BTW, if someone wonders about my argument that Plavix does not reduce hospitalizations, that is my understanding of current research: no change in hard endpoints including MIs, strokes, and cardiac death. Same is true for DES in general.

Future research, with finer grained distinctions among pt. groups, may show more promising outcomes.

The makers of Plavix never saw the popularity of the drug coming. The advent of drug eluting cardiac stents requiring Plavix therapy for extended periods made the market for Plavix. Virtually none of the company research was done in that setting, the stars aligned perfectly for the drug.

It was hailed in the marketing industry as the best marketed pharma product for 2008. For what? The marketing team had no real impact on usage. The DTC ad campaigns were never needed.

So you have a captive patient population with no competition for 10 years - what do the companies do? Raise the hell out of the price, always in the name of R&D costs.

My only hope is that the general public is beginning to see the bogus arguments made by pharma on pricing.

Even the PhRMA guy quoted only had to say that the drugs kept people out of the more expensive hospital (for which, btw, there is no evidence whatsoever as far as Plavix is concerned).

I’ve saved people’s lives directly in my work. Do I now deserve their first-born child?

You’ll love this article:

http://www.pressdemocrat.com/article/20091125/OPINION/911249889?Title=PD-EDITORIAL-Big-Pharma-offers-savings-but-only-after-increasing-prices

I don’t think you understand the Medicaid rebate law for oral products. If a product is priced at $1.00 in the year it is launched, Medicaid automatically gets the product for a net cost of ~$0.85. If the price is increased to $2.00 in year two, while CPI is say 4%. For a Medicaid program, the net cost has only increased to ~$0.89. The pharma company is essentially paying a rebate of $1.11. This is the LAW. The overall change in AWP doesn’t matter; the only increase that is important to Medicaid is up to to level of CPI.

Atlex

You are incorrect about discounts to the VA and DoD, as well as Medicaid; they are quite significant. By law, the baseline discount/rebate on all brand drugs to Medicaid programs is a minimum of 15.1%. If the brand manufacturer gives any private payer a discount in excess of 15.1%, Medicaid must also receive this “best price.” In addition to this, any price increase above CPI must be returned to the state in the form of a rebate. The VA also has federally mandated rebates, but its rebate starts at 24% and has CPI adjustments, as well.

Thus, if a large percentage of Plavix’s price is based on excessive price increases, there is little doubt that Sanofi/BMS are paying substantial rebates to the states.

Atlex

The hospital was charged $300 per _pill_. (Why I wasn’t just given 8 x 75 mg. is anyone’s guess.)

In my own case, private insurance paid it. But I assume DOD/VA, et. al. are paying the same.

Since Plavix was approved in the U.S. almost 11 years ago, it has had NO competition, until the last 4 months from Effient (Lilly).

Bristol-Myers and Sanofi have raised the price of this necessary medication (for cardiac stent patients) unmercilessly for over 10 years.

WE taxpayers pay for over 40% of all Plavix in the U.S. via Medicare/Medicaid/ VA/ DOD - why should WE pay these exorbinant prices when WE taxpayers provide 40% of their business?

Discounts on Plavix to VA & DOD are miniscule.

James Cornelius, the BMS CEO, had total compensation of $25 million dollars for 2008.

There is the stench of greed in the air, coming from New York and France.

I remember how difficult it was to understand Plavix when I first started investigating the problems with it about 3 years ago.

Every time I see a commercial for that drug I get ticked off to the max.