Friday, October 16, 2009
Tuesday, October 13, 2009
Saturday, October 10, 2009
Monday, October 5, 2009
In that world, shelf space is key. Eye level is where everyone wants to be and manufacturers actually count facings (number of units displayed) as they pay for such space. If a large manufacturer comes out with a new line of product or even a line extension of one product, they must pay the retailer to carry it (a listing allowance) then they must pay them for the amount of space they want, and at what level (eye level being the most expensive). Then they have to work out a deal for a promotion or end isle display etc all with volume expectations and more cost.
Now consider the retailers and drugs. The front of the store runs like above, but behind the counter, the brand manufacturer does not pay a listing allowance or anything like the above scenario. At least not to my knowledge. The store is obligated to carry the new product if a physician writes it. These products are the most expensive so they drive up the retailers inventory level and cost of goods sold. If the new product is accepted by the physician community, and takes off in sales, a larger space is required to store the product but still no manufacturer financial support for this. Unlike the front of the store, there are some extra fees the retailer charges the customer for; i.e. dispensing fees. Really the retailer is dictated to by the manufacturer of the patent protected products.
Once the product is off patent however, there is competition and the retailer gets rebates by the generics. It becomes much like the front store scenario with listing allowances, incentives or rebates. The cost of goods goes down as these products are less expensive but so too does retail sales. If they lower the price of these products they have to make up the sales dollars elsewhere as investors would hammer them if retail sales decline year over year. (a catch 22). So unlike the front store, where manufacturers pay for shelf space etc in the hope to increase sales and market share of their product, these manufacturers know that the overall market is going to decline or not grow as physicians switch to other promoted agents. And the cycle continues.
Saturday, September 19, 2009
Thursday, June 25, 2009
Thursday, May 21, 2009
Friday, May 15, 2009
Tuesday, May 5, 2009
Tuesday, April 28, 2009
Friday, April 24, 2009
In this age of twitter, facebook, text messaging, e-mail, media, and all sorts of IT and high tech ways of communicating with one another, what has happened to face-to-face contact? Who, in business still uses this ancient method to communicate with clientele or customers and is it still effective?
In sports, it is about the personalities. Just look at how hockey has Wayne Gretzky and now Sidney Crosby. One could say they are the face of hockey. Most of us would love to meet them and for those fortunate enough to do so, it only reinforces their perspective and love for the game. The clubs know they have to do things for the fans to keep the sales up at the gate, and it is why, early on, in the careers of hockey players, programs and awards are set up for community involvement. Wayne or Sid are well versed in Media and fan support techniques and so are their fellow players. These fan face-to-face exchanges are an integral part of sports.
Love them or hate them, politicians are experts at the art of personal contact. If this is an election year in your province, you certainly will see efforts by the political parties to take every advantage of getting in front of a camera, a podium, or a group gathering. Door to door contact is still a big undertaking even if the candidate themselves can't get out. Representatives will knock at your door and ask for support. In an effort to sway voters, these face-to-face contacts are as much about listening to the concerns of the electorate as it is about getting your platform across. This is because often voters have not all made up their minds and just want to be heard by the politicians. Some of these folks will vote based on the candidate that seams to listen the best, or said the right response to the concerns. It is often the defining moment in how a voter will vote. In the American election last year of President Obama, this face-to-face, eye-to-eye contact was visible each and every day. Obama certainly used the Internet as an effective tool to augment his efforts but it was his face-to-face efforts, and on the ground support where they really added shine.
One industry that most people know little about is the Brand Pharmaceutical Companies. This group has taken the art of personal contact to levels that perhaps Obama could learn from. The marketing efforts of these companies utilize, all of the typical media, Internet, and other support initiatives but the power of personal contact is the cornerstone to their success. The industry may have pushed this contact to the extreme in the last few years which has lead to a bit of a backlash by physicians, academics, and politicians. They essentially had so many personal contacts that physicians began to see fewer representatives. However the industry is adjusting to more acceptable levels, and make no mistake about it, personal contact remains the focus of these companies. They implement numerous face-to-face, eye-to-eye contacts with the physician to build business. After all, it is the physician that will cast the vote (in this case a prescription). These contacts are positive in nature and the companies listen to the needs of the physician much the same as the politician looking for support.
A recently released Report by the Canadian Institute for Health Information, “Drug Expenditure in Canada 1985 to 2008” stated “Over the last 20 years, drugs have consistently remained one of the major cost drivers in health care,” says Michael Hunt, Manager of Pharmaceutical Programs at CIHI. “Spending on pharmaceuticals has more than doubled over the past 10 years, outpacing growth in health spending by hospitals, physicians and other health professionals.”
