This is the article from The Australian on the weekend on our...

This is the article from The Australian on the weekend on our old little favorite Humira........

Docs use rubber stamp for US drugs’

EXCLUSIVE NATASHA ROBINSON HEALTH EDITOR

Pharmacists have raised the alarm over the influence of a US pharmaceutical
corporation on Australian doctors who are signing trademark-stamped letters
requesting their patients be given the company’s branded drugs rather than
biosimilar medications that cost taxpayers less.
Pharmacists around the country are reporting receiving proforma letters from
specialist rheumatologists, gastroenterologists and public hospital clinics that have
been supplied by the Illinois-based pharmaceutical company AbbVie to doctors
instructing chemists to only dispense the branded version of the widely prescribed
auto-immune medication adalimumab.
The medication, Australia’s highest-grossing drug, is prescribed to 27,000
Australians for conditions including rheumatoid arthritis, Chrohn’s disease and
psoriasis. It has the brand name Humira but is off-patent and there are several
biosimilar versions of the drug available on the Pharmaceutical Benefits Scheme.
The influence campaign has been criticised by pharmacists as highly inappropriate.
But doctors say there are good reasons they may want a patient to take only the
branded medication and they do not want patients swapping between Humira and
biosimilars.
AbbVie has admitted supplying “information and resources” to specialists to be
given to pharmacists requesting only the branded medication be dispensed, saying
the provision of such letters by drug representatives to doctors to assist prescribing
is common practice. It has also supplied stamps to doctors to be stamped onto
scripts stating the doctor only authorises the prescription of the Humira brand.
“Based on my clinical judgment and in consultation with my patient, I have
prescribed Humira (adalimumab),” a letter supplied by AbbVie to doctors which has
been signed in identical form by many specialists and given to pharmacists reads.
“I have determined that brand substitution is not clinically appropriate for my
patient and they should be treated with the Humira brand of medication. No other
brand of adalimumab may be dispensed in place of Humira.”
“These letters are definitely inappropriate, big time,” said Fady Fahmy, a pharmacist
in Newcastle in NSW. “Reading the wording of the stamp and the letters, it’s really
pushing the line. We understand that each company has the right to protect its
product, but if you have been cashing in all these millions it’s too much to keep
pushing it when the patent is gone and then anyone can manufacture it.”
AbbVie has been the subject of a house oversight committee inquiry in the US which
fingered the company for engaging in anticompetitive practices to block competition
and inflate prices.
The company said the materials were supplied to doctors to avoid confusion on
medications.
“AbbVie supports the ability for doctors to determine, in consultation with patients,
which brand of medicine is prescribed and subsequently dispensed, and as part of
our commitment to Quality Use of Medicines, we provide relevant information and
resources to healthcare professionals to be used solely at their discretion,” the
company said.
The federal government has enacted legislation that ensure medicines are prescribed
by their active ingredient rather than their brand, to support the uptake of generic
and biosimilar medicines which cost the PBS less.
Adam Rodger, a Queensland pharmacist, said he was surprised that doctors were
signing off on the proforma letters.
“These letters are not information and resources,” Mr Rodger said. “They are
essentially creating forms and templates for people to act in the drug company’s best
interests. How can that be the doctor’s exact professional opinion when it’s been
written by somebody else?”
Medical and patient groups say there are valid reasons why a prescribing physician
may want their patient on the branded Humira rather than a biosimilar.
Britt Christensen, the chair of the IBD faculty of the Gastroenterological Society of
Australia, said doctors were not comfortable with patients switching back and forth
between Humira and biosimilars. “Patients can go to different pharmacies and they
could end up on four different types of medication,” she said.
“We don’t know the safety of that, we don’t know whether they then lose response. If
the patient loses response, that’s a disaster.”
Susanna Proudman, the medical director of Arthritis Australia, said patients needed
consistency.
“I’ve never seen one of these letters before and I wouldn't be happy signing it myself,
but I guess rheumatologists and consumers may argue the clinical decision about
what drug is prescribed should be the drug that is dispensed – and if that is not
happening, some form of correspondence is entered into that may be justified,” Dr
Proudman said.

‘How can that be the doctor’s exact opinion when it’s been written by somebody
else?

’ ADAM RODGER PHARMACIST