Kohl Examines Drug Industry Practice Of Providing Payments To Doctors, Influencing Prescribing Behaviors, USA

Senate Special Committee on Aging Chairman Herb Kohl (D-WI) held a hearing to examine the pharmaceutical industry’s costly practice of providing payments and gifts to doctors, and to consider what kind of influence this wields over some of our nation’s physicians. It is estimated that drug companies spend 19 billion dollars annually on doctors in the form of lecture honoraria and conference registration fees, research grants, trips, meals, drug samples, and other freebies. A study published in the New England Journal of Medicine earlier this year reported that 94 percent of physicians have received such gifts and payments from drug companies.

“The financial ties between doctors and drug companies are only deepening,” said Chairman Kohl. “These gifts and payments can compromise physicians’ medical judgment by putting their financial interest ahead of the welfare of their patients.” Read more

A miracle cure for ailing drug pipelines?

CAMBRIDGE, Massachusetts: Can an antipsychotic drug from the 1950s be paired with a 1980s antibiotic to shrink 21st-century tumors? Might an anti-clotting drug help a steroid relieve arthritis? How about a cholesterol treatment and a pain reliever teaming up to tame diabetes?

Alexis Borisy, the pharmaceutical industry’s master matchmaker, is betting they can. And if he is right, he may have found a cheap and quick way to develop a new cornucopia of medicines. Other drug makers are placing similar bets, though perhaps none as single-mindedly as he.

Borisy, 35, is the co-founder and chief executive of CombinatoRx, a biotechnology company dedicated to the proposition that two old generic drugs can together make a powerful new medicine, often for an entirely different disease. Read more

A miracle cure for ailing drug pipelines?

CAMBRIDGE, Massachusetts: Can an antipsychotic drug from the 1950s be paired with a 1980s antibiotic to shrink 21st-century tumors? Might an anti-clotting drug help a steroid relieve arthritis? How about a cholesterol treatment and a pain reliever teaming up to tame diabetes?

Alexis Borisy, the pharmaceutical industry’s master matchmaker, is betting they can. And if he is right, he may have found a cheap and quick way to develop a new cornucopia of medicines. Other drug makers are placing similar bets, though perhaps none as single-mindedly as he.

Borisy, 35, is the co-founder and chief executive of CombinatoRx, a biotechnology company dedicated to the proposition that two old generic drugs can together make a powerful new medicine, often for an entirely different disease.

With drug makers big and small struggling to fill their product pipelines, various biotechnology companies share CombinatoRx’s hope that pairing old drugs can be a better business bet than inventing new ones from scratch – which can take years and cost hundreds of millions of dollars, with no guarantee of success.

Others in the hunt include Pozen, a company based in Chapel Hill, North Carolina, developing combination drugs in partnerships with the pharmaceutical giants GlaxoSmithKline and AstraZeneca.

Another, Orexigen, of San Diego, recently went public based on the prospects for two combination drugs it is developing to treat obesity. And Celator Pharmaceuticals of Princeton, New Jersey, which is privately held, has raised more than $40 million from venture capitalists to combine old cancer drugs in a new way.

“We think if we prove this concept clinically we have an almost unlimited pipeline,” said Andrew Janoff, Celator’s chief executive.

Helping propel the trend is the growing supply of raw material: drugs that have lost patent protection, providing a lode of material to test for newfound potential.

Information technology also plays a major role. CombinatoRx (which is pronounced com-bin-a-TOR-ics, as in the mathematics field that deals with combinations), relies on the latest robotic drug-screening technology and software to test several thousand pairs of medicines a day.

At its laboratory in Cambridge, Massachusetts, researchers and robots systematically pair about 2,000 generic drugs with one another, with two million different combinations possible. Each is tested on human or animal cells, to see what happens.

If a drug pair inhibits the cells’ production of inflammatory proteins, for example, that might be reason to start exploring whether the combination might work against arthritis.

Borisy describes it as a “dumb, brute-force, empirical approach” that assumes current knowledge of disease is too limited to predict in advance what combinations might work. The company does, though, give priority to testing pairs it believes have the best chance of working.

