[LLY MRK] Doctors See New Osteoporosis Drugs as Benefit to Treatment
Bloomberg News
September 16, 1998, 1:16 p.m. ET
Doctors See New Osteoporosis Drugs as Benefit to Treatment
Berlin, Sept. 16 (Bloomberg) -- Doctors returned home from
Europe's biggest gathering of osteoporosis experts this week with
new evidence that drugs from Eli Lilly & Co., Merck & Co. and
others can help patients, while even newer treatments are moving
through development.
The U.S. drugmakers presented new data at the European
Congress of Osteoporosis in Berlin that showed their drugs can
cut the risk of dangerous bone fractures by about half, sending
their stock prices higher.
Doctors said there is a strong need for new drugs to treat
the bone-thinning disease that can cause debilitating fractures
and deformities in an estimated 200 million women worldwide.
While they hailed progress made in finding new drugs, in the
worldwide $2.8 billion market, some say even better drugs with
fewer side-effects are needed to help post-menopausal women avoid
landing in hospital.
''These drugs are important, but we want more efficacious
drugs and safer ones,'' said Ego Seeman, a doctor with the Austin
& Repatriation Medical Center in Heidelberg, Australia, who
presented a study on Merck's Fosamax, the best-selling drug in
one class of osteoporosis drugs called bisphosphonates.
''We want drugs that have an effectiveness of 80 percent or
90 percent, not 50 percent,'' said Seeman.
Until recently, osteoporosis was widely viewed as part of
the natural process of aging. While its origins are still
unclear, researchers now say it appears osteoporosis is caused
when the natural balance of bone-building cells and bone-
destroying cells is thrown off, and it's not an inevitable
process.
New Drugs
New drugs like bisphosphonates made by Merck, the world's
biggest drugmaker, Procter & Gamble Co. and Hoechst AG appear to
''turn off'' the bone-destroying cells, slowing the depletion
process. So far, no drug has been proven to activate the bone-
building cells, however.
Even with the new drugs, there is still much debate about
when to treat and which drugs to use, or which drugs can be used
in combination. Doctors agreed that detection of osteoporosis had
made giant strides, however, and urged health authorities to
adopt regular screening for osteoporosis.
''There are far too many patients that are not diagnosed and
far too many that are diagnosed but not treated,'' said Pierre D.
Delmas, president of the International Osteoporosis Foundation,
one sponsor of the Berlin conference.
Even though the cost of treating hip fractures alone is
estimated to be $16 billion a year in Europe, Delmas said
national health agencies have largely failed to adopt widespread
screening for osteoporosis.
''The cost of diagnosis is extremely low compared to the
cost of treatment,'' said Delmas.
At dozens of symposia at the European Congress of
Osteoporosis, questions were raised about the cost of a new crop
of medicines drug companies are bringing to market and whether
insurance companies, governments and other so-called payers will
underwrite what will probably be long-term therapy to treat the
bone-thinning disease.
Bone Deterioration
New drugs, including Lilly's Evista, Merck's Fosamax and
Novartis AG's Miacalcic, all were shown to cut the rate of bone
deterioration from osteoporosis with fewer side-effects than
older drugs on the market. However, the new drugs can cost twice
as much as older generic drugs, raising a new debate over cost
versus benefits at a time of ever-tightening purse strings by
those who pay for medicines.
''It's a huge issue for Blue Cross,'' said Steven R.
Cummings, assistant dean at the University of California, San
Francisco, referring to the Blue Cross and Blue Shield
Association, one of the biggest health insurers in the U.S.
Cummings, who has tested a number of new women's health
drugs, said Fosamax and Evista both cost about $600 a year for
daily treatment as required. The current standard treatment for
osteoporosis -- hormone replacement therapy -- costs about $300 a
year.
Multiplying that by several million post-menopausal patients
translates into a major new cost for health insurers when many
are facing unprecedented competitive pressures, said Cummings.
Doctors said that while hormone therapy will probably
continue to be the main treatment for post-menopausal symptoms,
they anticipate rising demand for Evista and Fosamax, as well as
a crop of newer drugs that are in late-stage clinical trials.
Only recently have insurance companies and health maintenance
organizations begun to recognize that new medicines can save
heavy costs down the road, they say.
''It's only now that people have started to put together
health economics strategies for these treatments,'' said John A.
Kanis, a professor of medicine at the University of Nottingham,
England, and a board member of the International Osteoporosis
Foundation.
Most troubling, said Kanis, is that the new drugs ''will
have to compete against other long-term therapies,'' such as
medicines for the heart, kidney or respiratory systems taken
daily by millions of people.
The key message for health care providers, he said, is that
''they can save money with early detection and early
intervention.''
--Dane Hamilton in the London newsroom (44-171) 330-7727/ph |
