Further memorandum submitted by Sanofi-Aventis
& Bristol Myers Squibb Pharmaceuticals Ltd
Further to our earlier submission and to the
11 June PAC evidence session relating to the NAO Report, Prescribing
Costs in Primary Care we thought it appropriate to draw to
the attention of the Committee some additional points relating
to our product Plavix that may inform the publication of the Committee's
report into this subject.
1. There was discussion at the evidence
session of the switching of patients from branded medicines onto
generic medicines. We would like to emphasise to the committee
that aspirin is not a generic version of Plavix and that there
is in fact no licensed generic alternative to Plavix. Plavix has
a pharmacologically different mode of action to aspirin and has
been shown in extensive clinical trials to have a clinical benefit
over and above that of aspirin when used in its licensed indications.
It should also be noted that Plavix is used in combination
with aspirin in patients with acute coronary syndromes (some
forms of heart attack and angina), and that this use is endorsed
by NICE.
2. We reiterate to the committee that there
is evidence that many NHS patients who according to the 2004 NICE
guidance[7]
should receive Plavix but do not in fact receive it. An audit
of NHS hospitals carried out by Innovex Health Management Solutions
showed that 40% of heart attack (NSTEMI) patients and 61% of unstable
angina patients were discharged from hospital without receiving
Plavix. More detailed briefing on this evidence has been sent
to the National Audit Office and is enclosed.
3. It is important that patients on Plavix
who are identified as potentially appropriate for a switch to
aspirin are properly assessed and reviewed on an individual basis
by their clinician. The importance of any change of medication
being led by the patient's doctor was stressed to the committee
in evidence from Dr David Colin-Thomé. Many patients who
have been treated with Plavix for 12 months will require longer-term
therapy, for example if they remain at high risk of a further
event or if they are aspirin intolerant.
August 2007
7 NICE Technology Appraisal 80; Clopidogrel in the
treatment of non-ST-segment-elevation acute coronary syndrome;
July 2004. Back
| 
