Latest Drugwonks' Blog

A new report from the President's Council of Advisors on Science and Technology (PCAST) has recommended the Agency for Healthcare Research and Quality (AHRQ) receive funds above and beyond the $1.1 billion earmarked in the President’s initial stimulus package to develop a test network for comparative effectiveness research.

The report notes that if patient progress and outcomes are routinely captured in data and made available in near real time, "partial data can be used in sophisticated ways to assign treatments to new patients in optimal ways. These data also could be used to personalize treatment for patients already enrolled in a study."

“Assign treatment?” Perhaps “help a physician decide” or “provide important clinical information”  -- but … “assign?” Sounds rather top-down, don’t you think?  Alas, as this report was drafted by experts who understand the importance of precise language, we have to assume what they wrote is what they meant.

And that’s frightening.

Sounds like a good topic for a Congressional hearing.

The Council’s report can be found here.

Waiver This!

  • 12.10.2010
I wonder how Obamacare's visionaries will deal with doctor drop outs. Perhaps another unemployment benefit extension?
 
 
Nation's Frontline Physicians Unhappy With Health Care Reform Measures
November 18, 2010
 
The Physicians Foundation today released the results of a national survey of physicians that finds strong negative feelings towards the new health care reform law and fear that patient care will suffer in the months and years ahead. The survey was intended to gauge physicians’ initial reaction to the passage of health reform and to learn the ways in which they plan to respond to it.
The research, conducted by Merritt Hawkins, a national physician search and consulting firm, on behalf of the Foundation, comes on the two-year anniversary of the Foundation’s first national physician survey that found growing dissatisfaction among doctors as they struggle with less time for patient care and increased time dealing with non-clinical paperwork, difficulty receiving reimbursement and burdensome government regulations. The new research reinforces those findings and shows that the new health care reform could intensify existing problems for doctors and worsen the shortage of primary care doctors, making it more difficult for patients to access quality care.
“Physicians support reform; in fact, we were the ones leading the fight against the status quo. But this new research shows that doctors strongly believe the law is not working like it needs to – for them, or for their patients,” said Lou Goodman, PhD, President. “For any health care reform effort to be successful, it must include the viewpoint of our nation’s doctors. Their perspective from the front-lines of patient care is critical in determining what’s broken in our system and how we can fix it.”
Notably, physicians also felt that Medicare’s Sustainable Growth Rate formula (SGR) had an equally large impact on their practices as health care reform. Proposed cuts have been repeatedly put off by Congress and in January will reach approximately 30% if not addressed. “Despite the high profile nature of the health reform discussion, physicians are equally concerned over the impact of SGR on their practices,” said Walker Ray, MD, Research Committee Chair. “The fact that SGR was not addressed as part of this year’s reform effort shows that we don’t have a comprehensive solution yet, and also that doctors simply didn’t have a voice at the table during the reform debate. That needs to change.”
Key research findings include:
• The majority of physicians (60%) said health reform will compel them to close or significantly restrict their practices to certain categories of patients. Of these, 93% said they will be forced to close or significantly restrict their practices to Medicaid patients, while 87% said they would be forced to close or significantly restrict their practices to Medicare patients.
• 40% of physicians said they would drop out of patient care in the next one to three years, either by retiring, seeking a non-clinical job within healthcare, or by seeking a non-healthcare related job.
• The majority of physicians (59%) said health reform will cause them to spend less time with patients.
• While over half of physicians said health reform will cause patient volumes in their practices to increase, 69% said they no longer have the time or resources to see additional patients in their practices while still maintaining quality of care.
• 67% of physicians said their initial reaction to passage of the 2010 Patient Protection and Affordable Care Act was either “somewhat negative” or “very negative” and a great majority (86%) believes the viewpoint of physicians was not adequately represented to policy makers during the run-up to passage of the law.
• Physicians are almost evenly divided over the relative importance of SGR (36%) and health reform (34%) to their practices, while 30% are unsure which will have the greatest impact.
The full research report is available as part of “Health Reform and the Decline of Physician Private Practice,” an expert analysis of the potential effects of reform on physician practices. The report is available at www.physiciansfoundation.org.
 
 

BioCenturions

  • 12.10.2010
BioCentury con brio!

This Sunday on "BioCentury This Week" TV

Broadcast on WUSA Channel 9 in Washington, D.C.
and Fox affiliate WFXT Channel 25 Boston
8:30 - 9:00 a.m. EST

Dec. 12 broadcast investigates
POLITICAL COMMUNICATIONS
Finding Biotech's Voice in a Divided Washington

continuous webcast at
www.biocenturytv.com

Biotech avoided the eye of the storm during the bruising healthcare reform debate. In the newly divided Washington, the question is whether the industry can afford to stay under the radar on its hot button issues, such as PDUFA, as other interest groups join the fray. On Sunday, Dec. 12, BioCentury This Week examines this political communications landscape.

