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The Value of New Medicines


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Title: The Value of New Medicines

The Value of New Medicines
WIPO Arab Regional Meeting IP as a Power Tool
for Economic Growth
Susan Kling Finston Associate Vice
President PhRMA
Amman, June 1, 2004
Value of New Medicines
  • To Individual Patients and Families
  • For the Benefit of the Larger Societies,
    including the Levant
  • Specific Benefits to the Jordanian Economy (2000

The value to Patients
  1. Improving quality of life by reducing
    hospitalizations and helping patients avoid
  2. Reducing side effects.
  3. Decreasing mortality and morbidity.

I. New Drugs Improving Quality of Life
  • Reducing hospitalizations and emergency room
  • Avoiding surgery
  • Helping patients remain more active and

New Drugs Reduce Visits to Hospital and ER
Asthma Management Program Improves Outcomes for
Children with Asthma
Source P.J. Munzenberger and R.Z. Vinuya,
Impact of an Asthma Program on the Quality of
Life of Children in an Urban Setting,
Pharmacotherapy, 22 (2002) 8, 1055-1062.
Medicines Help Prevent Invasive Surgeries
  • For ulcers, a few pills have replaced major
  • Former FDA Commissioner Dr. Mark McClellan,
    Speech before Drug Information Association,
    Ottawa, Canada November 18, 2003

Medicines Allow Patients to Remain Independent
New Alzheimers Medicine Delays Need for Costly
Nursing Home Care
73 Months
43 Months
Source G. Provenzano, et al., Delays in Nursing
Home Placement for Patients with Alzheimers
Disease Associated with Treatment with Donepezil
May Have Health Care Cost-saving Implications,
Value in Health, 4 (2001) 2,158.
II. New Medicines Reduce Side Effects
  • New medicines have been found to reduce side
    effects, often leading to improved compliance and
    better health outcomes.
  • Approximately 20 to 30 of patients who take
    conventional NSAIDs develop persistent side
    effects, and more than 10 are estimated to
    discontinue treatment as a result. (Source
    Anti-Inflammatory and Upper Gastrointestinal
    Effects of Celecoxib in Rheumatoid Arthritis,
    The Journal of the American Medical Association,
    Vol. 282, No. 20, November 24, 1999.)
  • A new family of NSAIDs known as Cox-2 inhibitors
    have been proven to cause less stomach irritation
    and carry a lower risk of complications than
    conventional NSAIDs.

New Medicines Often Have Fewer Side Effects and
Less Complicated Dosing Regimens
  • In the United States, the number of patients
    treated for depression has grown from 1.7 million
    to 6.3 million over the last decade.
  • One of the primary reasons for the increase was
    the steady broadening of prescription drug
    options available to treat depression, including
    a new class of antidepressant medications, which
    have fewer side effects and require less
    complicated dosing regimens.
  • Source Olfson, Mark et al., National Trends in
    the Outpatient Treatment of Depression, The
    Journal of the American Medical Association,
    2002 287 203-209.

III. Pharmaceuticals Reduce Mortality and
  • Pharmaceuticals have eliminated or brought under
    control many diseases that once had high
    mortality rates (e.g., influenza, polio,
    pneumonia, diphtheria).
  • Medicines have helped dramatically reduce
    mortality rates for other diseases and conditions
    (e.g., AIDS, asthma, heart attacks, strokes,
  • Medicines are alleviating symptoms for a wide
    range of diseases.

Drug Discoveries Have Helped Control Death Rates
for Chronic and Acute Conditions
  • Examples
  • Antibiotics have helped cut death rates from
    rheumatic fever and rheumatic heart disease by
    83 from 1965 to 1996.
  • Medicines such as ACE Inhibitors, beta-blockers,
    and nitrates have helped cut death rates from
    atherosclerosis (hardening of the arteries) by
  • H2 blockers and proton pump inhibitors helped cut
    death rates from ulcer of the stomach and
    duodenum by 72.

New Drugs Decrease Mortality for Deadly Diseases
  • From Killer to Chronic Disease Drugs Redefine
    Cancer for Many
  • Headline to Washington Post story, January 29,
    2003, which noted that thanks to advances in
    care, cancer has evolved into a chronic disease,
    much like asthma, diabetes, and, more recently,
  • AIDS death rate fell 80 in the last decade with
    introduction of HAART drug therapy.
  • Source CASCADE Collaboration, Determinants of
    Survival Following HIV-1 Seroconversion After the
    Introduction of HAART, The Lancet, 362 (2003)

Study Finds Direct Correlation Between Reductions
in Mortality and Number of New Drugs for Disease
  • Over 45 of the variation in mortality across
    diseases 1970-1991 is explained by the amount new
    drugs are used to treat the disease New drugs
    the most important factor in mortality
  • Each of the 436 new drugs introduced 1970-1991,
    annually adds 11,200 aggregate years of life to
    the U.S. population.
  • Source Lichtenberg, Frank, Pharmaceutical
    Innovation, Morality Reduction, and Economic
    Growth, Presented at the Conference on the
    Economic Value of Medical Research, December 1999.

