Press review

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Spotlight on side effects of Sanofi's top-selling painkiller Nolotil in Spain

Country : Belgium, France, U.S., Portugal

Keywords :
MADRID, 29 Mar (APM) - Daily ABC on Tuesday carried a story about the side effects Sanofi’s painkiller Nolotil (metamizole magnesium), the best-selling drug in Spain.
The newspaper said that severe reactions to Nolotil can be fatal, but are quite rare. It is authorised for the treatment of acute pain and can also be used in antipyretic-resistant fever.
The drug "that some people take as if it were water” must be prescribed by a physician and is by no means free of side effects, the newspaper reported.
According to data provided by the Spanish ministry of health, the use of Nolotil in the country has doubled over the past decade, with steepest increases in 2013 and 2017, when 14.6 million and 22.8 million packages of Nolotil were sold, respectively.
Among its side effects, metamizole has been associated with agranulocytosis, also known as neutropenia, which can kill the patient. The cause of this rare side effect is unknown. Experts think it is linked the immune response, ABC reported.
The newspaper included in the story the names of other metamizole-containing drugs sold in Spain.
After Nolotil was linked to the death of 10 British people, Spanish regulator AEMPS warned that the drug can only be administered for a short period, a maximum of seven days. If a longer course is needed, the physician must request blood analysis to evaluate the patient’s white cell count and be alert for symptoms of agranulocytosis. Caution is recommended in elderly patients.
Metamizole-containing drugs must not be prescribed to patients who cannot return to the doctor for follow-ups, the regulator warned.

Compliance vs. sales paradox

On Monday, financial Cinco Días carried an editorial by José Francisco Zamarriego, head of deontology of Spanish branded pharma lobby Farmaindustria, about the difficulties of implementing compliance rules and, at the same time, trying to boost sales.
Zamarriego wrote about a "close friend", a senior pharma executive, who expressed his concerns about the challenge of increasing sales and being respectful of compliance rules.
Currently, sales representatives who do not achieve a certain sales threshold are most likely fired. Bluntly speaking, there is a 100% chance of losing their job if this happens, Zamarriego said.
Most employees rather take their chances and risk being caught breaking compliance rules, because that risk is always lower than that of failing to sell the expected quantities, he added.
The first step to solve this paradox would be changing the current "punitive" compliance model to a one focused on preventing misconduct, he added.

Financial newspaper carries second HIV PrEP story in two weeks

On Tuesday, financial Cinco Días carried an interview with Peter Hunt, HIV researcher at the University of California, San Francisco, who argued that the most efficient strategy to fight AIDS is a combination of early diagnose and prevention with pre-exposure prophylaxis (PrEP) treatment in at-risk populations.
The treatment, approved in the U.S. in 2012, is available in Portugal, France and Belgium, but not in Spain, Cinco Días reported.
Last week, the financial carried a story with similar arguments by a number of experts in the field. In that story, references to Gilead’s Truvada (emtricitabine+tenofovir disoproxil fumarate) were included. (APMHE 62363)

Health minister justifies decision to block price rise of J&J's antidiarrheal drug

Asked about the ministry's decision to block a price rise of J&J's antidiarrheal drug Fortasec (loperamide hydrochloride), Spanish health minister María Luisa Carcedo said that prices of some medicines excluded from public funding are excessively high, medical journal Diario Médico reported on Saturday.
This kind of unjustified price hike will not be authorised by the ministry in the future, Carcedo warned. This was the first time that the ministry has blocked a price rise of a non-reimbursed medicine, the journal noted.

OTC advertising in Spain increased 1%

Pharmaceutical companies operating in Spain spent a total €144 million on advertising over-the-counter medicines in 2018, 1% more than the previous year, Europa Press agency reported on Thursday.
Reckitt Benckiser spent the most at almost €20 million. Johnson & Johnson and GlaxoSmithKline were second and third with €11.6 and €10 million, respectively.
Sanofi, Procter & Gamble, Pfizer, Synfórmulas and Omega Pharma increased their spending in OTC advertising, whereas Novartis, Pharma OTC and Reckitt Benckiser's expenditure was lower than the previous year, the agency reported.
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