Policom Basics -- Gene Grabowski, SVP at Levick Strategic Communications, and Wayne Pines, President of Regulatory Services and Health Care at APCO Worldwide, warn that biotech must make its voice heard.
 
Policom Tactics -- Peter Pitts, President and Co-founder of the Center for Medicine in the Public Interest and Partner/Director for Global Healthcare at Porter Novelli, and Sally Greenberg, Executive Director of the National Consumers League, focus on how industry and consumer groups will carry their messages to Capitol Hill.
 
Web Exclusive -- Gene Grabowski, Wayne Pines and Peter Pitts assess biotech's visibility on Capitol Hill and debate what to do about it.

Final Word -- BioCentury Washington Editor Steve Usdin says it's not too early for biotech CEOs to begin building their messages for their annual "legislative fly-in" to Washington.

Bathrobes and slippers optional.

Enjoy!

Billions are being spent on health IT systems that will supposedly be used by Donald Berwick and cohorts to feed one size fits all guidelines for every aspect of care.
 
Meanwhile consumers are moving at the speed of life to adopt more nimble and portable tools to personalize care... Will the IPad be the latest weapon in fighting Obamacare?
 
IPads Are Latest Tool in Medical Sales

Medical-sector companies are passing out thousands of iPad tablet computers to salespeople to spruce up their pitch to doctors, and at the same time giving Apple Inc. a crucial foot in the door to business customers.

Abbott Laboratories, Medtronic Inc. and Boston Scientific Corp. are among the drug and medical-device firms making the move, while others say they are testing out the devices.

The tablet computers offer new ways to display product information or surgical-implant techniques, according to companies. Their quick start-up times mean the salesmen can jump into their presentations before doctors lose interest.
 

Organic Pharming

  • 12.09.2010

I spent the last two days chairing the Social Media for Pharma conference and boy are my arms tired.

Actually, it’s my brain that’s tired – because it got a lot of exercise.

Some speaker comments that resonated:

Julie Zawisza (CDER’s Director of Communications):  “If we don’t tell our own story – others will.”

So true.  And not just for the FDA.  The same is equally relevant for pharmaceutical and medical technology companies.  Perhaps even more so.  In fact, definitely more so.

Paul Buckman, the FDA’s new Dean of Digital, revealed that there is an FDA employee who is (in real time) posting responses to queries generated on the agency’s FaceBook page.  This is surprising considering that such a thing would certainly constitute an FDA “written response.” More on this as it develops.

Ambre Morley and Alpesh Patel (product communications and regulatory affairs at Novo Nordisk respectively) discussed their much-ballyhooed Twitter campaign (for Levemir) with IndyCar driver Charlie Kimball.  At the beginning of the presentation, Alpesh said that when Ambre first discussed the idea with him, he said, “Let me think about it.” To which Ambre replied, “Actually, you said no.”  Success, as they say, has many fathers.

J&J’s always-insightful Marc Monseau shared some gems, discussing the need for well-developed social media “policy, process and guardrails.”  The most important pharmaceutical company asset for success in social media?  “A cultural willingness to try.”  Amen.

Shwen Gwee and Zach Barber (Vertex) discussed their company’s foray into Twitter – and the interesting correlation between number of tweets and number of followers.  Shwen also shared their concern over “proactive following.”  Add that one to things that make you go hmm.  (FYI – current Vertex Twitter guidelines can be found here.)

Both the Novo Nordisk and the Vertex presentations raised questions about retweets – especially those with a hotlink.  All present agreed that all links should be carefully vetted before being retweeted.  (Here’s a brainteaser – what about retweeting an FDA tweet with a product-specific hotlink that doesn’t one-click to the P.I.?  Once again – hmm.)

Relative to FDA tweets and the aforementioned FDA FaceBook – and as if things weren’t ambiguous enough – what happens when you have the federal agency in charge saying (for all intents and purposes) “do as I say, not as I do.” And, of course, this is made even worse since the FDA isn’t saying much.

But I digress.

During one of the breaks, I participated in a very entertaining conversation with three regulatory types from three different companies. We decided there is an unmet need for “regulatory emoticons.” The consensus opinion was for an emoticon representing arms crossed across the chest. We felt that a more, shall we say, digit-based representation was overly confrontational.

