e., the payment system is biased against full reimbursement for higher cost therapies). Reimbursement compared to acquisition cost for the top IO pharmaceuticals by total expenditures indicates that 9 of the 10 are significantly under reimbursed."
Clinical Trials Report:
Congress established Medicare beneficiaries numbering 40 million with a prescription drug coverage, which has been called a "vast expansion of federal support for and control of expenditures on medicines. Even in its early stages, this program is focusing public attention on prescription drug prices, marketing, utilization, and effectiveness." (Weschler, 2004) Further stated in the Clinical Trials report is that, " the Medicare drug benefit is expected to boost prescription drug use by seniors and provide incentives to develop therapies needed by elderly patients such as arthritis, cardiovascular conditions, and Alzheimer's disease. But it also may squeeze prices and profit margins of pharmaceutical companies that sponsor research. A new payment system for oncology treatments and other therapies administered by physicians may alter incentives for R&D in these areas, while the Medicare outpatient pharmacy benefit will establish model formularies, post negotiated prices, promote treatment protocols, and track adverse events and outcomes more thoroughly -- all likely to shape prescribing practices and new product utilization. These developments will require sponsors to incorporate outcomes measures into studies earlier in the development process, and may cause earlier abandonment of unpromising research."
The fall of 2004 was replete with the pharmaceutical industry experiencing one crisis after another as well as for the federal regulators which together managed to raise questions of serious import and "pre and post approval safety testing of new products." (Weschler, 2004) According to the report congress blamed FDA "oversight, accusing agency officials of trying to squelch staff warnings on drug safety issues and of ignoring signs of trouble at Chiron. One response was to call for full disclosure of all clinical trial results by sponsors and FDA -- including those studies that rail to demonstrate efficacy. Investigations were launched into the possibility of manufacturer ethics in behavior and the following issues were considered by government officials and industry leaders":
The nation's adverse event reporting and post marketing surveillance systems are limited and slow to identify looming safety problems *
Sponsors may need to provide much more safety data to bring to market treatments that patients may use for years
DTC advertising for chronic-use drugs may encourage overmedication and unsafe practices
The U.S. vaccine supply system is antiquated and unreliable and needs a major overhaul to prevent shortages and inequitable access
Perhaps regulators and policymakers should rethink efforts...
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