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New drugs: prices bear no relation to reality

Prices of new drugs often have nothing to do with assessment data or sales volumes.

Eplerenone is a new drug very similar to an old drug, spironolactone, which has proved effective in treating chronic heart failure. Spironolactone has not been specifically evaluated as a treatment for heart failure following a myocardial infarction, for which it is probably effective. Eplerenone’s manufacturer opted to evaluate the new drug precisely for this indication, for which there are no in-depth studies on spironolactone; and the firm has refrained from comparing the new drug to the old one. Despite these questionable choices, the drug costs 9 times as much as the old one!

Another example: the high price initially authorised for trastuzumab, a cytotoxic drug recommended for the treatment of some metastasized breast cancers, could appear justifiable. But now, there are more indications for trastuzumab: off-label use as an adjunctive therapy is widely practised and tolerated, despite a number of unanswered questions, and the number of patients treated is growing considerably. But there is no drop in price (around 2,600 euros per month).

If the prices authorised corresponded to relevant assessment data, if they were adjusted according to the number of patients treated and the duration of the treatments, the allocation of public resources would be more coherent and effective in terms of public health.

©Prescrire December 2005

Source: "Prix artificiels" Rev Prescrire 2005 ; 25 (267) :

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