New Medicines Seldom Contain Anything New, Study Finds
By MELODY PETERSEN

Two-thirds of the drugs approved from 1989 to 2000 were modified
versions of existing drugs or even identical to those already on the
market, rather than truly new medicines, according to a new study.

The report also said that most of the increased spending on new
prescription drugs was on products that the Food and Drug
Administration had determined did not provide significant benefits
over those already on the market.

Some of the reformulated prescription drugs are now among the most
heavily advertised. For example, Nexium, a recently approved ulcer
medication, is a modification of Prilosec, which is soon expected to
lose its patent protection. Clarinex, an allergy drug, is a
reformulation of Claritin. Sarafem, for premenstrual irritability, is
the same drug as Prozac but has been renamed and repackaged in
capsules of pink and lavender. 

"The plain fact is that many new drugs are altered or slightly
changed versions of existing drugs, and they may or may not be all
that much better than what's already available," said Nancy Chockley,
president of the National Institute for Health Care Management
Foundation, which wrote the report. "Consumers should be more aware
of that."

The institute receives 40 percent of its financing from the Blue
Cross Blue Shield health insurers and has often clashed with the
pharmaceutical industry because of its reports on the rising cost of
prescription drugs. The drug industry's trade group, the
Pharmaceutical Research and Manufacturers of America, criticized the
study yesterday, saying that it was "flawed and misguided."

Richard I. Smith, vice president for policy and research at the
group, said that even if a medicine was similar to one already on the
market, it could still offer many benefits to patients. For example,
he said, even though there are several similar drugs that fight
depression � including Prozac, Paxil and Zoloft � many patients may
not respond to one medicine but will to another.

"If a new drug does not have sufficient advantages, it will not be
used," Mr. Smith said.

He said the report by the National Institute for Health Care
Management "appears to be little more than a political and
financially motivated cheap shot masquerading as science in the
public interest."

While it has been known for some time that many of the drugs approved
were similar to existing medicines, the institute's study appears to
be the first to use data from the F.D.A. to try to determine just how
prevalent these medicines are. Often such modified versions of
medicines are called me-too drugs.

Of the 1,035 drugs approved by the F.D.A. from 1989 to 2000, only
361, or 35 percent, contained new active ingredients, the study said.
The rest contained active ingredients that were already available in
other medicines on the market.

Of those 361 drugs, fewer than half were given priority reviews by
the F.D.A. because of their significance. The agency grants priority
reviews to medicines that are believed to be more effective, have
fewer side effects or otherwise perform better than existing drugs.

Considering those statistics, the institute found that highly
innovative new medicines � those with new chemical ingredients that
offer significant improvements over existing drugs � made up only 15
percent of those approved in the period. These medicines included
Fosamax, for osteoporosis; Avandia and Actos, for diabetes; and
Viagra, for erectile dysfunction.

The study said that drug companies were increasingly relying on the
me-too products as patents on top-selling drugs expired, and they
could not discover enough truly new medicines to increase revenue as
fast as investors expected.

The modified drugs also provide a high return on investment, the
study stated, since developing them is much less expensive and also
less time-consuming than trying to find a new medicine.

"This is more evidence that the pharmaceutical companies are turning
more into marketing companies," Ms. Chockley said. By using
advertising to sell drugs that are essentially line extensions of
existing medicines, she said, the companies have learned to be like
Procter & Gamble, the maker of Tide.

The institute's study said that the modified medicines were often
more expensive than were older medicines, even if the F.D.A. had
found that they did not offer significant advantages. In 2000, the
average price of a modified drug not given a priority review by the
F.D.A. was about $65 � almost double the price of a drug approved
before 1995, the study said.




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