April 19, 2007

Temporary Reprieve

Amgen reported this afternoon that a closely watched trial of its anti-anemia drug Aranesp in lung cancer patients had no impact on overall mortality. Relieved stockholders bid up shares in heavy trading. The last trial of Aranesp in cancer patients speeded up patients' demise.

It's important to remember that cancer patients who use Aranesp and J&J's Procrit

are not looking for any survival benefit from the drugs. Doctors inject it to relieve the symptoms of other chemotherapy drugs, which include suppression of red blood cell production and its attendant run down feeling.

However, the entire strategy was called into question when a study in head-and-neck cancer patients was released a few months ago by European researchers, not Amgen, a coverup whose unveiling by the Cancer Letter sent Amgen's stock plunging. That study showed that the anti-anemia drugs reduced survival times. Scientists who've argued all along that stimulating red blood cell production may actually feed the cancer had their moment in the sun.

If I were an Amgen stockholder (full disclosure: I most assuredly am not; I make it a point not to invest in any drug or health care-related stocks to avoid any conflicts of interest in my writing), I would not jump to any conclusions about this latest study. The Food and Drug Administration's May 10 meeting of the Oncology Drugs Advisory Committee to discuss anti-anemia drug use in chemotherapy is shaping up to be quite a doozy.

Posted by gooznews at April 19, 2007 09:41 PM
Comments

My sense is that the controversy over the safety of EPO relative to various target hemoglobins is distracting from the issue of its cost including how EPO got to be so costly and why it remains so costly. The numbers of adverse events are small in studies such as the Aranesp lung cancer study and hard to correlate to EPO use. Consequently, different studies will continue to give different results regarding EPO's relative safety. Despite studies correlating EPO's potential hazards for some patients other studies will continue to show its relative safety. The net effect will be to allow Amgen and J&J to continue to sell alot of EPO and continue to raise the price for it.
I think the questions about EPO should be posed differently. Something like,
How has Amgen and J&J shaped medical practice and clinical research in the treatment of anemia. How has Amgen and J&J shaped health care policy including payor policy and the maintenance of indefinite patents costing the health care system an unprecedented penalty. Is it okay for example that J&J for example pays prominent Key Opinion Leaders in HIV Medicine to issue and promote expert and pruportedly "evidenced based " guidelines for the treatment of anemia in HIV infected patients?

Posted by: Dr. Paul Bellman at April 24, 2007 10:16 AM

The issue of how Amgen and J&J have set the standards for medical practice also extends to the treatment of anemia in dialysis patients, a huge market for epoietin drugs.

Posted by: Shannon Brownlee at April 24, 2007 10:36 AM