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Pharmaceutical industry dismayed at final TGP list
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AUSTRALIAN PHARMACEUTICAL MANUFACTURERS ASSOClAnON INC. APMA
REPRESENTING MANUFACTlJRERS OF PRESCRIPTlON MEDICINES AAe,., 02:1 580 663
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Pharmaceutical industry ~ dismayed at final TGP list Australia's pharmaceutical industry is bewildered at the logic behind the make-up of five life-saving groups of medicines wh ich are being stripped of part of their Pharmaceutical Benefits Scheme subsidy.
This follows today's announcement by Parliamentary Secretary to the Health Minister, Ms Trish Worth, of the final list of medicines to be affected by Therapeutic Group Premiums.
"While we are pleased the Government has excluded a number of drugs because of the clinical problems highlighted by the industry since May, we are dismayed at the lack of consultation over these groups of drugs.
"We have been denied any information on how drugs are being assessed , and were faxed just a brief outline of the tinallist last night -only hours before being released to the media," APMA CEO Mr Pat Clear said.
"Government has ignored the evidence shown in the international reference pricing study we provided them in August, which highlighted the potentially severe medical consequences of unilaterally swapping products which are not interchangeable. (the list of products follows)
"Many of these products are life saving. The premiums will affect around one and a half million people, and from our estimates, thousands of patients -not just the rare case -will be unable to use the lowest-priced product and require exemptions from the premium.
"In Canada , where a similar scheme of reference pricing exists, the Government has had to exempt a number of patient groups, including all frail. elderly patients who would experience confusion from a switch in therapy; and all patients taking other drugs which may interact with the benchmark product.
"APMA also believes patients who have been stabilised and have compliance problems should be exempted . The cost of visiting doctors to trial and swap medication, and the cost of possible hospitalisation from medical misadventure, will be far higher than the pharmaceutical savings.
"TGPs contradict the Government's owi,-policies. The Coalition has identitied heart disease as one of its leading health priorities, yet has targeted the three leading classes of heart disease drugs -ACE inhibitors, calcium channel blockers, and H2 antagonists.
BmER HEALTH THROUGH BEITER MEDICINES
LEVEL 2 77 BERRY STREET NORTH SYDNEY NSW 2060 " TELEPHONE: (02) 9922 2699 " FAX: (02) 9959 4860
UThis is despite the Australian Institute of Health and Welfare reporting in August that heart disease is Australia's biggest killer, accounting for 43 per cent of all deaths. Figures show the rates of chronic heart failure jumping 400 per cent in Australia in the past four decadesâ‘, and according to leading UK heart researcher
Professor Philip Poole-Wilson, optimal medicines lower the chance of death by 20 per cent
"The impact on industry also seems to be ignored -several projects worth billions of dollars still hang in balance pending the Government releasing its prices for the products within the five groups.
"We question the advice the Government is receiving from the bureaucracy, and urge it to establish an open and transparent process to progress this policy," Mr Clear said.
10 October 1997
CONTACT: Mr Pat Clear (0411) 170 651
APMA Chief Executive Officer (02) 9922 2699
Virginia Nicholls Public Affairs Manager (0411) 194648 (02) 9922 2699
The Government intends to save $550 million over four years through the introduction of Therapeutic Group Premiums . The proposal targets 110 drug products in five leading therapeutic categories -ACE inhibitors and calcium channel blockers (for cardiovascular disease), statins (cholesterol reducing medication). H2 antagonists (ulcer treatment) and SSRls (antidepressants) .
These groups make up one third of Pharmaceutical Benefits Scheme expenditure ($2.2 billion total). Other categories are also under consideration. Under the TGP plan. the Government will only subsidise the cost equivalent to the lowest-priced drug in each category. This means patients will be required to pay any difference for the medicine of choice -which could mean up to $8 extra based on present prices.
â‘Source: Circulation journal, June edition. Author. Sydney cardiologist Professor David Kelly
AUSTRALIAN PHARMACEUTICAL MANUFACTURERS ASSOCIATION INC.
RfPRfSEN11NG MANUFAcnJRERS OF PRESCRJP110N MEDICINES
APMA ARBN 0'.' 580 683
Interaction with other medicines
There are significant differences between all the drugs in the five groups, such as in their potency, how they are absorbed by the body, how they are metabolised, how and where they act and how they may be safely excreted by the body.
There are also differences in how the drugs may interact with other drugs.
Potentially severe medical consequences in changing medication
Patients who are stabilised on the following therapeutic group medicines should be particularly careful in switching:
" patients with angina taking a calcium channel blocker and stabilised on their current medication " patients with hypertension taking calcium channel blockers or ACE inhibitors and stabilised on their current medication
Patients on more than one medication may have significant medical interactions if they switch produds within some therapeutic groups:
" patients on warfarin ag Coumadin or Marevan (those at risk of blood clots) " patients with epilepsy and taking phenytoin eg Dilantin or carbamazepine eg Tegretol or Tenl " patients with asthma and taking theophylline eg Nuelin or Thee-Dur or Austyn " patients on cyc1osporin (Neoral) eg those who have had organ transplants, are
being treated for rheumatoid arthritis or for severe psoriasis " patients with diabetes and who are taking metformin eg Glucophage or Diabex or Diaformin
Concerning medical consequences
Patient~ on more than one medication may have medical consequences if they
switch products within some therapeutic groups:
" patients with depression and who are taking imipramine eg T ofranil or Melipramine " patients taking medication for sleeping problems such as benzodiazepines (Valium) " elderly patients, especially those with1
changing within any of the therapeutic groups " patients with hypertension and on betablockers such as propranolol eg Inderal or Deralin or metoprolol eg Minax or Betaloc or Lopresor or on calcium channel blockers
BETTER HEALTH THROUGH BmER MEDICINES
LEVEL 2 77 BERRY STREET NORTH SYDNEY NSW 2060 " TELEPHONE: (02) 9922 2699 " FAX: (02) 9959 4860
