely present reports of any type in this area. I use the numbers that go into those reports. Less of a chance that a partisan hand will pick and choose.

As for proving anything to people on the forum? I spend my time trying to educate myself. I share my observations and point out the mistakes I believe others make.

Oh.... and I hate rhetoric (anywhere).

Good Roads

Harpist

lady_express_44

01-10-2008, 09:25 PM

Cherie,

First, I am not trying to prove the drug industry is in hardship - only that it is not neccesarily the gouger that it is represented as (and possibly the need for innovation incentive).

Second, I rarely present reports of any type in this area. I use the numbers that go into those reports. Less of a chance that a partisan hand will pick and choose.

As for proving anything to people on the forum? I spend my time trying to educate myself. I share my observations and point out the mistakes I believe others make.

Oh.... and I hate rhetoric (anywhere).

Good Roads

Harpist

Rhetoric, def: "using language effectively to please or persuade"

I am not trying to persuade or please anybody, and my use of language (of late) leaves something to be desired. :rolleyes:

I am expressing my opinion, and even though you don't acknowledge what I write (personally, all by myself, without any influence, and with no agenda), it is JUST my personal opinion. It is based on my values.

Cherie

lady_express_44

01-10-2008, 10:45 PM

I have been away from my computer since I posted this originally, and I see there has been alot of information and opinions since posted. I thank all of you for those.

Cherie.....you asked where I got that information as you doubted it were true. If you google Canadian pharmacies and pull one up, you will see that there is a generic for Copaxone available. That is where I got my information.

Again, I thank everyone for their responses.

Jen

So I found a "Canada Pharmacy" which is an internet site. It states "The International Generics Program provides customers with the generic versions of medications that are currently only available as brand names in Canada."

http://www.canada-pharmacy.com/

I have no idea who this company is, and when I clicked on "order", it took me to a page that says "this is a parked page, domain for sale".

Is this the only site that apparently sold generic Copaxone? If not, do you have any other links where the generic Glatiramer Acetate (Copaxone) can currently be ordered in Canada?

Thanks, Cherie

Harpist

01-11-2008, 12:57 AM

Rhetoric, def: "using language effectively to please or persuade"

I am not trying to persuade or please anybody, and my use of language (of late) leaves something to be desired. :rolleyes:

I am expressing my opinion, and even though you don't acknowledge what I write (personally, all by myself, without any influence, and with no agenda), it is JUST my personal opinion. It is based on my values.

Cherie

Cherie,

I need to apologize for the "rhetoric" comment. I was not directing in your way, but as a general comment. I in no way meant to imply that your replies were such. That was poor writing on my part.

Again my apology.

Good Roads

Harpist

BTW - just to clear up the definition I was using. I have to admit that I didn't know of the alternative definition definition that you wrote until I looked it up.

rhetoric - (in writing or speech) the undue use of exaggeration or display; bombast.

http://dictionary.reference.com/search?q=rhetoric

Jakaloke

01-11-2008, 01:13 AM

From your link, Cherie:

The IGP is a program set up by a Canadian Prescription Broker to respond to the high prescription drug prices set by Big Pharma. The International Generics Program provides customers with the generic versions of medications that are currently only available as brand names in Canada.

"Prescription Broker"? Is that what shady drug dealers are calling themselves these days?

Scott

Harpist

01-11-2008, 01:45 AM

Harpist, excuse me for barging in here, but have you found evidence that the article by Senator Henry Waxman that Cherie gave a link to is unbiased and inaccurate? If so, where?

Hi Agate,

Well, no one came out to say whether they thought this report was strong evidence of price gouging by the drug companies, so here goes.

The primary misleading facts/interpretations in this report come in two places:

Calculating the drug company profits (Table 1) and then
Equating these profits to increased revenue from increased drug prices

In reality, profit is a combination of revenue, expenses, taxes and the purchase or sale of assets. If you compare 2005 to 2006, the revenues from drug sales for these companies are not nearly enough to account for the profit numbers reported by Rep. Waxman.

