Module 9: Pharmaceuticals HC Economics Chapter 11: Pharmaceuticals Student lecture

Facts In a given week 80% of US adults will use some type of pharmaceuticals Annually

Most common Rx drugs Name Treatment for Synthroid = 21.5 million/month (7% of the pop) Crestor Ventolin Nexium Advair Lantus Vyanese Lyrica Spiriva Januvia

Was on old list (4 years ago) Hydrocodone  realizing a problem  not even top 100 Generic Zocor  Crestor Lisinopril  Diovan Generic Synthroid  Same/now higher Norvasc (BP)  Diovan Generic Prilosec  Nexium Azithromycin  realizing a problem  not even top 100 Amoxicillin  realizing a problem  not even top 100 Generic Glucophage  Lantus Hydrochlorothiazide (water pill)  side effects  not even top 100

Most profitable drugs Drug Company Use $ Lipitor Pfizer Cholesterol-lowering 13.5B Plavix Sanofi-Aventis Prevent blood clots 7.3B Nexium AstraZeneca Acid reflux 7.27B Seretide GSK Asthmna 7.2B Enbrel Amgen Autoimmune (arthritis, psoriasis) 5.4B

Pharmaceutical companies by revenue Johnson & Johnson (Band-aid, Tylenol, Accuvue) = US Gilead Science (Tamiflu, HIV/AIDS drugs) = US Merck & Co (Gardasil, Zocor, Propecia) = US Novartis (Ritalin, tegretol) = Switzerland Roche (Valium, Accutane) = Switzerland Pfizer (Chapstick, Xanax, Zoloft) = US Sanofi (Codeine, Allegra, Ambien) = France Amgen (Embrel, Neulasta) = US Novo nordisk (Novolog, Victoza) = Denmark Glaxosmithkline (Advair, Boniva) = UK

OTC/CAM 8 in 10 consumers use OTC/CAM 8% of pharmaceutical sales Common illnesses

Pharmaceutical sales Pharmaceuticals are very profitable 10% of national expenditures 2014 Worldwide = 981 B 48% US

Substance Abuse

Legal drugs Type Example Alcohol Beer, Wine, Liquor Nicotine Smoked tobacco (cigarettes, cigars), E-cigarettes, Smokeless tobacco (dip) Caffeine Sodas, Coffee

Commonly abused prescription drugs Type Categories Example Depressants Barbiturates Benzodiazepines Sleep medications Nembutal Valium, Xanax Ambien Opioids and Morphine Codeine Other Opioid Pain relievers Oxycontin, Percocet, Vicodin Steroids N/A Anabolic steroids Stimulants Amphetamines Methylphenidate Adderall Ritalin Other Dextromethorphan Cough and cough

Commonly abused street drugs Type Categories Example Hallucinogens Lysergic Acid Diethylamide Psilocybin LSD Mushrooms Cannabinoids Natural Synthetic Marijuana K2 and Spice Depressants Opioids Cannabis Synthetic Cannabinoids Benzodiazepines Heroin Rohypnol Stimulants Cocaine Methamphetamine Crystal Meth

DIRECT TO CONSUMER ADVERTISING

DTC Direct-to-consumer advertising (DTC advertising) Spend $2.5 billion/2005 Marketing of pharmaceutical products Directed towards the patients, rather than health care professionals FDA regulates DTC advertising Forms TV, print, radio, social media Only 2 countries allow it

How does DTC affect prices? Raises the demand (sales) for the advertised drug as well as its price. 100% increase in DTCA  Increase demand by 10% Increase price by 5%

Which is the most effective? DTC Detailing and Sampling?