This certainly points to the success of the Pharma business model and to the success or power of personal contact.
In an effort to control these rising costs, individual benefits groups have focused on a defensive strategy of adding restrictions, slowing authorization of drugs, cost shifting to members, plan management, and reduction of benefits where possible. From the above report, this defensive strategy has not attained the desired effect. We have all heard the old adage, “The best defense is a good offence”. I suggest that the strategies currently in place neglect the prime decision maker the physician (who is equivalent of a voter or fan) and do little or nothing to garner their support. To bring this back to hockey, this strategy is like having two teams in a constant rivalry and one team has a number of high scoring forwards and the second team has mostly defensive players and may include the best goalie in the league and perhaps some goon players. The fans are supporting the team which continually is shooting at the net, winning the most games, constantly looking to please the fans, . Go Sid Go.
So with all of the new technology and communication techniques , it appears from the above examples that the power or personal contact still reigns supreme. If personal contact wasn’t so powerful, Hockey would ignore the fans, Politicians would only do advertising, and Brand pharmaceutical Companies would not spend detailing efforts on Physicians.
Friday, April 17, 2009
Saturday, April 4, 2009
Thursday, April 2, 2009
- Are all of these Americans at significantly greater risk than Canadians?
- Why is there such a difference?
- Why do Canadian governments and Industry not take advantage of the price reductions?
- Can we learn from what is happening in the US ?
- Are there ways the Canadian health Care system can save $?
- etc. etc. etc
Wednesday, March 18, 2009
InNOVAcorp helps high potential early stage companies commercialize their technologies and succeed in the global marketplace. Our internationally recognized High Performance Incubation (HPi)™ business model incorporates incubation, mentoring and investment. Every day, we provide hands-on business guidance, tailored to meet the unique and evolving needs of high potential early stage technology companies.
Friday, March 6, 2009
Tuesday, March 3, 2009
Monday, March 2, 2009
Wednesday, February 11, 2009
I just did a search here and the Data is only showing for 2007. If a drug is promoted heavily to Canadian physicians , its usage can soar quickly. Just look at the Vioxx case... Now if physicians and patients had timely access to this , would that not be a good thing?
You can access the database below. Check the drugs you currently are taking, compare the number of events from one drug to another.
Health Canada Drug Adverse event database
CMA Calls for Attitude Shift to Transform Health Care System
TORONTO, Feb. 10 /CNW Telbec/ - Canadian Medical Association (CMA)
President Dr. Robert Ouellet is urging Canadians to set aside old attitudes
and instead seek transformative change within the health care system.
"Making our health care system both sustainable and accessible for
patients requires that we make fundamental changes in how we think about
health care," said Dr. Ouellet in a speech to the Economic Club of Toronto
today. "We have tried to throw money at the problem, but money is not the only
In recent months, Dr. Ouellet and a team of CMA researchers have visited
several European nations to meet with doctors, nurses, patient associations,
researchers, government and other officials to see what has worked within
their health care systems, and why it has worked.
Preliminary findings and discussions show that these countries -- the
United Kingdom, Belgium, the Netherlands, France and Denmark -- face many of
the same issues that Canada does: aging populations, difficulty providing
timely access to quality care, and increasing demand for services.
Dr. Ouellet cited several key points that the CMA will be bringing to
Canadians for discussion, including:
- the fact that European states use the private sector within their
health care systems yet strictly adhere to the principle that no
citizen will go without health care because of an inability to pay;
- the fact that in the European systems studied there is no difference
for patients between public and private systems because the interchange
between the two is transparent, with patient need -- not ideology or
cash -- determining how and where care is provided;
- the fact that Europeans face short, or no, wait times, yet spend less
money on health care than Canada;
- the fact that, for these countries, there is a real solidarity against
suffering and a commitment to ensure not only equal but also timely
access to health care for everyone;
- The fact that options such as funding hospitals based on activity
rather than just block funding can dramatically improve efficiency
within our system.
"In Canada we focus on turning the funding tap on or off depending on our
economic situation instead of on improving efficiency and boosting
productivity within the system," added Dr. Ouellet. "Something has to suffer
in this scenario, and all too often it is the patient."
