arznei-telegramm 2004; 35: 135 | ||||||||||||||||
CREATING FEAR AND ANXIETIES: PFIZER'S MARKETING CAMPAIGN FOR SORTIS
"Savings will be performed from January. On account of the health of millions of cardiovascular patients. From 1st January 1.5 million patients in the statutory sickness funds will no longer be fully reimbursed ... SORTIS lowers cholesterol levels the most, reduces the risk fastest and is also well tolerated even at the highest dose" (1). With such headlines, Pfizer stokes fears in the consumer. The competent Regional administrative Council in Karlsruhe has now filed a court injunction against the company, as the advertisements in the daily newspapers contravene the medicine advertising act. Prescription medicines must not be advertised in the lay press, particularly not with formulations that can produce anxiety in the consumer (2). However, Pfizer continues to contravene the medicine advertising act with the most recent advertisement series "Can publicly insured patients really do without SORTIS?" (3). With its campaign, the company is reacting to the decision of the Joint Federal Committee to include atorvastatin together with the other HMG-CoA inhibitors available on the market, simvastatin (ZOCOR etc.), pravastatin (PRAVASIN etc.), fluvastatin (CRANOC etc.) and lovastatin (MEVINACOR etc.) in a common reference price group ("jumbo group") and thus reduce the cost of these high-priced medicines. Pfizer does not want to reduce the costs for atorvastatin (annual sales worldwide 8 thousand million €) to the fixed amount, and - especially - does not want to jeopardise the internationally established price level for SORTIS through unilateral price reductions in Germany. The consequence for the patients are substantial surplus charges, which will be liable from 2005 (e.g. 48.51 € for 100 SORTIS 40 mg tablets). The suppliers of the simvastatin and pravastatin originals must also reduce the prices in order to avoid patient payment contributions. For atorvastatin there are still no cheap generics (patent expiring not before 2011). Pfizer obtains willing back-up support from the "Ärzte Zeitung", in which there is a polemic against the decision of the Joint Federal Committee (G-BA) and a statement of the Institute for Quality and Economy in Healthcare (IQWiG) (4). However, extolling atorvastatin as the "best cholesterol-lowering agent" proves to be wishful thinking by the manufacturer when the data are analyzed carefully:
That atorvastatin produces less severe side effects cannot be stated for usual dosages: the evaluation of statin-induced myopathy from the American FDA's ADR reporting system too for the time period 1990 to 2002 indicates a similar incidence of rhabdomyolsis for all statins on the market taking into account the prescription figures (19). A recent analysis of the data from eleven regional American healthcare providers shows a similar incidence for atorvastatin, simvastatin and pravastatin (20).
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(R = randomised study) | ||
1 | Pfizer GmbH: advertisement for SORTIS, Süddt. Ztg. of 10th Nov. 2004 | |
2 | Karlsruhe Regional Council: press release of 26th Nov. 2004 | |
3 | Pfizer GmbH: advertisement for SORTIS, Süddt. Ztg. of 26th Nov. 2004 | |
4 | Ärzte Ztg. of 1st Dec. 2004 | |
R | 5 | KOREN, M.J., HUNNINGHAKE, D.B.: J. Am. Coll. Cardiol. 2004; 44: 1772-9 |
R | 6 | ATHYROS, V.G. et al.: Curr. Med. Res. Opin. 2002; 18: 220-8 |
R | 7 | Scandinavian Simvastatin Survival Study Group: Lancet 1994; 344: 1383-9 |
R | 8 | Heart Protection Study Collaborative Group: Lancet 2002; 360: 7-22 |
R | 9 | SACKS, F.M. et al.: N. Engl. J. Med. 1996; 335: 1001-9 |
R | 10 | The Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Group: N. Engl. J. Med. 1998; 339: 1349-57 |
R | 11 | SEVER, P.S. et al.: Lancet 2003; 361: 1149-58 |
R | 12 | SHEPHERD, J. et al.: N. Engl. J. Med. 1995; 333: 1301-7 |
R | 13 | DOWNS, J.R. et al.: JAMA 1998; 279: 1615-22 |
R | 14 | COLHOUN, H.M. et al.: Lancet 2004; 364: 685-96 |
R | 15 | COLLINS, R. et al.: Lancet 2003; 361: 2005-16 |
16 | Pfizer: Fachinformation SORTIS, Stand Jan. 2003 | |
R | 17 | SCHWARTZ, G.G. et al.: JAMA 2001; 285: 1711-8 |
R | 18 | CANNON, C.P. et al.: N. Engl. J. Med. 2004; 350: 1495-504 |
19 | THOMPSON, P.D. et al.: JAMA 2003; 289: 1681-90 | |
20 | GRAHAM, D.J. et al.: JAMA 2004; 292: 2585-90 |
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| 4-S = Scandinavian Simvastatin Survival Study; |
© arznei-telegramm 12/04 |