Bristol-Myers’ Blood Thinner Plavix ‘Not Worth’ the Cost in Long Term, NEJM Study Finds
Plavix, a blood thinner manufactured by Bristol-Myers Squibb Co., only "works slightly better" than aspirin to prevent repeat heart attacks or strokes and "is not worth the extra cost" in the long term, according to a study in today's New England Journal of Medicine, the AP/Worcester Telegram & Gazette reports (Nano, AP/Worcester Telegram & Gazette, 6/6). Past studies have found that Plavix can reduce the risk of stroke, heart attack or death by 8.7% for patients with cardiovascular disease when compared to aspirin and by 20% when taken in combination with aspirin. In the new study, researchers from the University of California-San Francisco and the Harvard School of Public Health determined the cost of "a year of life gained" by patients who took Plavix, which costs $3.22 per pill, and aspirin, which costs four cents per pill. The study found that each additional year of life gained cost $11,000 for patients who took aspirin and $130,000 for patients who took Plavix or a combination of Plavix and aspirin (Agovino, AP/Hartford Courant, 6/6). The study found that the price of Plavix would have to drop between 60 cents and $1 per pill to reduce the cost of each additional year of life gained to $50,000, the level they set as a benchmark.
According to the AP/Telegram & Gazette, the study raises a number of questions in the debate over increased health care costs in the United States. Dr. Lee Goldman, chair of the department of medicine at UCSF and co-author of the study, said, "You or I might well say that we think our own lives are worth more than [$50,000 per year]. The question is: Would we pay for it out of our own funds or would we want to pay for someone else out of our own funds? That's where the debates take place" (AP/Worcester Telegram & Gazette, 6/6). Bristol-Myers officials and some cardiologists said that the study "doesn't reflect how Plavix is really used." Researchers based the results of the study on patients "taking the drug for 25 years, when most take it for less than one" -- when "they are at most risk for a heart attack or stroke," the AP/Courant reports (AP/Hartford Courant, 6/6). Dr. Eric Topol, a cardiologist at the Cleveland Clinic, said that most patients take Plavix for 30 days after an angioplasty or for 90 days after chest pain or a mild heart attack. Dr. Christopher Cannon of Boston-based Brigham and Women's Hospital added, "When you treat high-risk patients for short periods of time, then [Plavix] becomes cost-effective" (AP/Worcester Telegram & Gazette, 6/6). The AP/Courant reports that the study will likely "hurt sales" of Plavix, Bristol-Myers' "second-best-selling drug" for Bristol-Myers (AP/Hartford Courant, 6/6).
Meanwhile, according to a New York Times editorial, patients and doctors "need to adopt a more skeptical stance" about "costly and heavily promoted" brand-name prescription drugs. The editorial cites the case of two arthritis drugs, Celebrex and Vioxx, which "have been touted as better alternatives" to ibuprofen and other over-the-counter anti-inflammatory drugs. Drug companies have "besieged doctors with promotional pitches" and patients with television advertisements for the treatments, but the editorial points out that "there is no evidence that they are any more effective at relieving pain" and that "increasing evidence that their main virtue -- that they cause fewer side effects -- has been oversold." The editorial concludes that patients should "turn to these costly drugs only when cheaper alternatives prove unsatisfactory" (New York Times, 6/6).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.