The Wall Street Journal Blog by Avery Johnson reported that Pfizer invited the media, including the WSJ Health Blog, to a roundtable about Chantix at the company’s 42nd Street HQ. The purpose of the meeting was to send the following message regarding recent negative Chantix media reports:
#1 Smoking is a serious health problem that kills people.
#2 Most of the adverse events that have been reported recently are already in the Chantix label.
#3 Smokers who are trying to quit can be depressed and irritable.
#4 Paying close attention to adverse-event reports helps the FDA and Pfizer enhance drug safety.
As I noted previously, all of the Chantix-related side effects are also known to be associated with cigarette smoking and cigarette smoking cessation withdrawal.
I’m glad to see that Pfizer called a round table to clear up this issue with the media.
However, Pfizer needs to also communicate MUCH better with its physician customers since they are the ones who write prescriptions for Chantix, and have to face the anxious and nervous patients who read the worrisome media reports. The same patients that lead to the media reports!
Last time I looked, no one at the Wall Street Journal blog was writing scripts for Chantix.
Pfizer management needs to understand the physician communication concept much better or all the other Wall Street analysts will be following Goldman Sachs’ lead.
Robert Cykiert, M.D.
President,
WhatDoctorsThink.com
DoctorNet.com
Friday, June 6, 2008
Thursday, June 5, 2008
I’d like to see Pfizer rate Goldman for a change
The Wall Street Journal Blog by Scott Hensley reports that
Goldman Sachs lowered rating of Pfizer stock from buy to neutral.
Let’s not forget that Goldman Sachs is down over 30% since November 2007 because of the mismanagement in the entire banking sector. If the Fed+Chase’s bailout of Bear Sterns had not occurred, then Goldmans Sachs' stock may have sunk far lower than Pfizer's.
It fascinates me to see how financial institutions and investment bankers rate stocks and trigger market fluctuations in that sector, that many capitalize on.
I’d like to see Pfizer rate Goldman for a change.
By the way, much of Pfizer’s Chantix problems, and other pharmaceutical company misfortunes can be attributed to spending more time with Wall Street analysts than they do with their most important customers--physicians.
Doctors wrote prescriptions for about $270 billion in 2007. They control pharmaceutical sales to a great degree, yet pharma tends to ignore them and not communicate well when bad news comes out about a particular drug or class of drugs. The failure to communicate leaves doctors to make decisions based on sometimes exaggerated or sensationalized media reports rather than science from the drug manufacturers. The classic example is the recent Vytorin debacle which we’ve written about here.
The pharmaceutical sector will come back most likely sooner rather than later since health is the most important thing to humans, and advances made by pharma are responsible for much of our good health and extended longevity in recent decades. Clearly there is much more work that needs to be done.
However, I don’t think we’ll need to see the government bailing out Pfizer.
Robert Cykiert, M.D.
President,
WhatDoctorsThink.com
Goldman Sachs lowered rating of Pfizer stock from buy to neutral.
Let’s not forget that Goldman Sachs is down over 30% since November 2007 because of the mismanagement in the entire banking sector. If the Fed+Chase’s bailout of Bear Sterns had not occurred, then Goldmans Sachs' stock may have sunk far lower than Pfizer's.
It fascinates me to see how financial institutions and investment bankers rate stocks and trigger market fluctuations in that sector, that many capitalize on.
I’d like to see Pfizer rate Goldman for a change.
By the way, much of Pfizer’s Chantix problems, and other pharmaceutical company misfortunes can be attributed to spending more time with Wall Street analysts than they do with their most important customers--physicians.
Doctors wrote prescriptions for about $270 billion in 2007. They control pharmaceutical sales to a great degree, yet pharma tends to ignore them and not communicate well when bad news comes out about a particular drug or class of drugs. The failure to communicate leaves doctors to make decisions based on sometimes exaggerated or sensationalized media reports rather than science from the drug manufacturers. The classic example is the recent Vytorin debacle which we’ve written about here.
The pharmaceutical sector will come back most likely sooner rather than later since health is the most important thing to humans, and advances made by pharma are responsible for much of our good health and extended longevity in recent decades. Clearly there is much more work that needs to be done.
However, I don’t think we’ll need to see the government bailing out Pfizer.
Robert Cykiert, M.D.
President,
WhatDoctorsThink.com
Putting the cart before the horse
Wall Street Journal reports that congress is working to force doctors to switch from hand-writing prescriptions to using new digital technology referred to as E-Prescribing.
E-Prescribing like all e-Things sounds great until you try to implement it. The problem with e-Prescribing at this time is that there is no one standard that doctors can adhere to, and no assurance that current platforms and protocols will persist.
One of the main reasons that physicians are not buying into electronic medical records is that they do not want to make a huge initial investment, pay for maintaining the system, and invest huge time in training staff only to find out that the government or some insurance industry group changes the standard in a year or two making their expensive systems obsolete.
