Drug industry tactics cost NHS millions

5 October 2006

Efforts to control the annual NHS drugs bill, currently over £10 billion, by using generic drugs rather than their more expensive brand-name equivalents are being seriously undermined by the pharmaceutical industry, according to Drug and Therapeutics Bulletin (DTB).

A generic drug can only be introduced onto the market once the patent protection of the brand-name drug has expired. And tactics employed by drug companies can leave doctors or patients little choice but to use new, heavily promoted, 'brand' versions. This is despite the fact that the new drugs often offer no convincing advantages over the original products in terms of effectiveness or safety.

Typical ploys used by industry include:

• Introduction of a new brand-name drug that is very similar chemically to the original but marketed as being in some way better
• Presentation of an old drug in a different form, for example as a capsule rather than a tablet
• Combination of the original drug with another old established drug to form a new product.

Companies may also withdraw the original brand-name drug before its patent actually expires, and around the same time, introduce the new brand-name product. Because the old patent protection is still operative, no generic equivalent can be released onto the market. So, by the time a generic eventually enters the market patients may already be well established on, and very unwilling to switch from, the new-brand drug.

Dr Ike Iheanacho, Editor DTB comments: “Strategies designed to obstruct the emergence and use of generic medicines waste NHS money and can be disruptive for patients and doctors alike.

"Very often, the new-brand-name products offer patients no convincing advantage compared with the originals. Indeed, there is no legal requirement for new medicines to be tested against current standard treatment before they can be marketed. However, drug companies often give the impression that the new drugs are better than the old, and doctors may be unaware that they are being manipulated."

One infamous example is the antihistamine loratadine (Clarityn) which was taken off the market as a prescription medicine and replaced with the 'new' desloratadine (Neoclarityn), despite the lack of published evidence on how the two drugs compared. In this case, the drug company responsible openly admitted that the move was designed to maintain its market share for antihistamines.

Dr Iheanacho concludes: "Prescribers and patients need to be aware of industry tactics and to question the claimed value of switching to new products.

"There also needs to be a more critical assessment of products during the licensing process to include comparisons with existing treatments. This would help to ensure that the introduction of new drugs is led more by the needs of patients and less by the interests of industry."

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