Tuesday, November 18, 2014

IMPROVE-IT: What Does "Only A Modest Benefit" Mean? It Means The Economics Of Vytorin® Treatment... May Not Make Sense.

At the outset, I do not mean to cheapen human life, by reducing the entire analysis to dollars and. . . sense.

However, the PIs of the IMPROVE-IT study admit that the results suggest that one MI hospitalization event (for example) would likely be avoided over seven years, by putting 50 patients on Vytorin® (as opposed to simvastatin, or any statin as mono-threapy).

A month's supply of Vytorin costs $200 at CVS -- a statin costs $15 for that same month's supply.

So. . . ($200 minus $15, or $185), times 12 months times 7 years, times 50 patients. . . equals $777,000 in additional drug costs.

It looks like the recent average US cost for an acute myocardial infarction hospital admission was around $30,000. So I guess Merck's marketing thought is that -- based on IMPROVE-IT's data -- we should pay an incremental $777,000 over seven years, to prevent one additional $30,000 hospital admission.

That math doesn't really work, from a clinical stand-point.

Please tell me what I'm missing here. I must be mistaken. [But I bet I'm not.]


Anonymous said...

Why just knock Vytorin on this, which has just proven an outcomes benefit vs. generic simva? Vytorin has a much lower market share than Crestor, which hasn't proven to reduce risk any more than a generic statin. Why not go knocking AZ's $7B behemoth, which only has outcomes vs. placebo and is taking a much bigger bite out of the healthcare economy?

Condor said...

I do hear you, Anon.

However, this blog originated out of the ENHANCE study debacle, and we personally have been following IMPROVE-IT closely -- for seven years.

In addition, this blog was always a narrative line about the CEO Hassan-led legacy Schering-Plough miscues.

Now the corporation that was Schering-Plough has a new name: Merck.

So we tend to focus our commentary on matters related to these two companies.

My thesis here is that because the outcomes benefit is so small, Merck is not likely to see material increases in Vytorin franchise sales.

I wasn't looking to compare various branded statins to the generic versions. And we all know Vytorin is just a statin, with Zetia, in a single pill combo.

Namaste -- and do stop back! Good question!