In the coming weeks the CMA will begin a consultation with Canadians that
will include doctors, other health care professionals, patients, governments
and policymakers. The Association will use this input to formulate a plan -- a
"Made in Canada" solution -- to make transformative change in the health care
Friday, February 6, 2009
This followed by Dr. Neil MacKinnons article in CMAJ on the above. The National Pharmaceuticals Strategy: Rest in peace,
revive or renew?
You certainly get a sense of the frustration of trying to get all sides working together.
Then there was the report from the University of Calgary (Department of Economics and Institute for advanced Policy Research) entitled " Generic Drug Pricing and
Procurement: A Policy for Alberta"
This is a terrific explanation of the situation across this country . Each province doing their own thing. When will we learn?
Monday, January 19, 2009
Now , If this is the case in your Drug Benefit Plan, it should be expected that this % has gone up. Why? Well, here in Canada we have had a few, very large drugs lose patent. When this occurs you see a spike in your GFR. The real question is can your plan sustain it. In the US today , the GFR is approaching 70 % while here in Canada it sits at about 50%.
Friday, January 16, 2009
We can expect that as these blockbuster drugs come off patent a big shift is going to occur. In Canada we have a group called the Common Drug Review (CDR). A program funded by the FPT Ministries of Health that operates under the aegis of the Canadian Agency for Drugs and Technologies in Health. It reviews and makes recommendations but the provinces are free to make there own decisions. It will be interesting to watch for these new products as they come to market and our Health Care System struggles with the costs.
The article can be found below.
In the pipeline: Drugs to watch in 2009
Jan 20, 2009
Several blockbuster drugs will fight to hold onto their top spots in 2009 as new products come before FDA for marketing approval, reported Brian W. Kolling, PharmD, at a recent meeting of the Academy of Managed Care Pharmacy (AMCP) in Kansas City, Mo. Key therapies to watch as they move through the pipeline include medications for cardiovascular (CV) disorders, central nervous system (CNS) disorders, respiratory disease, and diabetes, he said.
According to Keith Bradbury, executive director of drug information at Medco Health Solutions Inc., FDA has delayed approval of many NDAs while the agency struggles with implementing new regulations established by the 2007 FDA Amendment Act (FDAAA).
“We are at a historic time in terms of the number of products the FDA has delayed or allowed the user end-date to pass and extended the review period,” Bradbury said.
For this reason, he said, as many as 62 NDAs could be submitted in 2009. Of these, perhaps 25 will be approved. “There are about 40 to 45 drugs sitting at the FDA today waiting for action,” Bradbury said.
According to Bradbury, a home run might occur in the CV field. Bradbury was referring to rivaroxaban (Bayer/Johnson & Johnson); if approved, this agent will be the first new anticoagulant oral drug to reach the market in more than 40 years, with the potential to replace warfarin.
“This is potentially a multibillion-dollar drug. It looks very promising,” Bradbury said. The benefit of rivaroxaban is the potential elimination of the costly monitoring associated with warfarin.
Another important CV agent in the pipeline is prasugrel (Daiichi Sankyo/Lilly), which, if approved, will compete with clopidogrel. The Cardiovascular and Renal Drugs Advisory Committee is scheduled to meet on February 3 to discuss prasugrel.
“The $64,000 question is: Is the FDA going to be able to tease out from the data whether the drug is in the net beneficial and not harmful? If this happens, then [clopidogrel] is going to have some...competition,” Bradbury said.
Although most of the new drugs expected to hit the market will inevitably carry hefty price tags, the introduction of several key generics should offset some of the medication costs consumers face. “It is our expectation that in 2009, about $11 billion of prescription drugs will be subject to generic competition,” Bradbury said.
The following therapeutic areas are the ones to watch for emerging therapies.
During the next several years, generic products will continue to make inroads into the CV market as the top statin, angiotensin II receptor blocker (ARB), and antiplatelet drug all go off patent by 2012. There is also a full field of factor Xa inhibitors, several of which are now in phase 3 trials.
Statins will still dominate cholesterol management, but combination products and several agents with new mechanisms of action are in development. New products to watch for include GlaxoSmithKline’s darapladib, which targets lipoprotein-associated phospholipase (Lp-PLA2), an enzyme linked to artery-clogging plaque, and Isis and Genzyme’s mipomersen, an apolipoprotein B100 antisense inhibitor designed as a lipid reducer for high-risk CV patients. Two new cholesteryl ester transfer protein (CETP) inhibitors, Merck’s anacetrapib and Roche’s dalcetrapib, are also on the horizon.
