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Healthy Skepticism Library item: 19863

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Magazine

Wenley S
Free drug offer puts pressure on GPs to prescribe
GP Date uncertain Before 2000 4


Full text:

The NZMA is disappointed about the marketing of a new asthma drug.

Since last week, Merck Sharpe & Dohme have been offering Kiwi asthma sufferers a free month’s trial of their new steroid free product Singulair.
NZMA chairman, Dr Anton Wiles, says he’s not impressed by the strategy and he says other GP’s agree with him.
He describes the one month free offer of the drug as ‘the bait on the hook’.
“If I had a patient I thought it was useful for, I would use it. But there is also the caution of what people expect from it and how they intend using it.”
Dr Wiles says another major concern is that people may think they can stop taking their current medication and switch to the new one.
He says the drug company is quite clearly trying to market their new drug.
The NZMA doesn’t have a policy on this type of issue, but Dr Wiles says they will be discussing it.
‘New Zealand is under a free market health system, but this sort of thing doesn’t make a doctor jump up and down with joy’, he says.
‘I would have much rather preferred it to have been marketed direct to doctors, and only to doctors, saying this is here and this is what it does, without going out to the public as such’.
Dr Wiles says he’s concerned by one pamphlet which says up to 40 percent of asthma sufferers are able to throw away their steroid inhalers’.
‘That starts to raise an expectation with doctors, if not with patients’.
But Merck, Sharpe & Dohme doesn’t agree at all.
The company’s managing director, Alister Brown, says the idea behind the free month’s supply of Singular was to let patients ‘try before they buy’.
Mr Brown says asthmatics or their parents and caregivers can arrange to receive Singulair after discussing the matter with a GP.
‘There’s no direct to consumer advertising with this. We’ve just said it’s a breakthrough, a newsworthy story, and made the public aware of it’.
Mr Brown says everything being sent to doctors has been up front about the ongoing cost of the product ($117 per month).
‘They [doctors] should discuss that cost with the patient before they start them on Singulair, and if the patient is unwilling or unable to pay – well it’s inappropriate to start them on it’.
He doesn’t expect all patients to continue on the drug as it mightn’t be right for them or it might be too expensive.
Mr Brown says there’s been no negative feedback from the public at all.

Clinical Profile
Singulair works by blocking the effects of leukotrines, which trigger asthmatic reactions.
Taken as a once-a-day dose at bedtime, Singulair (montelukast) is a steroid-free medication which helps control asthma in adults and children as young as six.
Merck Sharp & Dohme’s managing director, Alister Brown, says the effectiveness will be evident within on month, sometimes within a week or two.
In clinical trials involving more than 4000 adults and children, Singulair was well tolerated and effective.
It decreased asthma attacks by 37 percent on average, increased asthma-free days by 42 percent and reduced steroid use by 47 percent, with 40 percent being tapered off inhaled steroids completely.
The most commonly reported side effects, for both placebo and Singulair, were headache, diarrhoea, influenza and abdominal pain.
Singulair is not indicated for the relief of an acute asthma episode.
Dr David Woolner, medical director of Merck Sharpe & Dohme says the goal was to develop a once-a-day, medicine that was both effective and well tolerated, providing chronic asthma patients with a new way to help control their disease.
‘Patients not controlled solely by as-needed-quick-relief medicines can start Singulair’.
It may also be added to the regimens of patients who aren’t controlled completely on daily inhaled steroids.
Those patients who are controlled on high doses of inhaled steroids can use the medication to help decrease the dosage of inhaled steroids while still maintaining asthma control.
In late October, Merck Sharpe & Dohme submitted an application to Pharmac for Singulair to be made available to asthma sufferers on a subsidised basis and a decision is expected early next year.
Until then, the medication will cost patients a maximum of $117.86 per month if they stay on it after the one month free offer the drug company is currently offering.
Singulair comes in a 5mg cherry-flavoured chewable tablet for children and is available as a regular 10mg tablet for those over 14.
Full product information has been sent to GPs, specialists and asthma groups and an 0800 line (0800 800 683) us also available to assist the medical community as required.
Meanwhile, in the US MSD’s parent company has written to doctors and pharmacists warning them to carefully monitor patients on Singulair for Churg-Strauss syndrome which, if untreated, can destroy organs. As yet, there’s no proof that Singulair causes this syndrome.

 

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