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The NAD Takes Another Swipe at Big Pharma -- This Time Bayer Gets Hurt

The National Advertising Division (the marketers' self regulation body) has gotten Bayer to discontinue advertising for Aleve in which Bayer claimed that Aleve was the No. 1 "preferred" medicine for mild arthritis pain among orthopedic surgeons.

Although Bayer did indeed have a survey showing docs preferred Aleve, the survey didn't define "preferred." So the NAD nixed the ads in case consumers believed that the ranking was based on something objective like efficacy. The ruling is a victory for Wyeth (which makes Advil), which brought the challenge.

"In response to NAD’s inquiry, the advertiser [Bayer] advised that it had discontinued the radio advertising at issue," the ruing said. Translation: Pretending that your advertising is already over and done with is the stock response of every corporation caught engaging in slippery advertising by the NAD.

FDA Tells Sanofi to Take a Hike on Acomplia; Champagne Corks Popping at GSK

By now I'm sure you've all seen this news.

So what next? First, Sanofi could mount a lobbying campaign and get the FDA to change its mind in July -- but that's unlikely because if the commissioner went against the advisory panel then it would be a huge scandal and invite intense coverage.

Second, the brand managers on GSK's Alli now have the field all to themselves. You shoulda bought GSK stock yesterday, apparently ....

Why DrugWonks' Campaign to Demonize Michael Moore Will Fail

The pro-industry bloggers at DrugWonks have been on a tear, insulting and denigrating Michael Moore and his movie Sicko at any chance they get. (This isn't surprising as the blog is paid for with drug biz money -- Peter Pitts is employed by pr firm Manning Selvage & Lee, where his clients are drug companies.)

The DrugWonks people seem to believe that if they can just remind us enough times that it is ironic that a clinically obese man has made a film about healthcare, that somehow nobody will watch or believe it.

But here is what DrugWonks just doesn't get: Moore gets one thing right -- it is a nightmare being a patient in the American healthcare system.

Yesterday I mentioned that I was trying to schedule an MRI, and that the pricing structure for MRIs at my local hospital (in Hoboken NJ) worked out so that it was cheaper to pretend to have no insurance than it was to use your insurance.

So this morning I made a few phonecalls -- funny how everything in US healthcare revolves around endless phonecalls -- in an attempt to find out what, exactly, my out-of-pocket costs would be if I got this MRI at a different place (Union City NJ). I've had an MRI there before and was only charged $50 in out-of-pocket costs -- on the same insurance plan.

The Union City company told me that they would charge my insurance company, United Healthcare, $600-700. United has previously told me they would cover 90% of the costs after meeting a $250 deductible. So that would mean I might have to pay $295 for a $700 scan.

Those numbers are far different from the ones I cited yesterday at the facility in Hoboken, where I was offered $580 out-of-pocket on a bill of about $2600, or to pay $450 in cash without insurance.

So, I called United to see if they could tell me -- exactly -- how much the charges would be  at the Union City site, which seems to be cheaper. After giving all my code numbers and reconfirming my date of birth -- twice -- I spoke to two people who both declined to give me a straight answer. One of them pointed to their website, myuhc.com, where there is a cost estimator. The estimator revealed that my out-of-pocket expenses could be $186.

See how insane this is:

Hoboken: $580
"Uninsured": $450
Union City (less than a mile away): $295
United Healthcare's estimate: $186

But the most infuriating thing was that United declined point blank to tell me what the cost would be. I put it to the woman on the phone that as soon as the MRI people sent them the paperwork, then United would know EXACTLY what my costs would be, and that the company was basically lying to me be saying it "didn't know" what my costs would be.

This process took about an hour. I still have no idea what the charges will be. This is why Americans have come to hate US healthcare -- it's time consuming, complicated, contradictory, expensive, and no one can ever give you a straight answer to a straight question.

And until DrugWonks gets that, all the mud they're throwing at Michael Moore will make them look Antoinette-like: a bunch of guys in suits who don't understand why we don't all just eat the cake.

Coupon Site Tests Whether People Will Shop for Drugs the Same Way They Buy Groceries

Internet Drug Coupons just launched the "Pre-release Beta Version 9.0" of its site, which is a sort of trading post for drug coupons. Got migraines and are taking Maxalt? Save $50 here, the site suggests.

The site tests the notion that people on scrips will shop for drug deals the same way they shop  for groceries -- by taking advantage of special offers.