There has been a push to develop new antiplatelet and antithrombotic agents to replace less effective and more costly products. As mentioned above, if approved, prasugrel, a platelet inhibitor used for the prevention of CV events in patients with acute coronary syndrome (ACS), could rival clopidogrel, which is set to see its patent expire in 2011. Clinical trials demonstrated that prasugrel may be more effective than clopidogrel in preventing CV death, nonfatal myocardial infarctions (MIs), and strokes, but also that it was more likely to cause serious bleeding. If FDA calls for additional clinical trials to study the bleeding issue, the drug’s approval would be delayed.
SCH-530348 (Schering-Plough), an oral antiplatelet drug, would be the first in a new class of thrombin receptor antagonists. SCH-530348 prevents blood clots by inhibiting the action of thrombin, a key coagulation factor that converts fibrinogen into fibrin. This agent is in phase 2/3 trials.
Another new antiplatelet formulation is ticagrelor, the first reversible oral adenosine diphosphate (ADP) receptor antagonist. Developed to reduce the risk of thrombotic events in ACS patients, ticagrelor inhibits platelet aggregation, which may reduce clot formation. Clinical benefits of reversibility are unclear; however, results of phase 2/3 trials now under way may shed light on the issue.
With limited clinical choices for the prevention of thromboembolic disease, 2 new anticoagulants could meet the need for new products in this area: rivaroxaban, a once-daily direct Xa inhibitor being studied for the prevention of venous blood clots in adult patients undergoing elective hip- or knee-replacement surgery, and dabigatran etexilate (Boehringer Ingelheim), an oral reversible direct thrombin inhibitor being studied for acute venous thromboembolism (VTE) treatment and secondary prevention of VTE, as well as prevention of CV events in ACS.
Dronedarone (Sanofi-Aventis), a multichannel blocker with antiadrenergic properties that is chemically similar to amiodarone, is being studied in patients with atrial fibrillation or atrial flutter. Clinical trial results indicate that this agent may be better tolerated than amiodarone.
Central nervous system
Researchers are aggressively working to develop new products that will eliminate some of the undesirable side effects associated with many currently available CNS drugs. Several new migraine treatments are under investigation, as are new fibromyalgia agents. The CNS market will also see several top drugs going off patent in 2010 and 2011.
Existing antidepressants often have negative side effects, efficacy problems, and poor patient compliance. One new drug in the pipeline is saredutant (Sanofi-Aventis), a neurokinin-2 receptor antagonist with a mechanism of action different from any employed by existing drugs. It blocks the effects of neurokinin-2, thereby preventing the neurochemical changes induced by stressful conditions in various brain regions.
Melatonin receptor agonists are also in the pipeline, with one of the lead compounds, agomelatine (Novartis), now in phase 3 trials. Compared with existing antidepressants, agomelatine is the first melatonergic agent to demonstrate favorable results in its effect on sleep, weight, and sexual function.
Although antipsychotic drugs are the mainstay of schizophrenia treatment, common side effects such as metabolic disturbances, sexual dysfunction, hyperprolactinemia, and cardiotoxicity lead to poor long-term adherence. As a result, researchers are working to develop a third generation of antipsychotics that may provide broader efficacy, reduced side effects, and improved tolerability. Several NDAs have been submitted, among them applications for sertindole (Lundbeck), which is associated with less sedation when used to treat schizophrenia, and asenapine (Schering-Plough), a new 5-HT2A/D2 receptor antagonist for treatment of schizophrenia and bipolar mania disorder. FDA issued a complete response letter for asenapine earlier this month; the letter asked for supplemental data but not for additional clinical trials.
Two migraine treatments are in late-stage development: telcagepant (Merck), an oral calcitonin gene-related peptide (CGRP) receptor antagonist, and botulinum toxin A (Botox; Allergan), which is injected every 12 weeks in trials. Both agents are in phase 3 trials, and the manufacturers hope to file for FDA approval in 2009.
Milnacipran (Savella, Forest/Cypress), a selective norepinephrine serotonin reuptake inhibitor (NSRI), was approved earlier this month for the management of fibromyalgia. [S,S]-reboxetine (Pfizer), a norepinephrine reuptake inhibitor, is also in development for this indication. Reboxetine is in phase 3 clinical trials.
The sleep-disorder market may see the arrival of 2 new insomnia drugs: doxepin (Somaxon) and eplivanserin (Sanofi-Aventis). Unlike existing sleep aids, doxepin selectively blocks the neurotransmitter histamine and may improve insomnia symptoms without serious adverse effects. The PDUFA date for the doxepin NDA was recently extended to February 29, 2009. Eplivanserin, a selective 5HT2A receptor antagonist, is in phase 3 trials. Zolpidem tartrate extended release (Ambien CR; Sanofi-Aventis) is scheduled to go off patent in March 2009.
