Comments from Richard van den Broek, biotechnology analyst with Hambrecht & Quist:
''There is a lot of nervousness, people are nervous that we are going to have a return to the debate of 1992-1994, which lasted a lot longer and was a lot worse than anyone expected,'' he said.
A Medicare drug benefit could end up providing full coverage for only one or two drugs particular class, and leave patients to pay higher co-payments or full price for other options, van den Broek said. ''People will have to pay out of pocket more.''
That means even drugs like Warner-Lambert Co.'s powerful Lipitor cholesterol could see increasing competition from similar drugs which may be less potent, but which also cost less, he said. Drug discovery efforts may become even more important because companies with first-of-a-kind drugs will still be able to set their own price.
''From the biotechnology perspective, the premium on novel proprietary drugs has gone up again,'' he said.
''If you have a survival benefit or an (overall healthcare) cost savings, when you have that you can name your price,'' he said.
Drugs such as Immunex Corp.'s Enbrel for rheumatoid arthritis and Genentech Inc.'s Herceptin breast cancer drug have that type of pricing advantage because there aren't yet any other comparable treatments, van den Broek said, whereas Lipitor, while the ''best in its class, is in a class with seven or eight competitors.''
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