While CombinatoRx must still prove its concept can lead to marketable drugs, eight of the company’s randomly arranged marriages, including the drugs for cancer, arthritis and diabetes, have moved into clinical trials – an unusually high number for a company that is only seven years old. Other companies are taking more rational approaches. Orexigen, in creating its main obesity drug, Contrave, took a treatment used for drug and alcohol addiction and combined it with an antidepressant sometimes used to help people quit smoking.

Meanwhile, Celator is focusing on drugs that are already used together to treat cancer. But while doctors now generally use the maximum tolerable dose of each drug, Celator says the ratio of the drugs is what matters more. So the company is developing combination products meant to deliver optimal ratios of the drugs to tumors.

Besides being quicker or cheaper to develop than single new drugs, combinations might also be more effective. Scientists have long known that the biochemical pathways involved in disease are complex, with numerous alternate routes. Trying to interfere with disease by blocking a single point can be like trying to keep traffic from reaching downtown Manhattan by closing a single intersection.

That is why doctors routinely use two or more drugs to treat people with cancer, heart disease, HIV infection and other diseases.

But only recently have single drugs with a one-two punch emerged as a business model in their own right.

Successful combination drugs already on the market included GlaxoSmithKline’s Advair, which pairs two asthma drugs, and Vytorin, which combines cholesterol-lowering drugs from Merck and Schering-Plough that work in different ways.

When they work, combination drugs mean fewer pills to swallow, making it easier for patients to complete a course of treatment – and, thus, helping companies hit sales targets.

Combination drugs can also let a weaker selling medication ride the coattails of a stronger drug, or partly shield a product that has lost patent protection from generic competition. One of the ingredients in Vytorin, for instance, is Merck’s Zocor, which has gone off patent.

AMA Wants Probe of Pharmacy-Based Health Clinics

TUESDAY — (HealthDay News) — The American Medical Association is calling upon federal and state agencies to investigate possible conflicts of interest posed by store-based health clinics operated by pharmacy chains.

The AMA said the request, made Monday at its annual meeting in Chicago, was spurred by reports that retailers say the store-based clinics help increase store traffic, which can increase sales of prescription drugs and non-health related items.

“It seemed to many [AMA] members that there was an inherent conflict of interest in a relationship between a health clinic and a pharmacy chain in terms of writing prescriptions and getting them filled in that pharmacy,” said Dr. Peter Carmel, a member of the AMA board of trustees, and chairman of the Department of Neurological Surgery at New Jersey Medical School. Read more

Eye disease sufferers ‘going blind in cost row over drugs’

Ulster sufferers of an eye disease are being left to go blind because of indecision among health chiefs on whether to fund new sight-saving drugs, two charities have warned.

The grim warning was delivered ahead of a public meeting being held in Belfast to highlight concerns for those diagnosed from wet age-related macular degeneration (wet AMD).

The Royal National Institute of Blind People (RNIB) and the Macular Disease Society were set to host the meeting this morning to call for ” immediate action from the Health Service in Northern Ireland to ensure patients get access to new sight saving treatments”.

The meeting comes just a week after concerns were raised by draft guidance from the National Read more

Brazil health chief takes on bishops, beer drinkers

By Andrea Welsh

BRASILIA – (Reuters) – Brazil’s new health minister has upset people from bishops to beer-drinkers in his few months in the job.

But Jose Gomes Temporao has also won fans among social activists, pro-abortion groups and Brazil’s poor.

The outspoken Temporao has emerged as the most contentious member of President Luiz Inacio Lula’s government since he took office in March — even taking on Pope Benedict.

“Health has become the right of every citizen and the duty of the state,” he said when he was sworn in.
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All over-40s ‘to be screened for heart disease’

Every adult over 40 could be screened for heart disease under recommendations expected from a Government advisory panel.

The scheme would identify those suitable for statins, the cholesterol-busting drugs, and mark the beginning of one of the largest programmes of mass medication.

Research suggests that half of all adults aged 40 or over – 14 million people – could benefit from taking the drugs, even though they show no symptoms.

Screening would take place at 40, 50 and 60, conducted by general practitioners, under recommendations expected this week from the National Institute for Health and Clinical Excellence (NICE).
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