The Triumph of Marketing Over Science

The Washington Post reports that the newest generation of atypical anti-psychotic drugs is no better than older drugs, which have been around since the 1950s and had moderate success in treating schizophrenia. This isn't exactly news. The Lancet reported the same thing back in 2003.

So will this scientific insight be bad news for Johnson & Johnson, whose blockbuster anti-schizophrenia drug Risperdal racked up $3.6 billion in sales last year, making the biggest selling anti-psychotic on the market?

Not likely. Last week, the Wall Street Journal reported that the company is on the cusp of receiving Food and Drug Administration approval to market a new drug for this troubling condition. Is it a major breakthrough? I’m sure psychiatrists will be told it is by the small army of detailers that will be visiting their offices in the coming months. But don’t believe a word of the hype. As Scott Hensley reported last Friday (subscription required, or I'd give you the link), paliperidone is nothing more than the metabolite of Risperdal. What used to be done in the patient’s stomach will now be done in the company’s lab.

And for this, they will get an additional five years to market this line of antipsychotics, which are no better than generics that have been around for two generations.

We’ve seen all this before. Sometimes the companies subtract out the inactive portion of an older molecule (AstraZeneca did that and came up with Nexium to replace Prilosec). Sometimes the companies add a chemical tail to the drug to make it stay in the body longer (Amgen did that and came up with Aranesp to replace Epogen).

Then they make great claims that the new drug is somehow better. But it rarely is. J&J didn’t even try to make that point. It’s clinical trial for paliperidone tested it in 1,600 patients against a placebo – not Risperdal, the drug it was meant to replace. The one physician Hensley found who defended the “new” drug was, no surprise here, a paid consultant to J&J.

Still, stock analysts are predicting sales of $2.5 billion annually for paliperidone by 2010. That would be $2.5 billion for a drug that works no better than generics available for a tenth the cost (if they work at all, and there's plenty of people out there who argue they don't and have side effects that far outweigh the alleged benefits).

Is it any wonder that we have the highest health care costs in the world?

Posted by gooznews at October 3, 2006 05:02 PM