I reckon this site will take off. Here's why:  There's a $250 deductible on my insurance which also only pays 90% of certain costs. Doesn't sound too unreasonable, right? But this means that when you're scheduled for an MRI visit -- as I was recently -- your out of pocket costs can reach $580 on a $2600 bill even though the hospital doing the MRI charges only about $450 for patients who pay cash. In other words, on my insurance it's sometimes cheaper to be "uninsured."

So, naturally, I balked before sticking my head in the magnet and am now currently shopping around the NYC area for an MRI center with more reasonable rates.

I'm guessing I'm not the only one, which is why my gut says this site will be successful.

Cafe Pharma, the Pungent Sewer of the Drug Biz, Gets Its NYT Moment

The scandalous, often-wrong-but-right-enough-to-be-taken-seriously Cafe Pharma was the subject of an NYT profile story yesterday. Don't worry, the paper skirted round the really vulgar stuff.

But it made the overall point: Everyone says they don't read it, but in reality everyone does. Reps for Pfizer and Medtronic are quoted spinning furiously in an attempt to imply they don't read it without actually outright lying about the fact that, obviously, they read it all the time.

And for the four reps in the country who haven't seen this yet, check it out. Hilarious.

Looks Like AZ Was Not the Only Company With a 'Bucket of Money' Problem

Alex Berenson in the NYT published this nice little expose of drug company memos from pre medicare pricing reform. They show that companies behaved pretty much the same as AZ did recently, when it published an internal newsletter comparing cancer docs to buckets of money.

AstraZeneca, Bristol-Myers, Johnson & Johnson and Schering-Plough are defendants in a suit in Massachussetts and the litigation has revealed that they encouraged cancer docs to prescribe their drugs based on price rather than diagnosis.

The story says: "In one PowerPoint presentation from 2000, a Bristol-Myers Squibb executive told employees that oncologists’ biggest concern was 'Reimbursement Today, Reimbursement Tomorrow, Reimbursement!'"

But it was AZ, once again, that put it most bluntly: "Pitching Zoladex, a treatment for prostate cancer, a sales representative for AstraZeneca was more blunt. 'DO THE MATH!' he wrote in a letter to a group of urologists in Arizona."

It's Turning Into a Real Nail-Biter at Sanofi...

Shares drop 1.7% as FDA notes show concerns over Acomplia patients and suicide ... you can read the feds' safety appraisal here. Note that on the higher dose, adverse events were more than double those of the placebo ...

Wednesday Is Judgment Day at the FDA for Sanofi's Acomplia

The FDA is set to give a thumbs up/thumbs down to Acomplia/Zimulti on Wednesday. Expect a media maelstrom on that day.

Should the Sanofites get their long-delayed wish, it will set up a battle royale against GSK's OTC Alli product. GSK is putting a ludicrous amount of money behind Alli.

Acomplia Report is urging caution, noting that the FDA is likely not concerned with efficacy but with the drug's weird side effects (anxiety, depression and nausea).

If the feds go all cautious on us and again ask Sanofi to provide more data before reaching for the big red "Approved!" stamp,  then the Sanofites could have GSK's Avandia flap to blame, it sez here.

Stop the Presses -- Pfizer's Exubera Showing Signs of Life

Scrips for Exubera, the bong-like inhalable insulin brand that Pfizer once touted as a blockbuster but has performed like a big-money-loser, are ticking upwards, reports Andrew Forman, an analyst at WR Hambrecht & Co. (See download below).

Exubera "may break the psychologically meaningful 2,000/week" level, sez Forman.

Exubera is still at a 0.6% share, Forman reckons, but with the fallout from the Avandia business, Forman thinks Exubera literally has nowhere to go but up. He's rating Nektar (Pfizer's bong supplier) a "buy," which is interesting from a PR perspective because it is the first time in weeks that Forman hasn't written something hilariously insulting about the company he used to describe as being run by incompetent "Nektarines."

Forman also mentions in a headline "Latino DTC" but gives no detail or indication on what that might be about. Pfizer has previously said it would kick off long-delayed Exubera DTC in the second half of 2007 ... and in 4 days we're in the second half of 07 ...

Download PHARMIU061107-1.pdf

Looks Like All that Alleged Maraviroc Pre-Marketing Wasn't in Vain

The FDA is set to approve Pfizer's Maraviroc anti-HIV drug, the AFP reports. The drug should do well, assuming Pfizer's non-approved softening up of the market prior to its approval worked as allegedly planned.

Update: Check out the comments section. It features a very thoughtful post from the Maraviroc whistleblower who first gave the dubious documents to Peter Rost.