The increased profit margin actually came from the sale of assets (and a smaller amount in reduced expenses). For example, Pfizer sold their Consumer Healthcare Business to Johnson and Johnson for 16.3 billion (of which the realized half of this income in 2006 and the other half will be realized in 2007). Pull out 8.3 billion and suddenly Pfizer goes from the top of the profit margins to having a negative change in profit margin for 2006. In other words, if they hadn't sold this business to J&J, they would have had a decrease in profit margin (which is probably why they sold it).

After looking at the balance sheets for these ten companies a quick check indicates a 10% profit in 12 months instead of a 27% increase in profits in 6 months that Rep. Waxman was reporting. Both numbers are technically correct, but one is "apples" and the other is "oranges".

Don't get me wrong - 10% is still a pretty good number. But not a "go screaming into the night" kind of profit margin that Waxman was showing. Trust me when I say - if those type of profits were there - I might forget what scruples I have and put some money down (to heck with the kids' college education funds *grin*).

The quickest gut check on this type of thing is the stock prices. If Pfizer had reported a 73% increase in the true profit for Q1 and Q2 of 2006, the stock price would have gone through the roof (unless of course they had predicted a 150% increase). As it was, I think Pfizer stock didn't change much between 2005 and 2006. This is why I suspected Waxman's numbers.

So that is what I believe is the main bias in this report.

Good Roads

Harpist

BTW: just a couple of comments to pull myself off the drug company sidelines and get myself at midfield again:

I believe that health care costs are increasing way to fast in the US.
I believe that there is some excessive profit taking occurring in the drug industry - but not nearly to the extent that many people claim
I believe that drug marketing costs are too high and there should not be direct consumer marketing for drugs
I believe we need to have better focus in our drug development
I believe that Bill Clinton will be our next First Lady (Laddie?) and Seattle will not win the Super Bowl

agate

01-11-2008, 02:27 AM

My mistake. It's Representative Waxman, not Senator Waxman.

And it's a matter of opinion, of course, but Michelle Obama is destined to be the next First Lady if I have anything to do with it.

lady_express_44

01-11-2008, 11:09 AM

Cherie,

I need to apologize for the "rhetoric" comment. I was not directing in your way, but as a general comment. I in no way meant to imply that your replies were such. That was poor writing on my part.

Again my apology.

Good Roads

Harpist

BTW - just to clear up the definition I was using. I have to admit that I didn't know of the alternative definition definition that you wrote until I looked it up.

rhetoric - (in writing or speech) the undue use of exaggeration or display; bombast.

http://dictionary.reference.com/search?q=rhetoric

Fancy that . . . you and I finding different definitions of “rhetoric” on the web? :p I had just googled, and picked the first definition on the first link that I ran across . . . I deferred to it because I didn’t think my personal definition of “hogwash” would fly.

Apology accepted, of course. Thank you.

If we go back to page one of this thread, it began with the assumption that Canadians may be purchasing generic Copaxone in order to get it cheaper. My response was that I would be surprised, and so far I haven’t personally been able to locate any evidence that we are.

It would still surprise me if it proves true, firstly because it is unethical, but more importantly because we would have no incentive to do this. Almost everyone is covered by either our employer or government prescription plan, and I just can’t see this approach being endorsed by those entities.

From those initial postings, there were some unsubstantiated comments made, implying with some certainty that Canadians do have access to this rogue product, and supporting the profit and pricing of the industry. Leaving this one-sided version unchallenged would have been irresponsible too . . . well at least in my mind.

It doesn’t matter which are numbers/links are posted, they are likely to be biased in some way, and I truly hope everyone who reads them is astute enough to realize that. No matter how seemingly relevant the numbers are, they don’t provide a clear picture of what is really going on behind the scenes. There are going to be many (good and bad) business decisions made along the way, and any seasoned business person knows that there will always be perfectly justifiable buying/selling & losses/gains that go on year to year, or even decade to decade.

