1、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 Benefi
2、ts to the Jordanian Economy (2000 2004),The value to Patients:,Improving quality of life by reducing hospitalizations and helping patients avoid surgery. Reducing side effects. Decreasing mortality and morbidity.,I. New Drugs Improving Quality of Life,Reducing hospitalizations and emergency room vis
3、its Avoiding surgery Helping patients remain more active and independent,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 Ur
4、ban Setting,” Pharmacotherapy, 22 (2002): 8, 1055-1062.,After Program,Before Program,Medicines Help Prevent Invasive Surgeries,“For ulcers, a few pills have replaced major surgery.” Former FDA Commissioner Dr. Mark McClellan, Speech before Drug Information Association, Ottawa, Canada November 18, 20
5、03,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.,Medicines Allow Patients to Remain Independent Longer,New Alzheimers Med
6、icine Delays Need for Costly Nursing Home Care,43 Months,73 Months,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 pe
7、rsistent 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 NSA
8、IDs 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 g
9、rown 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
10、 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 Morbidity,Pharmaceuticals have eliminated or brought under control many diseases t
11、hat 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, ulcers). Medicines are alleviating symptoms for a wide range of diseases.,Drug D
12、iscoveries 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 athe
13、rosclerosis (hardening of the arteries) by 74%. 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 st
14、ory, 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.” AIDS death rate fell 80% in the last decade with introduction of HAART drug therapy.Source: CASCADE Collaboration, “Determinants of S
15、urvival Following HIV-1 Seroconversion After the Introduction of HAART,” The Lancet, 362 (2003): 1267-1274.,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 n
16、ew drugs are used to treat the disease New drugs the most important factor in mortality reductions. 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 Econ
17、omic Growth,” Presented at the Conference on the Economic Value of Medical Research, December 1999.,Medicines Ease Symptoms,Source: T.B. Boone, et al., “Treatment Patterns and Associated Symptom Improvement During Six Months of Care for Overactive Bladder: A Prospective, Observational Study,” Clinic
18、al Therapeutics, 24 (March 2002): 3, 397-408.,New Drug to Treat Overactive Bladder Improves Symptoms; Reduces Patient Care Needs,Patients Not Treated With New Drug,Patients Treated With New Drug,Improved Symptoms,Reduced Office Visits,Value to Society,Curbing overall health care spending. Increasing
19、 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
20、 in the hospital goes down Visits to family doctors and specialists are reduced Prevent costs associated with complications and symptoms Help avert costly surgeries,Research Shows Using New Medicines Reduces Health Care Spending,Use of newer medicines increased drug costs by $18, but reduced hospita
21、l 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 Bur
22、eau 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 (200
23、2): 1-3, 131-139,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.,Unimproved Group,Improved Group,Diabetes Costs Reduced Through Improved Glycemic Control,New Medicines Reduce
24、 Costs by Averting Complications and Reducing Symptoms,II. New Drugs Increasing Worker Productivity,Pharmaceuticals make it possible for patients to perform better on the job; worker productivity improves With effective medicines absenteeism falls Employers save money that would have been lost to ph
25、ysical and mental illness,Medicines Can Greatly Improve Productivity and Save Employers Money,New Migraine Medicine Produces Productivity Savings that Far Outweigh Drug Costs,Source: R.F. Legg, et al., “Cost Benefit of Sumatriptan to an Employer,” Journal of Occupational and Environmental Medicine,
26、39 (1997): 7, 652-657.,Monthly Costs,Monthly Savings,Monthly Drug Costs per Employee Treated,Monthly Employer Savings per Employee Treated,10 : 1 Benefits : Costs,Medicines Can Reduce Days Missed From Work,Antidepressants Reduce Absenteeism,Source: A.J. Claxton, et al., “Absenteeism Among Employees
27、Treated for Depression,” Journal of Occupational and Environmental Medicine, 41 (1999):7, 605-611.,SSRI Drug Treatment Begins,Month,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 disea
28、se complications Medicines lower risk of serious disease events, such as heart attack New medicines can slow disease progression,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.,Medic
29、ines Help Prevent Disability,Rheumatoid Arthritis Drug Treatment Reduces Chance of Disability,Medicines Prevent Serious Disease Events: Cholesterol 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 b
30、y 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 drugs. According to the studys lead investigator, if 10 million high-risk
31、 patients started taking statins, 50,000 deaths would be prevented each year.,Source: Lawrence K. Altman, “Cholesterol Fighters Lower Heart Attack Risk, Study Finds,” The New York Times, November 14, 2001.,Before 1977, the year in which stomach-acid blocking H2 antagonist drugs were introduced 97,00
32、0 ulcer surgeries were performed each year. By 1987, that number dropped to fewer than 19,000.In the 1990s cost of drug therapy for ulcers: $900/person/yearCost of surgery: $28,000 The new treatment saves at least $224 million a year in health care costs.,Source: “The Contribution of Pharmaceutical
33、Companies: Whats at Stake for America,” The Boston Consulting Group, September 1993.,Medicines Reduce the Risk of Complications: Strides in Ulcer Treatment Exemplify Ability of Pharmaceutical Innovation to Prevent or Mitigate Complications of Disease,Hepatitis C Virus (HCV) and its Epidemiology in L
34、evant Area,Discovered in 1989 as a small RNA blood-borne virus with a large reservoir of chronic carriers worldwideMajor cause of posttransfusion hepatitis prior to 1992Actual prevalence of HCV infection in Lebanon and Syria is not known.Prevalence in Iraq 0.5%, Libya 7.9% and Jordan 2%*.Genotype 4
35、is the most prevalent type in the Middle East.,Prevalence of HCV in Our Countries,0,10,000,20,000,30,000,40,000,50,000,Cost per life years gained (Euro),PegIntron(1.5) + Rebetol,Stool Guaiac,Pneum Vacc,Anti- hypertensives,CABG,Mammogram,Combination Therapy is Excellent Value Compared with Other Well
36、 Accepted Interventions,Value to Jordan,Growth in Pharmaceutical Industry Economic Activities Development of New Related Sectors Overall Benefits to the Jordanian Economy,Growth in Pharmaceutical Industry Economic Activities (2000 - 2004),More New Product Launches: More than 32 new product launches
37、Jordan joining “Global Launch” A-ListGrowth 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
38、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: Levan
39、t 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 Sectors in Jordan - - Clinical Reseach,PhRMA members: Aventis, BMS, Eli Lilly, Janssen Cilag, MSD, Novartis, Organon, Pfize
40、r and Schering AGKey areas: Cancer - Cardiovascular Renal Failure - Anti-infectives Schizophrenia - Diabetes Epilepsy - Osteoporosis Antibiotics - Painkillers,Growth of Clinical Trial Activity in Jordan,Data: Internal PhRMA Survey, Spring 2004,Development of New Sectors in Jordan - - Medical Tourism
41、,Jordan has four major sites Each with several medical/holistic health centers: Dead Sea Maeen Falls Jordanian Hummah Afra Falls,Overall Benefits to the Jordanian Economy,Benefits of Perception of strong Jordanian IP Regime Growth in Jordanian Economy based on Knowledge Economy 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: sfinstonphrma.org Susan FinstonAmman, Jordan: smansourphrma.org Samir Mansour,