Nancy Buono Cartwright (Kaiser Permanente) discussed using social media as an internal communications tool. Much smart thinking and nifty program elements.  Her suggestion for engagement --“Play in traffic.”  Not the best way to encourage an already skittish audience. Auto de fé indeed!

The omega presenter was Dennis Urbaniak (sanofi-aventis) and he had a keen observation about pharma and social media, “It’s not if anymore – it’s when and how.”

He also pointed out that social media (as part of an integrated marketing strategy) is unlike other, more traditional component – such as advertising.  Social media programs are the gift that (properly understood and harvested) is the gift that keeps on giving.

What does that mean?  Well, a DTC television commercial doesn’t generate anything once it’s been aired.  Social media, on the other hand, generates awareness, interaction, a call to action (when appropriate), and robust metrics that supply real-time competitive intelligence.

Need I say more?

There were many excellent presenters who I have not mentioned.  The complete program agenda can be found here.

Pitts times two

  • 12.08.2010
Who says there’s not enough room for another Pitts in the health care reform debate?
 
Congressman Joe Pitts (R-PA) has been selected as the Chairman of the House Subcommittee on Health in the new Congress, where he is expected to play a pivotal role in any move to repeal or roll back provisions of the health care law.
 
CMPI interviewed Congressman Pitts in 2008 just prior to the Presidential election to discuss health care reform proposals. We discussed everything from medical malpractice reform to tax credits for purchasing insurance.
 
To watch that interview, click here:

Joe Pitts (R,PA) on American Healthcare Reform from CMPI on Vimeo.


 
 

Fascinating and informative BioCenutury cover story on a 21t century regulatory pathway for diagnostics.  Penned by the always informed Steve Usdin, here are some snippets:

FDA and members of Congress are putting the finishing touches on different proposals to create a new regulatory pathway for diagnostics, making it almost certain that major changes will be unveiled in 2011. The question is which approach will prevail — and whether either approach solves the problem of value-based reimbursement.

Top FDA officials and lawmakers have concluded that the current oversight system for diagnostics, which imposes premarket review requirements for in vitro diagnostics (IVDs) but not for the vast majority of laboratory-developed tests (LDTs), is not sufficient to protect the public or to support the development of innovative tests that are at the heart of hopes for widespread adoption of personalized medicine.

The only option that is off the table is the status quo.

Senator Orrin Hatch (R-UT) is lining up bipartisan support — and his staff is trying to build consensus among labs, diagnostics companies and investors — on draft legislation that would preempt FDA’s efforts. His approach would create a new regulatory category encompassing both LDTs and IVD tests.

Under the Hatch bill, IVDs would no longer be regulated as medical devices. Also, FDA would for the first time routinely regulate tests performed in labs, although lab services and operations would continue to be regulated by the Centers for Medicaid and Medicare Services (CMS) under the Clinical Laboratory Amendments (CLIA) (see “BETTER at a Glance”).

Hatch hopes to use a new regulatory system to go even farther, as a platform for launching reform of diagnostics reimbursement policies, and shifting Medicare from a payment system based on the complexity of test procedures to one based on the value of tests, according to diagnostics.

FDA has clearly signaled that in the absence of legislation, it intends to regulate LDTs, fitting them into a structure that many labs and IVD manufacturers argue is ill-suited for diagnostics.

Indeed, according to Alberto Gutierrez, director of FDA’s Office of In Vitro Diagnostic Device Evaluation and Safety (OVID), laboratory directors who hope FDA will back off from its plans to regulate their tests are like “ostriches which have their heads in the sand.” Gutierrez, who made the comment at a Nov. 22 meeting organized by ACLA, said the agency is writing a guidance document outlining a proposed diagnostics oversight framework. While he declined to say when the guidance will be released, FDA has already begun recruiting staff to implement it. At the same time, FDA has indicated that it will move slowly, leaving room for Congress to intervene before the agency implements any major changes.

“The success of personalized medicine depends on having accurate diagnostic tests that identify patients who can benefit from targeted therapies.”

(From July NEJM commentary jointly authored by FDA Commissioner Peggy Hamburg and NIH Director Francis Collins.)

The complete BioCentury article can be found here.

I heard the news today, oh boy.
 

Pfizer Board of Directors Names Ian C. Read President and Chief Executive Officer  

 

Read Succeeds Jeffrey B. Kindler, who has Retired from the Company

New York – December 5, 2010 – Pfizer Inc. (NYSE: PFE) today announced that its Board of Directors has elected Ian C. Read, 57, currently head of the Company’s global biopharmaceutical operations, as President, Chief Executive Officer and Director. Mr. Read succeeds Jeffrey B. Kindler, who has retired from the Company.

