$20,000 Cure for Psoriasis Doesn't Reach those Who Need it Most

Amgen, Wyeth: Study Shows Enbrel Improves Plaque Psoriasis

January 16, 2008: 05:29 PM EST


DOW JONES NEWSWIRES
Amgen Inc. (AMGN) and Wyeth's (WYE) pharmaceuticals unit said data from a Phase III study showed that children and adolescents with moderate to severe plaque psoriasis who received Enbrel experienced significant improvements in their conditions.

Amgen, a Thousand Oaks, Calif., biotechnology company, said the study's purpose was to assess the safety and efficacy of Enbrel therapy in patients between four and 17 years old, with plaque psoriasis, whose disease had been inadequately controlled with topical therapy.

The most common adverse events observed during the 48-week trial in patients treated with Enbrel were upper respiratory tract infection, headache and nasopharyngitis.

-Adam Edelman; 201-938-5400; AskNewswires@dowjones.com

New Jersey Investigating Amgen’s Marketing of a Psoriasis Drug
By ANDREW POLLACK

New Jersey’s attorney general has begun investigating whether the biotechnology giant Amgen violated patient confidentiality laws in its effort to sell its drug Enbrel.

The investigation was prompted by accusations from two former Amgen sales representatives, who said they had been pressured by their managers to gain access to patient data to find people with psoriasis who might be candidates for treatment with Enbrel.

The attorney general, Anne Milgram, who has been looking into pharmaceutical marketing practices, said in a news release Thursday that the state had issued a subpoena to Amgen for “a comprehensive array of documents and information” related to the sale, marketing and prescribing of Enbrel.

Ms. Milgram said she was also looking into whether Amgen had engaged in off-label marketing. Enbrel is approved for moderate or severe psoriasis, but the two former sales representatives say the company tried to sell it for mild psoriasis as well.

The two former employees are now in arbitration with Amgen, saying they lost their jobs because they did not engage in what they considered illegal practices. One, Elena Ferrante, who was a sales representative in New Jersey, said she was fired in 2005. The other, Marc Engelman, whose territory was Southern California, said he quit last year after getting a poor performance review.

A spokeswoman for Amgen, Mary Klem, said that the accusations were “completely without merit” and that Amgen would cooperate with the investigation. She said Amgen representatives were instructed to “follow compliance guidelines with absolute consistency.”

Federal laws prohibit the sharing of medical information with unnecessary parties, though there are different interpretations of the rules. It is not clear whether there were violations in this case or, if there were, whether they were by Amgen or by the doctors

The accusations come as Amgen is facing declining sales of its popular anemia drugs because of safety questions.

Enbrel, first approved as a treatment for rheumatoid arthritis, is also a big-selling product. But its growth as a treatment for psoriasis has at times been slower than expected, in part because insurers balked at its cost, up to $20,000 a year.

Mr. Engelman said in an interview recently that sales representatives were told to find doctors willing to search through patient records to find patients with psoriasis, or to let the Amgen representatives find candidates in the same way.

The doctors would then be asked to write to the patients suggesting Enbrel, though Amgen employees might do the work and pay for the postage, he said. Mr. Engelman also said Amgen representatives would sometimes call or write to insurance companies, posing as a member of the doctor’s staff, to try to arrange reimbursement.

“You knew these patients’ data when you were calling the insurance company,” he said. “You would know the patient’s name when you are stuffing the envelope.” Mr. Engelman provided a voice mail message that his manager had left for him, as well as a memo urging him to have searches of patient records done at two or more medical practices.

This is a big part of what I think is wrong with healthcare in this country. Having suffered with psoriasis in the past (10/06 to 7/07) a known cure would have been divine! However, it seems this Amgen is not covered by insurance and is too costly to pay for out of pocket. What the fuck is the point in inventing and marketing a drug you know will have positive benefits for millions of people if nobody can afford to buy it?!? :mad:

A lot of people complain about doctors making too much money; but many don't earn as much as you might think, especially the first 5-7 years out of med school. The problem is these damned pharmaceutical companies. :12:

Comments

Enbrel and drugs like it have been miraculous for people who suffer from rheumatoid arthritis, psoriasis, and other rheumatoid diseases.

The other thing this article brings up is off-label prescribing-- which is extremely common and extremely beneficial for many people so they can get access to effective drugs that haven't gone through clinical trials yet.

