This is an interesting point, and one that impinges on "EBM"
I was recently at a rep's presentation of pravastatin and how the LIPID
trial showed conclusively that it prevented coronary *events* and thus
should be prescribed on EBM basis.
Cynically I wondered why they used 40mg pravastatin. 'Well, setting up the
trial was so expensive,we wanted to make sure we used a dose that was
certain to show an effect.' was the reply.
Well, that's as maybe. Funny they didn't include 20 mg in the trial, which
after all was their 'standard' dose.
So now, to practice EBM, we have to use twice as much at much greater cost.
For all we know, 20mg may be just as effective.
Is there not a case for the MCA or someone to say that all doses should be
equally priced, as drug comps are always telling us how exorbitant prices
are to reflect 20 yrs research etc.This means that the unit cost per mg. is
uninmportant anyway.
Just a thought.
Graham Balin, (Essex Man)
----------
> From: Ruth Livingstone <[log in to unmask]>
> To: [log in to unmask]
> Subject: RE: Shotgun marriage
> Date: 09 March 1998 08:23
>
>
>
> However, there is a fallacy to my arguement, which has nothing to do with
> averages.
>
> My understanding of the system is this:-
> Drug companies set the prices of their products, and these prices are
agreed
> in advance with some government body somewhere. Expensive drugs are
priced
> expensively to cover R&D, and to allow for profit on top. If a drug is
used
> widely, prices should eventually fall. If the drug flops, the company is
> allowed to INCREASE PRICES OF THEIR OTHER PRODUCTS to make up for the
> investment/profit loss.
> This price fixing is a secretive business. I read about it in an article
a few
> years ago, and was angry to think that the responsibility for high
prescribing
> costs for the country as a whole was being laid at the door of the
> prescribers, when, in fact, prices were being decided centrally, by some
> committee.
>
> Perhaps someone on the list knows more about this than I do? Am I wrong,
am I
> right, does this price fixing happen, or not?
>
> --
> Ruth
> http://www.stamford.co.uk/littlesurgery
>
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