ProPublica, an independent non-profit organization, recently published a public report on drugs promotional expenditures, with Xarelto being the top most expensive. The total spending for the infamous blood thinner topped all other medications in the United States in 2015, with a total $28.3 million spent to pay doctors expensive trips, speaking engagements, consulting fees and royalties.
Data from the Dollars for Docs report indicates that the pharmaceutical companies spent at leas $2 billion to invest in the promotional material used to convince over 618,000 health care providers to sell their brand-name medications. Rather than investing in marketing the most necessary medicines which could be used the most life-threatening conditions, each one of the Big Pharma seems to prefer fighting a never-ending war to place its own product against cheaper generic competitors. Most aggressive advertisement strategies aim at gaining bigger profits as well as conquer larger shares of the market. As other clinical studies published in many highly reputed journals already proved, doctors who prescribed more brand-name drugs received higher payment from the manufacturers, who spent more than $600 million in hospital and clinic teaching courses and information. More than often pharmaceutical companies keep working with physicians who received disciplinary sanctions because of their past wrongdoings.
ProPublica researchers obtained their results by combining payment data between August 2013 and December 2015, with data coming from the Medicare and Medicaid programs, finding that the leader in their rankings was Xarelto. The Novel Oral Anticoagulant (NOAC) is one of the most controversial medications in the last decade. Since it received clearance from the U.S. Food and Drug Administration (FDA) in 2011, Bayer and Janssen aggressively advertised it as a “safer and more efficient” alternative to the well-established Warfarin. Although the new blood thinner did not require any dietary restriction or continuous monitoring, the absence of a proper antidote to reverse its effects prevents doctors from saving a patient’s life if a bleeding accident occurs. At least 13,000 patients filed a Xarelto lawsuit seeking compensation for all the damage and injury sustained, and most of them have been centralized in a Multidistrict Litigation in the Eastern District of Louisiana.
Closely following up Xarelto’s trails, the rheumatoid arthritis medicine Humira saw a total of $24.9 million spent in promotional material. The third one is instead the popular (and controversial) diabetes drug Invokana, with $20.9 million in payments. Other NOACs such as Eliquis (apixaban) are also included the in the list, reaching the fifth place with a $18.8 million expenditure.
Article by Dr. Claudio Butticè, Pharm.D.