Medicines Ease Symptoms
New Drug to Treat Overactive Bladder Improves
Symptoms Reduces Patient Care Needs
Improved Symptoms
Reduced Office Visits
Source T.B. Boone, et al., Treatment Patterns
and Associated Symptom Improvement During Six
Months of Care for Overactive Bladder A
Prospective, Observational Study, Clinical
Therapeutics, 24 (March 2002) 3, 397-408.
Value to Society
  • Curbing overall health care spending.
  • Increasing worker productivity.
  • Preventing disease and/or mitigating the
    complications of disease.

I. New Drugs Reduce Total Medical Spending
  • The use of newer drugs tends to lower all types
    of non-drug medical spending, reducing the total
    cost of treating a condition.
  • Hospitalization rates fall
  • Length-of-stay in the hospital goes down
  • Visits to family doctors and specialists are
  • Prevent costs associated with complications and
  • Help avert costly surgeries

Research Shows Using New Medicines Reduces Health
Care Spending
  • Use of newer medicines increased drug costs by
    18, but reduced hospital and other non-drug
    costs by 129.
  • ? So for each additional 1 spent on newer
    pharmaceuticals, 6.17 is saved in total health
    care spending
  • ? Of that amount, 4.44 comes from savings in
    hospital spending.
  • Frank R. Lichtenberg, Benefits and Costs of
    Newer Drugs An Update, (Cambridge, MA National
    Bureau of Economic Research, June 2002).

Drugs Help Control Hospital and Ambulance Costs
Mood Stabilizers Result in Savings for Patients
with Bipolar Disorder
Source J. Li, et al, Cost of Treating Bipolar
Disorder in the California Medicaid (Medi-Cal)
Program, Journal of Affective Disorders, 71
(2002) 1-3, 131-139
New Medicines Reduce Costs by Averting
Complications and Reducing Symptoms
Diabetes Costs Reduced Through Improved Glycemic
Source E.H. Wagner, et al., Effect of Improved
Glycemic Control on Health Care Costs and
Utilization, Journal of the American Medical
Association, 285 (2001) 2, 182-189.
II. New Drugs Increasing Worker Productivity
  • Pharmaceuticals make it possible for patients to
    perform better on the job worker productivity
  • With effective medicines absenteeism falls
  • Employers save money that would have been lost to
    physical and mental illness

Medicines Can Greatly Improve Productivity and
Save Employers Money
New Migraine Medicine Produces Productivity
Savings that Far Outweigh Drug Costs
Monthly Costs
Monthly Employer Savings per Employee Treated
Monthly Drug Costs per Employee Treated
Monthly Savings
10 1 Benefits Costs
Source R.F. Legg, et al., Cost Benefit of
Sumatriptan to an Employer, Journal of
Occupational and Environmental Medicine, 39
(1997) 7, 652-657.
Medicines Can Reduce Days Missed From Work
Antidepressants Reduce Absenteeism
SSRI Drug Treatment Begins
Source A.J. Claxton, et al., Absenteeism Among
Employees Treated for Depression, Journal of
Occupational and Environmental Medicine, 41
(1999)7, 605-611.
III. New Drugs Can Prevent or Mitigate the
Complications of Disease
  • Drug treatments reduce disability resulting from
    a disease
  • They minimize the chance of serious disease
  • Medicines lower risk of serious disease events,
    such as heart attack
  • New medicines can slow disease progression

Medicines Help Prevent Disability
Rheumatoid Arthritis Drug Treatment Reduces
Chance of Disability
Source J.B. Wong, et al., Estimating the
Cost-effectiveness of 54 Weeks of Infliximab for
Rheumatoid Arthritis, American Journal of
Medicine, 113 (2002) 400-408.
Medicines Prevent Serious Disease
EventsCholesterol Fighting Drugs Reduce Risk of
Heart Attack or Stroke
  • Cholesterol-lowering drugs, known as statins,
    safely reduced the risk of a heart attack or
    stroke by one-third in the worlds largest study
    of people at high risk for these conditions.
  • About 25 million people worldwide take statins
    today. The new findings suggest that about 200
    million people worldwide would benefit from the
  • According to the studys lead investigator, if 10
    million high-risk patients started taking
    statins, 50,000 deaths would be prevented each