20K a year is a lot of money, but a lot of people with RA will say it's more than worth it to have their lives back. I do think we need a system in place where pharmaceutical companies can continue to profit from making new drugs (so they will continue to make them) but also where the drugs can be available to people who need them at an affordable price. I don't know how to do that, though.
 
I have lost a barber over my psoriasis.
Posted by invisibleman

I just lost my will to live. :frown1: Mine started as a small patch of dandruff or so I thought. Within 3 months 80% of my scalp had those horrible silvery-white scales. It seems to be in re-mission now! thank GOD! and my hair has come back. :smile: I think spending so much time in the hot Georgia sun last summer really helped.

I've been on Enbrel for a year and it's amazing. It's only 15 bucks a month through my insurance mail order specialty pharmacy. It is over 20k a year without insurance.

Posted 8 by winelover215

Wow! You are lucky! My dermatologist was trying everything (when I still had insurance) but mostly tar based shampoos, which did nothing.

That's not true, I always feared my head smelled like a freshly paved road afterwards, no matter how much I rinsed.

Enbrel and drugs like it have been miraculous for people who suffer from rheumatoid arthritis, psoriasis, and other rheumatoid diseases.

The other thing this article brings up is off-label prescribing-- which is extremely common and extremely beneficial for many people so they can get access to effective drugs that haven't gone through clinical trials yet. True! My mom takes a pill originally marketed for Restless Leg Syndrom that helps with her memory.

20K a year is a lot of money, but a lot of people with RA will say it's more than worth it to have their lives back. I do think we need a system in place where pharmaceutical companies can continue to profit from making new drugs (so they will continue to make them) but also where the drugs can be available to people who need them at an affordable price. I don't know how to do that, though.

Posted by snoozan

At it's worst I would have sold my soul to the devil to be rid of that damned psoriasis! :mad: What kills me is Enbrel never came up. I never even saw a pamphlet for it in her office. I guess it's possible she didn't know about its other use. :confused:

Would it be covered in Canada?
Postedby Think_Kink

I have no idea. I read where Canadian authorities are trying to crack down on us Americans sneaking across the border to buy your drugs.
 
NJ, Enbrel was just released in 2001 or 2002-- my best friend was on a waiting list for it for many months when it was originally just being used for rheumatoid arthritis. It was hard to get for a long time because it was one of the first of a class of drugs that has been one of the only treatments for RA that actually works. It's just starting to be used for psoriasis as far as I know, and many docs may not know much about it or even prescribe it for various reasons (i.e. severity). It's also not available as a pill-- you have to give yourself an injection twice a week which is enough to scare off a lot of patients. Who knows. I'm just glad it's here-- my father had severe RA and my best friend has it, and watching them suffer was awful.
 
As weird as this may sound, but if you fast for 3 days eating just apples & drinking water...all of your psoriasis will go away. I know, I did it. (Not easy though)

The problem is figuring out what causes it by process of elimination. However, having do so, I learned (so far) that oregano, thyme, coffee with cream (not black) and peanuts with chocolate are triggers for my psoriasis.

Its an uphill battle that really sucks!
 
I have psoriasis, but fortunately it's restricted to the palms of my hands and the soles of my feet, and it seems that after reducing work-related stress in my life, it's cleared up to a great extant where I only have small patches of it at any great time, whereas it used to cover nearly the whole palm of my hand, making a significant source of discomfort and increasing risk of infection.

I knew about Enbrel and asked my doctor about it a couple of years ago, and was told pretty clearly that my student insurance wouldn't cover it, and that my case wasn't "severe" enough to warrant using it.

I was pretty annoyed that I could be walking around with a treatable condition, but that the biotech company that created the drug was for some mind-boggling reason not willing to make it affordable.

However, this is unfortunately not a new thing. Drug companies pour millions and millions of dollars into developing these things, and they basically rob people with a disease for years until the drug's patent allows it to be made by generics. I actually took a course about it and was pretty sad to learn about how these companies wouldn't even exist to develop drugs if it weren't for those years where they charge a ridiculous amount for their products.
 
The whole health system sucks. I have multiple friends with various illnesses who can't afford doctors, treatments, and drugs that would eliminate or alleviate their conditions, but can't afford it. I have other friends who shell out tons of money a month for medication and/or rely on their physicians to give them samples. I don't know what the answer is-- the pharma companies put a lot of money in R&D and expect to get it back and turn a substantial profit. I'm not sure if making drug companies cut prices would hurt R&D instead the gratuitous shit they could cut out like pens and sales dinners. It's a fucking mess, the whole thing.
 

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