JEDDAH, 28 June — A French economist, internationally known for his studies in evidence based medicine and drug economic evaluation, has outlined why medicines tend to be generally expensive and how they could become more affordable. "Medicines for cancer and HIV/AIDS are expensive because there is as yet no cure for them, and research to find effective drugs is still in progress, which costs money. Pharmaceutical companies are known to invest 15 percent of their turnover in R&D, with most of the research devoted to finding remedy or relief for incurable diseases," Dr. Francis Fagnani, Paris-based research director at the French National Institute of Health and Medical Research (INSERM), said in an interview with Arab News.
Emphasizing that innovative drugs tended to be expensive, Fagnani said: "Pricing of medicine is based on two factors — severity of disease and absence of therapeutic strategy. If you are the first to cure or provide relief for an incurable disease then society finds it valuable and is willing to pay for that. If you are a manufacturer of generic drugs then they tend to remain competitive. In fact, there is tremendous competition in the pharmaceutical industry to produce generic drugs. The general public is not aware that prices of medicines are related to their manufacturing," said Dr. Fagnani who is also an expert at the transparency commission of the French Drug Agency focused on the importance of economical evidence within the concept of evidence based medicine.
"While the idea and commitment remain to make medicines as affordable as possible, the responsibility lies largely on doctors in prescribing medicines that are economical," Fagnani said, adding that he had been conducting studies on evaluation of drugs and medical programs. "When we evaluate drugs, we also evaluate the way it’s used by doctors."
Fagnani, also a member of the board of the French College of Health Economics and director of CEMKA consulting group in health economics, epidemiology and outcomes research, was here to give a presentation to the medical fraternity on "Economics of pharmaceuticals in health care systems: A review of stakes, methods of evaluation and criteria for policy decision making." Dr. Saad Saleh Al-Shohaib, associate professor of medicine and nephrology and consultant nephrologist, at King Abdul Aziz University Hospital and also consultant nephrologist at Dr. Erfan & Bagedo Hospital, chaired the lecture organized by Merck Sharp & Dohme Saudi Arabia (MSD SA) at Le Jeddah Meridien on Monday.
Fagnani stressed drug evaluation was a sequential process seeking evidence not only in terms of efficacy and effectiveness, but also in terms of efficiency, which related to the economical aspects. "Efficacy and effectiveness indeed represent drug ability to achieve the planned therapeutic effect when used respectively in the best possible conditions and routine medical practice. Conversely, efficiency relates to drug ability to produce a net benefit in routine medical practice at a cost that is judged acceptable," he added.
He presented the role, methods and interest to also seek evidence from pharmaco-economic studies to better compare costs and outcomes in an effort to maximize benefits with selected drugs. "Drug economical evaluation is particularly helpful to make rational decision-making in critical situations that are often encountered with high priced innovative medicines at the level of the committees for pricing, registration or formulary inclusion," Fagnani said. He stressed that crude comparison of drug prices was insufficient to take decision, and that seeking evidence of other related costs and outcomes is particularly helpful to optimize payer’s value for money."
Wail S. Al-Qasim, pharmacist and scientific office manager, MSD SA, said the availability of latest innovative drugs and treatments helped patients to live a better life and let the government decision-makers, physicians, pharmacists and patients rationalize on treatment costs.
Rohinton Kapadia, managing director, MSD SA, said new therapies in registration for arthritis and vaccines were in progress, while existing therapies in treating diseases like hypertension, heart failure, hypercholesterolemia, osteoporosis, asthma, migraine, HIV/AIDS, glaucoma and bacterial infections continued.