Source Lawrence K. Altman, Cholesterol Fighters
Lower Heart Attack Risk, Study Finds, The New
York Times, November 14, 2001.
Medicines Reduce the Risk of Complications Stride
s in Ulcer Treatment Exemplify Ability of
Pharmaceutical Innovation to Prevent or Mitigate
Complications of Disease
  • Before 1977, the year in which stomach-acid
    blocking H2 antagonist drugs were introduced
    97,000 ulcer surgeries were performed each year.
    By 1987, that number dropped to fewer than
  • In the 1990s cost of drug therapy for ulcers
  • Cost of surgery 28,000
  • The new treatment saves at least 224 million a
    year in health care costs.

Source The Contribution of Pharmaceutical
Companies Whats at Stake for America, The
Boston Consulting Group, September 1993.
Hepatitis C Virus (HCV) and its Epidemiology in
Levant Area
  • Discovered in 1989 as a small RNA blood-borne
    virus with a large reservoir of chronic carriers
  • Major cause of posttransfusion hepatitis prior to
  • Actual prevalence of HCV infection in Lebanon and
    Syria is not known.
  • Prevalence in Iraq 0.5, Libya 7.9 and Jordan
  • Genotype 4 is the most prevalent type in the
    Middle East.

Prevalence of HCV in Our Countries
Combination Therapy is Excellent Value Compared
with Other Well Accepted Interventions
Cost per life years gained (Euro)
Stool Guaiac
Pneum Vacc
Anti- hypertensives
PegIntron(1.5) Rebetol
Value to Jordan
  1. Growth in Pharmaceutical Industry Economic
  2. Development of New Related Sectors
  3. Overall Benefits to the Jordanian Economy

Growth in Pharmaceutical Industry Economic
Activities (2000 - 2004)
  • More New Product Launches
  • More than 32 new product launches
  • Jordan joining Global Launch A-List
  • Growth in PhRMA Activities in Jordan
  • Ten Regional Offices
  • 300 Growth in Direct Employment

Growth of Partnerships
  • Eli Lilly Agreed with Al Hikmeh to promote
    Cialis for erectile dysfunction in the Jordanian
    market, as the first multi-national company to
    provide exclusive promotion responsibility for an
    innovative drug.
  • Bristol-Myers Squibb Signed a 3-yr cooperative
    landmark agreement with King Hussein Cancer
    Center (KHCC). This agreement extended
    cooperation to Jordan already existing between
    B-MS and NCI (National Cancer Institute) in US.
  • Novartis Levant Regional Office in Amman
    celebrates its fifth year in operation serving
    several countries in the region reached a
    collaborative agreement with Dar Aldawa.

Development of New Sectorsin Jordan - - Clinical
  • PhRMA members Aventis, BMS, Eli Lilly, Janssen
    Cilag, MSD, Novartis, Organon, Pfizer and
    Schering AG
  • Key areas
  • Cancer - Cardiovascular
  • Renal Failure - Anti-infectives
  • Schizophrenia - Diabetes
  • Epilepsy - Osteoporosis
  • Antibiotics - Painkillers

Growth of Clinical Trial Activity in Jordan
Clinical trials Pfizer Eli Lilly Novartis MSD Aventis Schering AG
Pre-2000 1 Almost none None None None None
2004 4 2 4 3 6 1
Subject Antifungal Cardiovascular Osteoporosis Sepsis Cancer Thalassaemia Cancer Osteoporosis Osteoarthritis Cardiovascular Oncology Osteoporosis Cardiovascular Diabetes Anti-infectives Computer tomography Cardio angiography investigations
Data Internal PhRMA Survey, Spring 2004
Development of New Sectorsin Jordan - - Medical
  • Jordan has four major sites
  • Each with several medical/holistic health
  • Dead Sea
  • Maeen Falls
  • Jordanian Hummah
  • Afra Falls

Overall Benefits to the Jordanian Economy
  • Benefits of Perception of strong Jordanian IP
  • Growth in Jordanian Economy based on Knowledge
  • Springboard for attracting PhRMA member
    activities to Amman.
  • Jordans pharmaceutical exports produced by
    local firms increased by 30 overall to all
    markets through 2003.

PhRMA International Points of Contact
  • Washington DC
  • Susan Finston
  • Amman, Jordan
  • Samir Mansour