Press review

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Spanish medical societies criticise decision to limit reimbursement of smoking cessation drugs to Pfizer's Champix

MADRID, 11 Oct (APM) - Some pneumologists and medical societies in Spain have expressed their concern after the ministry of health decided to limit the reimbursement of smoke cessation drugs to Pfizer's Champix, daily newspaper El País reported on Saturday.
Three different drugs have been presented as safe and efficient in helping smokers quit the habit according to clinical trials. The treatment of choice depends on patients' characteristics, the time they have been smoking and other factors. However, the Spanish ministry of health will only reimburse Pfizer’s Champix (varenicline), El País reported. (APMHE 64530)
Many specialists and medical societies in Spain have welcomed the move, but others are questioning whether it makes sense to reimburse the drug at all, when patients are in fact saving money compared to what they used to spend in cigarettes, the newspaper said.
Sources from the ministry of health told El País the reason to choose Champix is previous experience in Navarra region, where it was approved for reimbursement in 2017. The sources said Champix is first, but other drugs are being considered.
However, Navarra did also reimburse GlaxoSmithKline's Zyntabac (bupropion) and its generic version and nicotine substitution therapy. "That is what the Spanish Society of Tobacco USE (SEDET) demands," the newspaper added.
El País quoted a SEDET statement as saying: "Even though it is true that varenicline is slightly more efficient than the other two options, that is not the case for every patient, due to interactions with other drugs, contraindications or side effects."
The newspaper added comments by Mónica Pérez Ríos, head of the tobacco experts' group of the Spanish Epidemiology Society. Pérez said: "Reimbursement is a good move but, why only one? Why are bupropion and nicotine patches excluded, when they are the first-line treatment for many patients?"
Vicente Baos, from the Expert Panel which advises Spanish regulator AEMPS went further when he told El País: "Money is not the reason why people would not quit smoking. In fact, buying cigarettes is way more expensive than paying for the treatment."
Baos thinks that public funding can in fact be counter productive because it can take the pressure off the patient and push more smokers who are not really motivated to stop into the doctor's office demanding the drug without real determination, increasing the drug expenditure for not good reason.

Branded lobby defends incremental innovation

On Monday, daily newspaper El Periódico carried a column by Emili Esteve, head of the technical department at Spanish branded pharma lobby group Farmaindustria. Esteve argued that when it comes to medicines, small improvements (sometimes called 'incremental innovation') can bring great benefits to patients.
Incremental innovation is frequently presented as little steps as opposed to so-called 'disruptive innovation'.
According to Esteve, new drug combinations, indications, improvements in safety or dosage are some examples of incremental innovation. These changes in the original drug can contribute substantially to increases adherence, among other benefits.
Esteve quoted a study carried out by IQVIA in Europe as exposing "a serious problem that we have been dealing with for years". It is the wide discrepancy between the perception of added value among drug regulatory agencies and payers, on the one hand, and healthcare professionals, patients, on the other.
Whereas payers and regulators rarely see incremental innovation as a real advance compared with what is already available in the market, physicians and patients do consider incremental innovation as relevant improvements, Esteve argued.
Farmaindustria, as representative of innovative pharmaceutical companies operating in Spain, has frequently called on a conversation about how difficult it is to bring this kind of innovation into the market in the country.
"Sometimes, even though it is important for patients and healthcare professionals and even though they can improve efficiency and save money, it [incremental innovation] is not valued, nor is it priced accordingly merely because it has the same active principle as conventional medicines," he said.

Boehringer's Praxada used to control disease progression in AD

A Spanish research team from the National Cardiovascular Research Institute (CNIC) has delayed the onset and progression of Alzheimer's disease in mice by administering Boehringer Ingelheim's Pradaxa (dabigatran), it was widely reported on Monday.
Daily newspapers ABC, El Mundo, La Vanguardia, 20 Minutos, Público and a number of regional newspapers carried the story on Monday.
On Tuesday, medical newspaper Gaceta Médica quoted Spanish health minister María Luisa Carcedo as saying this finding should be assessed "calmly" and that clinical trials are needed to see how safe and efficient the drug is in this clinical scenario.
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