Saturday, April 4, 2009

The PolyCap

Further to my last post, here are some considerations about the Polypill, which is five drugs combined into a single capsule. Firstly, the man behind the phase  2 testing of the drug.  Dr. Salim Yusuf, his bio can be found here, is a very, very respected investigator and physician in Canada.  In fact, it was through his work with the HOPE study (I think every physician in Canada knows this study inside and out), that lead to Ramipril becoming the #1 Ace Inhibitor in Canada.  Of course with a lot of marketing by the manufacturer.  Actually this points to another difference between Canada and the US.  The Number of total prescriptions for Ramipril in Canada was 4,736,000 for the one manufacturer that made the top 20 list from my previous post.  There are of course other manufacturers so that number is even higher.  It is the only ACE to make the list.  If you look at the US data you see that Lisinopril is the only ace to make their list and has 75.5 M prescriptions.  So the marketing efforts in the US for Ramipril were not as good. Two different companies had the marketing rights for Canada and the US.  
Ok, now back to the Polycap.  You can watch an ABC News story here to get more info, but I want to discuss what is next.   

They are suggesting a large follow up study.   This is a perfect time for Canada's Health bodies to get behind this world leader in his field and make the follow-up study happen.  It is most likely not a study that the BIG PHARMA group is going to fund.  These are drugs that have gone off Patent.  The Generic Industry most likely will not do this either.  One of the cornerstones of this product is that it can save $ and lives.  If, it saves dollars, then someone is not making as much.  That is a simple fact.  So who could see lost revenue from the introduction of such a pill.  I suspect the list includes the following, Big Pharma, Pharmacy (one prescription as opposed to 5), Insurance (if they are based on % of book of business), wholesalers, Generic companies (lost revenue of selling 5 products),  and perhaps even Consultants dependent on how their payments are structured.   So really it encompasses the whole supply chain.  But look at the masses that could potentially benefit.  Imagine, Benefit plans  and government plans could save money thereby  allowing more new break through drugs on their formularies.  The potential benefits may well be there in the end for the supply chain.  
The US Health structure promotes a desire to reduce pharmaceutical expenditures .   If a study is going to happen in the US , I hope we are getting behind Dr. Yusuf and helping him make this happen here in Canada. 

Something for future consideration is the following.... If the Study is done and indeed it proves that it saves lives, reduces expenditures, improves compliance,and makes it to market, how will it be promoted? Or Who will Promote it?  As from the Ramipril vs Lisinopril explanation, marketing is very very necessary.  

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