Monday, September 22, 2008

First Negative Quarter -- in at Least a Decade -- for US Scrips, per WSJ. . . .


Citing the U.S. economic downturn, this morning's Wall Street Journal is running a longish article on the first negative growth in quarter-over-quarter (an absolute decline, not just a decrease in the prior quarter's rate of growth) system-wide US prescription drug spending -- and, especially hard-hit it seems -- are preventative medicines (think Vytorin/Zetia here).

So, I think it safe to assume that the IMS Vytorin/Zetia monthly data for August 2008 (due out at any moment from Kenilworth) will show another overall cholesterol management drug market contraction, vis-a-vis July 2008. The most-salient question to be answered by that data will be -- how much share will Schering have lost, in that contracting market. Let's listen in to the WSJ -- but do go read it all, here:

. . . .Americans are already cutting back on health care, a sector once thought to be invulnerable to recession. Spending on everything from doctors' appointments to preventive tests to prescription drugs is under pressure.

The number of prescriptions filled in the U.S. fell 0.5% in the first quarter and a steeper 1.97% in the second, compared with the same periods in 2007 -- the first negative quarters in at least a decade, according to data from market researcher IMS Health. Despite an aging and growing U.S. population, the number of physician office visits also has been declining since the end of 2006. Between July 2007 and 2008, the most recent month for which data are available, visits fell 1.2%, according to IMS.

As consumers cut back, spending on everything from doctors' appointments to preventive tests to prescription drugs is under pressure. In a survey by the National Association of Insurance Commissioners last month, 22% of 686 consumers said that economy-related woes were causing them to go to the doctor less often. About 11% said they've scaled back on prescription drugs to save money. . . .

Should it persist, this will be an ominous trend-line for the longer term health of Americans, and consequently, the longer term cost of providing acute care to these Americans. They are either forced to skip required medication, or follow-up doctors' visits -- due to cost -- and that will inexorably lead to more acute problems (read: higher overall expenses).

3 comments:

Anonymous said...

"consequently, the longer term cost of providing acute care to these Americans. They are either forced to skip required medication, or follow-up doctors' visits -- due to cost -- and that will inexorably lead to more acute problems (read: higher overall expenses)."

Yes that is the conventional wisdom, but it may not be true. As we are seeing with the Vytorin/Zetia franchise approvals and usage based on biomarkers may not correlate with clinical outcomes, (e.g. Cancer). This may also be the case with a number of other situations. Including cholesterol lowering meds in women (see today's pharmalot article), various estrogen products in women, and most unnerving of all antipsychotic use that has correlated with a decrease in life expectancy of 15 years. Although this is in older patients the recent reports of 1% of children on antipsychotics which is way greeater than the estimated likely population for 'appropriate' off-label use. Indicate that certain medication use may be associated with increased acute and chronic problems.

Condor said...

I do understand -- and take heed of -- your points, Anonymous Poster No. 1. I agree, in part.

To the extent, however, that patients STOP taking efficacious, much-needed medicines (due to economics), I think that will be a bad thing for the health care system, overall. Think diabetes here. Think renal disease.

Both -- untreated (or undertreated) leave the patient in need of extensive, and expensive, acute care -- often for years.

But thanks -- I do concur with your point, insofar as you intend to make it -- as to certain other "treatments" of certain other "disease states".

Namaste

Anonymous said...

You raise good points. However even with diabetes where HgA1c is correlated with long term complications there are questions about certain medications, e.g. Avandia (rosiglitazone) and heart attacks. The point is perhaps we are over relying on biomarkers and are making ASSUMPTIONS about clinical outcomes that may not be true.

Grassley and others have been pushing on this issue and if the tide turns with the next administration this could change and may effect both sales and development stategies for pharmaceuticals.