A minority of physicians already have e-Prescribing in place, but it has limited value for the patient because the doctor’s system is tied to their office, and current pharmacy that the patient uses. If a patient goes to another doctor or switches from Rite Aid to CVS, then all the e-Pharmacy-Records become worthless.
Ideally, as with electronic medical records, there should be an online, universal e-drug-record that is accessible to all treating physicians, pharmacies and hospitals.
Bottom line: before the government mandates e-Prescribing and penalizes paper-prescribers, it should set a standard.
Robert Cykiert, M.D.
President,
WhatDoctorsThink.com
E-Prescribing like all e-Things sounds great until you try to implement it. The problem with e-Prescribing at this time is that there is no one standard that doctors can adhere to, and no assurance that current platforms and protocols will persist.
One of the main reasons that physicians are not buying into electronic medical records is that they do not want to make a huge initial investment, pay for maintaining the system, and invest huge time in training staff only to find out that the government or some insurance industry group changes the standard in a year or two making their expensive systems obsolete.
A minority of physicians already have e-Prescribing in place, but it has limited value for the patient because the doctor’s system is tied to their office, and current pharmacy that the patient uses. If a patient goes to another doctor or switches from Rite Aid to CVS, then all the e-Pharmacy-Records become worthless.
Ideally, as with electronic medical records, there should be an online, universal e-drug-record that is accessible to all treating physicians, pharmacies and hospitals.
Bottom line: before the government mandates e-Prescribing and penalizes paper-prescribers, it should set a standard.
Robert Cykiert, M.D.
President,
WhatDoctorsThink.com
Monday, June 2, 2008
Another failure to communicate with Doctors
In a Wall Street Journal Blog, Jacob Goldstein talks about Anemia drugs sold by Amgen and J&J (Aranesp, Procrit and Epogen) that may stimulate the growth of tumors in some cancer patients. Research suggests a genetic link that could potentially be used as a biomarker to figure which patients should and should not receive those drugs.
At the end of the WSJ article, Goldstein quotes Tony Blau, the lead researcher who said that “The definitive answer to this question lies locked in the files of pathologists’ offices.”
What a shame.
If drug companies had better communications with doctors, research on what works and what does not could be significantly enhanced.
WhatDoctorsThink.com performed a February 2008 online physician survey of oncologists and hematologists on the subject of Aranesp, Procrit and Epogen prescribing practices. See detailed survey and results.
65.6% of doctors agreed that certain dosages of these drugs resulted in more rapid growth of certain cancers and a decreased cancer survival rate. Consequently, about 66% of doctors have either reduced the dosages they prescribe, or reduced the number of patients they prescribe the drugs to, or reduced drug usage in certain cancer patients.
Amgen and Johnson & Johnson should do more prompt research on this issue and get answers as quickly as possible since many doctors are clearly nervous about using these drugs. Ironically, the answers are probably "locked in the files of pathologists’ offices."
The longer doctors are kept uninformed, the more likely they will be influenced by media reports as opposed to science, as occurred in the Vytorin debacle. See Analysis of Vytorin Surveys.
Failure to communicate promptly and effectively with physicians will certainly cause further erosion of sales of these drugs, as is occurring with Vytorin.
Robert Cykiert, M.D.
President,
WhatDoctorsThink.com
DoctorNet.com
At the end of the WSJ article, Goldstein quotes Tony Blau, the lead researcher who said that “The definitive answer to this question lies locked in the files of pathologists’ offices.”
What a shame.
If drug companies had better communications with doctors, research on what works and what does not could be significantly enhanced.
WhatDoctorsThink.com performed a February 2008 online physician survey of oncologists and hematologists on the subject of Aranesp, Procrit and Epogen prescribing practices. See detailed survey and results.
65.6% of doctors agreed that certain dosages of these drugs resulted in more rapid growth of certain cancers and a decreased cancer survival rate. Consequently, about 66% of doctors have either reduced the dosages they prescribe, or reduced the number of patients they prescribe the drugs to, or reduced drug usage in certain cancer patients.
Amgen and Johnson & Johnson should do more prompt research on this issue and get answers as quickly as possible since many doctors are clearly nervous about using these drugs. Ironically, the answers are probably "locked in the files of pathologists’ offices."
The longer doctors are kept uninformed, the more likely they will be influenced by media reports as opposed to science, as occurred in the Vytorin debacle. See Analysis of Vytorin Surveys.
Failure to communicate promptly and effectively with physicians will certainly cause further erosion of sales of these drugs, as is occurring with Vytorin.
Robert Cykiert, M.D.