Respiratory drug development is focused on a wide range of potential combination therapies. A new class of drugs is not likely to be available for at least 3 to 5 years.
Novartis is developing indacaterol, an ultra-long-acting beta agonist inhaler, for the treatment of chronic obstructive pulmonary disease (COPD) and asthma. An NDA for aclidinium bromide (Forest/Almirall), an inhaled muscarinic antagonist for COPD, is expected to be filed in the fourth quarter of 2009 or the first quarter of 2010.
Tadalafil (Cialis, Lilly) has demonstrated promising results for the treatment of pulmonary hypertension. An NDA for inhaled treprostinil (United Therapeutics) for the treatment of pulmonary arterial hypertension was submitted in June 2008. Pfizer is awaiting FDA approval for sitaxsentan, an endothelin receptor antagonist for pulmonary arterial hypertension treatment.
Few patients with diabetes achieve their target goals for blood glucose, cholesterol, and blood pressure, and many of these patients are undertreated. Drugs are being developed to meet the needs of this population as the incidence of diabetes assumes epidemic proportions.
Two new dipeptidyl peptidase (DPP-4) products, alogliptin (Takeda) and saxagliptin (Bristol-Myers Squibb/AstraZeneca), have demonstrated favorable results in patients not adequately controlled with existing insulin products. Alogliptin is pending FDA approval; the PDUFA date for this NDA was recently extended to June 26, 2009. An NDA was submitted for saxagliptin on June 30, 2008.
Novo Nordisk’s liraglutide, a GLP-1 analog, has demonstrated a risk of hypoglycemia much lower than that connected with many existing drugs. In phase 3 trials, more than half of the participating patients achieved a glycosylated hemoglobin A1c (HbA1c) of <7%. A benefit that liraglutide shares with other GLP-1 analogs is its potential to significantly reduce weight. An NDA was filed for liraglutide on May 23, 2008; the Endocrinologic and Metabolic Drugs Advisory Committee is scheduled to discuss this agent on April 2 or 3.
Dapagliflozin (Bristol-Myers Squibb/Astra-Zeneca), a highly selective inhibitor of sodium glucose cotransporter 2 (SGLT2), has a dose-dependent effect on HbA1c levels and fasting plasma glucose (FPG). In clinical trials, the drug produced slight weight loss but was also associated with a higher incidence of urinary tract infections.
In a field of failed attempts to market inhaled insulin, MannKind is hoping to gain approval for a delivery system that administers a dry-powder insulin formulation through a palm-sized inhaler. Phase 3 trial data comparing this powder formulation with injected insulin have demonstrated similar efficacy between the 2 formulations.
OTTAWA, Jan. 15 /CNW Telbec/ - Dr. Robert Ouellet, President the Canadian
Medical Association (CMA), will begin the second stage of his European health
care fact-finding mission on January 19.
"The goal of this project is to suggest compatible and efficient measures
that could improve access to our own health system and address lengthy wait
times," said Dr. Ouellet. "The current economic climate demands that we look
for ways to increase efficiency and provide value for money in health care
service delivery. There could be no better time to suggest to Canadians a
positive transformation of the health care system."
Dr. Ouellet's research will focus on finding concrete examples of how
certain measures were implemented and have contributed to improving the health
care system of various European countries. By drawing on the experience of
European countries that have been top performers in terms of value for money
and access to heath care, we can address the problems afflicting Canada's
Dr. Ouellet and CMA representatives will be meeting with key individuals
who have played a major role in improving their country's healthcare system
and will witness firsthand how certain programs or projects have been
implemented. The team will visit Denmark, Belgium, the Netherlands and France.
Stage 1 of this mission began in November 2007 with a visit to the United
"It's important that we look at the practices of countries that rank at
the top in terms of comparative international health policy studies. We're
going without any preconceived ideas, and we're keeping an open mind about all
types of practices," Dr. Ouellet stresses. "The first stage of the tour, to
the UK, revealed several interesting models. I'm looking forward to the second
A series of regional and national consultations with the Canadian public
will follow the first draft of the report of this study mission. The final
report should be made public in June 2009.
For further information: Lucie Boileau, Media Relations Manager, 800
663-7336, (613) 731-8610 ext. 1266
Government of Canada Works to Improve Knowledge About the Safety and Effectiveness of Drugs