Pharmalot has the story -- I'll have more later -- but offline duties call:
. . . .CREW Executive Director Melanie Sloan stated, "Patients presume that doctors choose vaccines based on the patient’s best interests. Now we learn that’s not always true. In some cases, doctors are choosing vaccines based on the discounts offered by the drug manufacturer."
To entice physician healthcare groups to purchase their vaccines, Sanofi Pasteur and Merck offer significant price discounts if the healthcare groups agree to buy all of their vaccines solely from one manufacturer. . . .
"Both of our agreements (Sanofi-Pasteur and Merck), contain pricing discounts earned by the collective membership maintaining purchases of the core product portfolios. Deviation from this will put the entire contract at risk and have negative impact on our ability to offer you (our members) the best available upfront discounts on vaccines," writes Ann Manning, director of the Cumberland Pediatric Foundation, which is based in Tennessee. ". . . .Please know that by your participation in the Merck/Sanofi vaccine contract, you cannot also particpiate in a GSK or Novartis contract. . . ."
UPDATED: 07.07.10 @ 10 AM EDT -- In response, Merck's corporate communications department has given a statement to MedPage Today, thus:
. . . .A spokesperson for. . . Merck & Co. of Whitehouse Station, N.J. told MedPage Today in an emailed statement, "We work with our customers to negotiate contracts that help meet their needs; those negotiations are private and all individual contracts are confidential."
The company statement added that "the terms of the contracts are lawful, and we strongly disagree with any statement or implication suggesting otherwise. . . ."
Lawful? Probably. But I think it an unwise commercial practice, from the larger perspective. No one seriously disputes that peer-reviewed literature indicates that some brands of vaccines are more effective (with generally fewer side effects) in specified sub-groups: i.e., meningitis vaccines in teenagers -- Menevo® (Novartis) seems better than Menactra® (Sanofi-Pasteur). However, these contracts would drive the giving of one vaccine over another of the same class, based on economic penalties, as opposed to peer-reviewed efficacy data. As ever, we'll keep an eye on it -- and, we'll await the next step from from FTC Director Feinstein's office.