President,
WhatDoctorsThink.com
DoctorNet.com
Yogurt for everyone except doctors
As a sign of our times, the Wall Street Journal blog
noted that Eli Lilly had a white sign at their Oncology meeting in Chicago with the following message:
Food, beverages and/or meals will not be provided by Eli Lilly and Company for the following parties:
* Physicians and individuals with prescribing authority in Minnesota in order to comply with Minnesota statutes
* Government employees in New York (both city and state) in order to comply with New York statutes
Particularly tempting was the frozen yogurt that everyone could have except Minnesota doctors and NY government employees.
Lilly’s sign prohibiting free frozen yogurt to MN doctors is a clever way to make a point, tongue in cheek. Free pizza, and other trinkets have no effect whatsoever on physician prescribing patterns since doctors receive the “gifts” from all the companies. Therefore, no one company has an advantage. If you ban all trinkets by all companies in all states then the pharmaceutical companies will simply divert those marketing funds to things like DTC, eDetailing, and online sponsorship of CME courses. A much better way to deal with pharma gifts to doctors is to require all medical companies to post all gifts on their public web sites. The transparency will keep everyone honest.
WhatDoctorsThink.com performed a December 2007 online physician survey of 290 doctors in various specialties to determine their views on medical company marketing to doctors. Click to view survey.
While 40.5% of doctors agreed that medical companies shouldn’t give any gifts, 71.6% said that doctors are not influenced by these small gift items. It seems like detailed public posting of all gifts with specification of doctor recipients would keep everyone honest. I checked Lilly’s web site--don’t see the frozen yogurt listed there yet.
Our publicly posted surveys are performed on randomly selected physicians, the doctors fill them out voluntarily and are not identifiable, and are completely anonymous. Therefore, the doctors have no incentive or advantage to give false or misleading answers in the survey. Doctors then read our publicly posted surveys to see what their colleagues are thinking on major issues in healthcare. It’s one of the few effective ways that doctors can take the pulse of their colleagues on controversial issues that affect their livelihoods and affect patient care.
noted that Eli Lilly had a white sign at their Oncology meeting in Chicago with the following message:
Food, beverages and/or meals will not be provided by Eli Lilly and Company for the following parties:
* Physicians and individuals with prescribing authority in Minnesota in order to comply with Minnesota statutes
* Government employees in New York (both city and state) in order to comply with New York statutes
Particularly tempting was the frozen yogurt that everyone could have except Minnesota doctors and NY government employees.
Lilly’s sign prohibiting free frozen yogurt to MN doctors is a clever way to make a point, tongue in cheek. Free pizza, and other trinkets have no effect whatsoever on physician prescribing patterns since doctors receive the “gifts” from all the companies. Therefore, no one company has an advantage. If you ban all trinkets by all companies in all states then the pharmaceutical companies will simply divert those marketing funds to things like DTC, eDetailing, and online sponsorship of CME courses. A much better way to deal with pharma gifts to doctors is to require all medical companies to post all gifts on their public web sites. The transparency will keep everyone honest.
WhatDoctorsThink.com performed a December 2007 online physician survey of 290 doctors in various specialties to determine their views on medical company marketing to doctors. Click to view survey.
While 40.5% of doctors agreed that medical companies shouldn’t give any gifts, 71.6% said that doctors are not influenced by these small gift items. It seems like detailed public posting of all gifts with specification of doctor recipients would keep everyone honest. I checked Lilly’s web site--don’t see the frozen yogurt listed there yet.
Our publicly posted surveys are performed on randomly selected physicians, the doctors fill them out voluntarily and are not identifiable, and are completely anonymous. Therefore, the doctors have no incentive or advantage to give false or misleading answers in the survey. Doctors then read our publicly posted surveys to see what their colleagues are thinking on major issues in healthcare. It’s one of the few effective ways that doctors can take the pulse of their colleagues on controversial issues that affect their livelihoods and affect patient care.
Thursday, May 29, 2008
Vytoringate keeps hurting Vytorin sales
Vytoringae keeps punishing... Schering-Plough's SEC filing shows a continuing drop of Vytorin prescriptions. No bottom in sight.
Based on our health care market research via online physician surveys of cardiologists, internists and GPs who prescribe cholesterol drugs, we predict at least a 50% drop in Vytorin/ Zetia sales. Our recent physician survey in April-May 2008 shows that 50% of doctors have stopped prescribing Vytorin or have reduced prescriptions. This, despite the fact that most doctors thought Vytorin is effective and would prescribe it for themselves and family members. How ironic, good will squandered by pharma missteps.
Click here to view this survey for details.
Our surveys also reveal that the reason doctors are reducing Vytorin prescriptions is related to poor communications with Merck and Schering-Plough, and negative media reports which have a growing influence on doctors’ prescribing decisions in the absence of good communications between doctors and the pharmaceutical companies.
For an in depth analysis of our survey results see Vytoringate: A Failure to Communicate with Doctors. We even suggest a way for pharma to stop it's self inflicted slippery slope and restore trust.
