Tuesday, April 15, 2014

Total Prescriptions Written & Per Capita Spending in U.S. Rise in 2013

According to a new report issued today by the IMS Institute for Healthcare Informatics, total spending on U.S. medicines increased 1.0 percent on a real per capita basis in 2013, while the use of healthcare services overall rose for the first time in three years.

The study – Medicine Use and Shifting Costs of Healthcare: A Review of the Use of Medicines in the United States in 2013 – found that "total dollars spent on medications in the U.S. reached $329.2 billion last year, up 3.2 percent on a nominal basis and a rebound from the 1.0 percent decline in 2012. Primary drivers include the reduced impact of patent expiries, price increases, higher spending on innovative new medicines, and greater use by patients of the healthcare system."

Over one-third of this spending was concentrated in 5 therapeutic areas: Oncology, Antidiabetes, Mental Health, Respiratory, and Pain. Three specialty classes (MS, autoimmune, and oncology) contributed $6.9Bn, or 68% of total growth. See the following chart:

Saturday, April 12, 2014

Mickelson's PGA Standing vs. Enbrel's DTC Spending

Phil Mickelson, 5-over, missed the cut at the Masters this year. Bummer!

Because of that, you might not see more Enbrel ads featuring Mickelson who is a hired gun - er, celebrity spokesperson - for the Enbrel brand (see "Amgen Blows Its Marketing Budget on Phil Mickelson Campaign"). Unless, of course, the TV ads were pre-purchased at a discount to run during the Masters.

It makes sense for Amgen to cut back on running the Mickelson-Enbrel ads if Phil is not going to be in the Masters. But Amgen already cut back on Enbrel advertising in 2013. That year, the Enbrel DTC spend was $77 million (see here) according to Nielsen. In comparison, the spend was $127 million in 2012 (see here).

Why did Amgen but back on Enbrel DTC in 2013 when Mickelson was doing well at the Masters and had a decent PGA standing?

Just for fun, I did some research to compare Mickelson's PGA standing and Enbrel's DTC ad spend from 2010, when Mickelson was first hired as an Enbrel spokesperson, to 2013, the latest year for which figures are available.

Here's what I found.

Friday, April 11, 2014

The Top 20 DTC Ad Spenders in 2013 Virtually Ignored Digital

April is the nicest month -- for data about direct-to-consumer (DTC) ad spending for the previous year thanks to MM&M magazine, which published Nielsen data in this month's issue. I've summarized the data in a couple of charts as I have done in previous years.

Keep in mind that the absolute numbers refer only to "measured" media (broadcast, print, outdoors, and B2B) and, in this case, does NOT include digital ad spending (more on that later). The numbers also do not take into account discounts -- they reflect "list" pricing as it were. At least that's my understanding.

The important take aways are the trends and comparisons between companies and brands AND estimating how much is spent on digital versus traditional media. More about that later in this post.

First up - the TOP 20 Big DTC spenders (i.e., companies) for 2013.

Click for an enlarged view.
The spending by the top 20 companies represents adds up to about $3.6 billion or 95% of the entire 2013 DTC spend, which was $3.8 billion (including Internet display ad spend). In 2011, the top 20 accounted for about 90% of the total DTC spend.

The takeaway?

Wednesday, April 09, 2014

An FDA Approved Opioid Delivery System

The Food and Drug Administration (FDA) announced the establishment of a docket (here) to receive suggestions, recommendations, and comments on innovative packaging, storage, and disposal systems, technologies or designs (“designs”) that could be used to prevent or deter misuse and abuse of opioid analgesics by patients and others.

Comments submitted in response to this notice will help the Agency determine whether innovative designs for opioid analgesic packaging, storage, and/or disposal systems could help prevent or deter misuse and abuse without diminishing access for patients with legitimate prescriptions.

These systems may include functionality to remind patients to take a dose, track when a dose is taken and how much is taken, and limit further access until it is time for the next dose. Additionally, many of these drug-device combinations electronically encrypt and capture the accumulated adherence data, which can be downloaded directly from the device or wirelessly transmitted to the prescriber.

I respectfully submit the following design …

Tuesday, April 08, 2014

Tsk! Tsk! Takeda May Pay $6 Billion Penalty for Hiding Actos Cancer Link - Lilly Only $3 Billion!

According to an article in the Financial Times, "Takeda has been ordered to pay $6bn in punitive damages for hiding a possible link between a best-selling diabetes drug and bladder cancer in one of the biggest corporate fines by a US jury. Eli Lilly, which marketed the drug in the US until 2006, was ordered to pay $3bn" (read the whole story here).

Although Takeda has vowed to appeal the decision, I have updated my "Pharma Criminal & Civil Settlement Planetary System" diagram to put this decision in context of other fines and jury awards against the drug industry made in the past couple of years.

Takeda said it believes the evidence did not support a finding that Actos caused the plaintiff's bladder cancer and remained confident in the benefits of Actos as a treatment for type 2 diabetes.

It's interesting that the FT article mentioned how a "near-blanket ban" on sales of GSK’s top-selling Avandia diabetes drug in 2010 "opened the way for Takeda’s success with Actos," which is exactly what I highlighted back in July, 2010 (see "Actos Launches DTC Attack on Avandia").

Monday, April 07, 2014

Are FDA's Efforts to Improve Adverse Event Reporting Being Hobbled by Pharma?

Source: FDA. 2012 data estimated based on first 6 months.
FDA resurrected a data mining project that it had abandoned for "lack of funding" but "just days after the agency announced the project's return, it is once again cancelling the project," reports Alec Gaffney (see "FDA Data Mining Project Proposal Once Again Withdrawn").

The project would have developed "predictions for safety signals that have not yet been recognized for drug candidates that have come to the FDA as New Drug Applications (NDAs)," which is a pretty radical idea, especially if it caused fewer dangerous drugs from being approved in the first place.

It does seem that more dangerous drugs are being approved by the FDA. As shown in the chart above/left, DEATHS reported to the FDA via its adverse event reporting system have increased dramatically in the last few years for which data is available.

Between 2003 and 2012, FDA received 588,000 death notices via Adverse Event Reports (AERs). This is scary considering that FDA's adverse event reporting system is notoriously inefficient. I've heard that FDA captures only about 10% of drug adverse events.

The number of adverse event reports received by FDA is also increasing dramatically as shown in the following chart: