Pharmaceutical Products R

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Innovation and Health CareJohn S. Swen
Pfizer Inc
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Innovation and Health CareJune 6, 2003

• Longevity and Quality of Life Improvements with
  Medical Therapy

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Medicines Save LivesUSA Example
Deaths/100k Deaths/100K Lives Saved
per 1920 1997 Year (2000) Flu /
Pneumonia 15 1 37,500 Syphilis 17 1 42,500 Per
tussis 13 1 32,500 Diphtheria 15 1 37,500 Meas
les 8.5 1 21,250 Tuberculosis 118 1 295,000
Disease
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Medicines Extend LivesDrop In Death Rates For
Diseases 1965-1996
Disease
Treatment
Atherosclerosis
Statins, ACE inhibitors, beta blockers, nitrates
Ulcer of Stomach and Duodenum
H2 blockers, proton pump inhibitors
Ischemic Heart Disease
ACE inhibitors, beta blockers, nitrates
Emphysema
Anti-Inflammatories, bronchodilators
Anti-Hypertensives, diuretics
Hypertension
DEATH RATE
Source Lasker/Funding First
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Practical Implications of Human Genome for Drug
Development

• Increase in Targets From 450 to gt 4000
• Can Focus on Human Receptors, Ligands
• Potentially Develop More Specific Medicines
• However
• Exploring New Mechanisms Takes Time and Money
• New Technologies are Very Expensive
• No Guarantee that New Medicines will Result

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Implications of the GenomeInsulin Signaling -
1977
Source J.E. Dumont, Cross Signaling, Cell
Specificity, and Physiology. Am. J. Physiology,
Cell. Physiology. Vol. 283, Issue 1, C2-C28, July
2002
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Glucose Transport and Storage Signaling Pathways
- 2000
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Centenarians in US Population
300
Number Per Million
250
200
150
100
50
0
1900
1920
1940
1960
1980
2000
Year 1900 46 Centenarians
Year 2000262 Centenarians
Source Caplow, Theodore, et al. The First
Measured Century, Wash DC AEI, 20019
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Growth in Health Care Spending as GDP
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Thomas Robert Malthus
1766-1834
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Technology-Driven Efficiency

• Human Resources Required to Produce Food Have
  Dramatically Declined Over the Past 100 Years
• We Produced More and Better Food With
  Dramatically Fewer Resources

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Illustration of the Potential Impact of Drugs on
Spending and Mortality
While Monthly Costs for AIDS Patients Decreased
by 16 After HAART Introduced
HIV Mortality Declined Dramatically After
Introduction of First Expensive
Antiretrovirals...
Total 1804
First new Drugs Introduced, 1995
Total 1521
Other Costs Decrease by 41
Highly Active Antiretroviral Therapy (HAART)
introduced, 1996-97
Drug Costs Increase by 34
Source Costs - Bozette et al.,New England
Journal of Medicine Vol. 344, No. 11, March 15,
2001 Mortality - Centers for Disease Control
data on drug development from PhRMA and the NIH
Office of Technology transfer.
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Numerous Silos Exist in the Health Care System
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Impact of New Hampshire Medicaid Drug
Reimbursement Limits on Schizophrenia Patients
Changes in Per Patient Drug Spending vs. Change
in Hospital and ER Spending, After Monthly Caps
Introduced
Change in Hospital and Emergency Cost
Change in Drug Costs
Source Soumerai S, et al. Effects of Limiting
Medicaid Drug-reimbursement Benefits on the Use
of Psychotropic Agents and Acute Mental Health
Services by Patients With Schizophrenia. New Eng
J Med. Sept. 8, 1994
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The Only Solution Technology
AR
Urology
Antibacterials
Tissue Repair
Antifungals
Sex Health
Antivirals
Psycho T
Athero
Pain
Osteo
Cancer
Ophthal
Obesity
CNS
Cardio
Inflammation
Diabetes
GI
Immunology
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We Have a Choice
Emerging Technologies
Increased Patient Costs
vs.