As we previously mentioned, John McCain joined this controversy (see Wall Street Journal Blog). Senator McCain’s physicians seem to also have made their treatment decisions based on the same influences that affected doctors in our survey.
As long as medical companies fail to communicate with their most important customers— physicians—the media and other external forces will have increasing control over prescription sales and pharmaceutical company profits.
Robert Cykiert, M.D.
President,
WhatDoctorsThink.com
DoctorNet.com
Based on our health care market research via online physician surveys of cardiologists, internists and GPs who prescribe cholesterol drugs, we predict at least a 50% drop in Vytorin/ Zetia sales. Our recent physician survey in April-May 2008 shows that 50% of doctors have stopped prescribing Vytorin or have reduced prescriptions. This, despite the fact that most doctors thought Vytorin is effective and would prescribe it for themselves and family members. How ironic, good will squandered by pharma missteps.
Click here to view this survey for details.
Our surveys also reveal that the reason doctors are reducing Vytorin prescriptions is related to poor communications with Merck and Schering-Plough, and negative media reports which have a growing influence on doctors’ prescribing decisions in the absence of good communications between doctors and the pharmaceutical companies.
For an in depth analysis of our survey results see Vytoringate: A Failure to Communicate with Doctors. We even suggest a way for pharma to stop it's self inflicted slippery slope and restore trust.
As we previously mentioned, John McCain joined this controversy (see Wall Street Journal Blog). Senator McCain’s physicians seem to also have made their treatment decisions based on the same influences that affected doctors in our survey.
As long as medical companies fail to communicate with their most important customers— physicians—the media and other external forces will have increasing control over prescription sales and pharmaceutical company profits.
Robert Cykiert, M.D.
President,
WhatDoctorsThink.com
DoctorNet.com
Tuesday, May 27, 2008
Pilots and smoking
Federal regulators ruled that Pfizer’s smoking-cessation drug Chantix can't be used by pilots and air-traffic controllers. See more details at the Wall Street Journal Blog
Chantix has been under scrutiny for a while for psychiatric side effects. A report this week also suggested that the drug may be associated with physical problems including seizures. Pfizer has said such potential problems are rare, and are already noted on the drug’s label. More than five million people have taken Chantix in the U.S., Pfizer said.
Smoking and smoking cessation have a high association with depression and suicide - http://ije.oxfordjournals.org/cgi/content/abstract/32/6/1000. So, is it the Chantix or the cigarettes? Smoking is also the leading cause of heart disease, heart attacks and strokes - http://www.clevelandclinic.org/heartcenter/pub/guide/prevention/smoking/smoking_hrtds.htm
So, is it the cigarettes or the Chantix? Smokers also have increased risks of seizures and more dangerous consequences of their seizures - http://www.med.nyu.edu/cec/living/lifestyle/smoking.html. So, is it the cigarettes or the Chantix?
Clearly, for the vast majority of people, Chantix is a far better option and much lower risk than cigarettes. However, no drug is perfect, and no drug is for everyone. Glaxo has offered free Commit nicotine lozenges to pilots. That’s a reasonable alternative option for pilots and good PR for Glaxo, while Pfizer is taking a hit and until we get more data on Chantix.
Lets hope Altria-Philip Morris doesn’t take Glaxo’s lead and offer free Marlboros to pilots.
Robert Cykiert, M.D.
President,
WhatDoctorsThink.com
Chantix has been under scrutiny for a while for psychiatric side effects. A report this week also suggested that the drug may be associated with physical problems including seizures. Pfizer has said such potential problems are rare, and are already noted on the drug’s label. More than five million people have taken Chantix in the U.S., Pfizer said.
Smoking and smoking cessation have a high association with depression and suicide - http://ije.oxfordjournals.org/cgi/content/abstract/32/6/1000. So, is it the Chantix or the cigarettes? Smoking is also the leading cause of heart disease, heart attacks and strokes - http://www.clevelandclinic.org/heartcenter/pub/guide/prevention/smoking/smoking_hrtds.htm
So, is it the cigarettes or the Chantix? Smokers also have increased risks of seizures and more dangerous consequences of their seizures - http://www.med.nyu.edu/cec/living/lifestyle/smoking.html. So, is it the cigarettes or the Chantix?
Clearly, for the vast majority of people, Chantix is a far better option and much lower risk than cigarettes. However, no drug is perfect, and no drug is for everyone. Glaxo has offered free Commit nicotine lozenges to pilots. That’s a reasonable alternative option for pilots and good PR for Glaxo, while Pfizer is taking a hit and until we get more data on Chantix.
Lets hope Altria-Philip Morris doesn’t take Glaxo’s lead and offer free Marlboros to pilots.
Robert Cykiert, M.D.
President,
WhatDoctorsThink.com
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