The Board’s Lead Independent Director, Constance J. Horner, said, “In 2006, Jeff Kindler took on the challenge of transforming Pfizer in the face of enormous changes in the global health care marketplace and significant patent expirations of major products, including Lipitor.  Acting with the highest level of ethics and professionalism, he moved aggressively to drive change at the Company, including putting new, more focused and agile business units in place, building and enhancing world class compliance systems, recruiting talented new leaders, and refocusing and streamlining operations in every part of the world.  He also led the acquisition of Wyeth, which brought the Company valuable in-line and pipeline products and capabilities in attractive growth areas, including vaccines and biologics.  Due to the efforts of Jeff, the executive leadership team and Pfizer’s talented employees around the world, the Company is now a stronger, more diversified and more focused company.”  
    
Mr. Kindler commented, “My nearly nine years at Pfizer and, particularly the last four and a half as CEO, have been extremely exciting and rewarding.  I feel our team can proudly boast of some transformational accomplishments.  However, the combination of meeting the requirements of our many stakeholders around the world and the 24/7 nature of my responsibilities, has made this period extremely demanding on me personally.  Now that we are about to complete a full year of operating Pfizer and Wyeth together, with our world-class team fully in place, I have concluded the time is right to turn the leadership of the company over to Ian Read.  Ian is an outstanding and experienced pharmaceutical executive who I know will make the next phase of the company’s future a successful one.  He is more than ready to take on these responsibilities and I am excited at the opportunity to recharge my batteries, spend some rare time with my family, and prepare for the next challenge in my career. 

Ms. Horner added, “In the last four years as President of Pfizer’s pharmaceutical businesses, Ian has redefined our go to market approach with the creation of global business units and has brought to product development a focus and commitment to advance only medicines that have clear value to our customers.  Today’s business leaders need to understand global markets, drive change and innovation, and move quickly to adapt to competitive pressures.  Ian’s track record throughout his career has demonstrated these exact strengths.”
 

Mr. Read said, “I am honored to lead an organization with outstanding and dedicated colleagues on the front lines of medical innovation. We have a broad portfolio that spans the entire spectrum of human and animal health, from vaccines to biologics to primary care, specialty care, oncology, consumer products, nutritionals and beyond.  I have great confidence in the strength of our company and our leaders and will be looking at the performance and potential of all of our businesses to ensure we are delivering value to our customers and shareholders. We have all the elements for success -- financial strength, global reach, a disciplined focus on the therapeutic areas with the strongest growth potential and a talented and dedicated workforce.”

Since 2006, Mr. Read has led Pfizer’s Worldwide Biopharmaceutical Businesses which now comprises five global business units – Primary Care, Specialty Care, Oncology, Established Products and Emerging Markets – and accounts for approximately 85 percent of Pfizer’s annual revenues.  He was responsible for more than 40,000 Pfizer colleagues.  His leadership team consisted of senior executives directing Pfizer development and commercial operations in 180 nations.

Mr. Read joined Pfizer in 1978 and quickly assumed positions of increasing responsibility in Latin America.  In 1996, he was appointed President of Pfizer’s International Pharmaceuticals Group, with responsibility for Latin America and Canada. He was named Corporate Vice President in 2001, and assumed responsibility for Europe in addition to Canada.  Mr. Read later added the Africa/Middle East and Latin American regions to his leadership responsibility.

The Board will elect a non-executive Chairman from its current membership at its next regularly scheduled meeting that will take place within the next two weeks.

The saga continues …

NEW YORK (AP) - Momenta Pharmaceuticals Inc. said Thursday it is suing rival Teva Pharmaceutical Industries Ltd. in a patent dispute over generic versions of the anti-clotting drug Lovenox.

The Cambridge, Mass., company said it filed a patent infringement lawsuit against Teva, alleging the Israeli company violated two patents held by Momenta that are related to its generic version of the drug. Lovenox, or enoxaparin, is used to prevent dangerous blood clots, including clots in the veins of the thigh or leg, or in patients who are having a heart attack or chest pain. The original version of the drug is made by Sanofi-Aventis SA, and it was approved in the U.S. in 1993..

When it comes to shaping the views of physicians,  David Rothman apparently believes it's ok for hiis Soros-funded views to hold sway and for companies to have nothing to do with doctors.

More here.
CMPI

Center for Medicine in the Public Interest is a nonprofit, non-partisan organization promoting innovative solutions that advance medical progress, reduce health disparities, extend life and make health care more affordable, preventive and patient-centered. CMPI also provides the public, policymakers and the media a reliable source of independent scientific analysis on issues ranging from personalized medicine, food and drug safety, health care reform and comparative effectiveness.

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