I don’t claim to be here to coach people on which stocks to purchase anyway. For the record though . . . “anyone wanting to invest a lot of money in a pharma company is probably wise to look at a much larger sample of financials then what I've provided (and/or to rely on any links/analysis provided here on the BT MS forum).” I would hate to lead anyone astray with misinformation . . .

Regardless, it remains my current personal opinion that some of the large pharma companies are making unnecessary profits, and that they may have too much political power. This is probably true of other industries too . . . it just happens to bug me more with the health care industry. Fortunately, I have lots of other subjects (and people) I care about (hence the 1200+ postings here alone), so I really don’t spend too much time stewing over this one particular subject.

I'll summarize by saying “if any of you big-wigs in the industry know you are wasting money and gouging us unhealthy consumers, how about just being nice guys (and gals) by giving some of it back to us”, ok? There . . . that ought to get their attention. ;) :p

Cherie

Harpist

01-11-2008, 11:56 AM

My mistake. It's Representative Waxman, not Senator Waxman.

And it's a matter of opinion, of course, but Michelle Obama is destined to be the next First Lady if I have anything to do with it.

Agate,

We live in Idahosi we don't get to decide anything about the presidential election *sigh*. The last time Idaho got close to voting anything but Republican was when Ross Perot was running. Ron Paul would have a chance too.

Good Roads

Harpist

mamamakk

01-11-2008, 12:33 PM

I found it readily from a pharmacy based in Montreal. This a copy of the ordering page for the copaxone and shows the price difference between the the generic and Teva Brand.

Buy Copaxone syringe 20mg/mL:

Chemical Name: Glatiramer Acetate
Buy Glatiramer Acetate 20mg/mL:
generic alternative

CA

Canada (called Copaxone Pre-filled)
BRAND | Format: syringe | Mfg: Avs
Quantity Price Price/syringe Savings
30 syringe $1,868.15 $62.27 n/a
60 syringe $3,736.28 $62.27 n/a
90 syringe $5,604.41 $62.27 n/a
120 syringe $7,472.56 $62.27 n/a
$9,340.69 $62.27
rx

IGP

International Generic Program Learn about our International Generic Program
GENERIC | Format: syringe
Quantity Price Price/syringe Savings
30 syringe $1,395.00 $46.50 n/a
60 syringe $2,734.20 $45.57 2%
90 syringe $3,975.75 $44.18 5%
120 syringe $5,189.40 $43.25 7%
$6,486.75 $43.25
rx

Here is the link: http://www.canada-edrugs.com/drugs/Copaxone/syringe/20mg_mL

Here is the address:

Canada-eDrugs.com
P.O. Box 370
Postal Unit B
Montreal, QC H3B 3J7
Canada

I think that this post went way off topic. Jen's initial post was really just a question wondering why she could not buy generic Copaxone here in the US. For many of us, we can obtain our pharmacy drugs at significant savings when we can buy the generic equivalent rather than the original patent.

I think people really need to reconsider the thought that they want drug companies around that are existing in "hardship". If that is the case, these companies wont exist. That is the bottom line.

My brother is a pharmaceutical researcher in the Lower Mainland of BC and his first employer has already gone belly up. He is working for another that is on shaky ground and he is now looking for a job in the US. There are few prospects in Canada.

The first company he worked for rolled all their money and research into one product and when it did not show promise in the initial drug trials, the investors pulled out all their money. Most of the employees were laid off and the company was bought by a European enterprise.

It can take a company 10-15 years to research and develop a single drug and I think they are entitled to some compensation for this, otherwise there would be no incentive to develop new drugs. What amount this compensation should be is open to interpretation and personal opinion of course but not entirely.

The FDA allows the companies to hold a patent, for a period of time
depending on the class of drug, before other companies can start to make generic forms of the drug, as a form of reward. Patents are held longer on orphan drugs and new chemicals, for example. I, for one, do not want to discourage the development or improvement of what drugs are currently available.