Article in medical journal criticises "unethical" marketing of medicines

Pharmaceutical wholesalers' growth viewed with suspicion

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A group of experts has criticised the pharmaceutical industry for unethical marketing, which they say is the greatest reason for the sharp rise in spending on medicines in recent years.
      In 2000-2004 the total costs of medicines eligible for a rebate from the Social Insurance Institution (KELA) surged by EUR 374 million, in spite of the implementation of generic substitution in March 2003. Now it appears that generic substitution has merely slowed down, but not reversed, the rise in costs.
      The number of pharmaceutical wholesalers has tripled from the early 1990s, even though the number of people receiving compensation has remained stable.
      The figures are from an article in Suomen Lääkärilehti, the journal of the Finnish Medical Association. It was written by a group of five top experts, including Professor Juhana Idänpään-Heikkilä, Secretary-General of the Council for International Organisations of Medical Sciences.
      According to Idänpään-Heikkilä, pharmaceutical companies seek to maximise profits by marketing the latest medicines to an excessively wide range of patients, even those who would benefit more from the older, cheaper medicines.
     
The costs rise when marketing is focused on new, more expensive medicines which still have patent protection, and therefore still lack generic substitutes.
      In an interview with Helsingin Sanomat, Idänpään-Heikkilä says that it is not right to market a preparation as a general medicine if it mainly benefits only a limited group of patients.
      He gives as an example the new coxibs, which are medicines for infectious pain. Idänpään-Heikkilä says that they give additional benefit only to those whose stomachs cannot tolerate more conventional pain killers. Nevertheless, pharmaceutical companies have been marketing coxibs for a wider range of patients with pain caused by infections, even though they cost three or four times as much as the cheaper preparations.
      Blood pressure and cholesterol medicines are another group where marketing has raised drug costs.
      For instance, the marketing of diuretics, which are known to be effective against high blood pressure among the elderly, has dwindled because of their low price, leading to a decrease in their use, and their substitution with more expensive preparations.
      "The higher prices are paid by innocent patients, and by others in the form of KELA rebates. When there is only a limited benefit from the medicine, the benefit should be directed at those for whom it can really help."
     
According to the writers of the article, the Finnish economy and the health care system cannot withstand the present rate of rise in pharmaceutical costs, especially with the increasing age of the population.
      Professor Idänpään-Heikkilä says that in the future, an increasing variety of expensive medicines will be developed for rarer diseases. He adds that if these treatments are to be affordable, cheaper medicines should be used for diseases that are more widespread in Finland.


Previously in HS International Edition:
  Mönkäre denounces price agreements between pharmacies and drug companies (8.3.2005)
  Generic drugs bring savings of EUR 55.1 million (5.1.2004)
  Generic medicines spark considerable price competition at pharmacies (15.4.2003)

Helsingin Sanomat