Novartis launches drug incentive plan

High blood pressure is known as the silent killer Keystone

Swiss pharmaceutical giant Novartis is offering a money-back guarantee to patients in the United States who buy its high blood pressure drugs.

This content was published on May 27, 2004 - 10:46

Critics say the move puts profits before health because cheaper generic versions may be more suitable in early stages of high blood pressure.

Novartis denies a profit motive, saying the money-back guarantee for its Diovan and Lotrel branded drugs – available on prescription only – is aimed at encouraging people to be more proactive in controlling high blood pressure.

It has described the incentive as an attempt to boost patient confidence.

“The main point of the programme is not the money-back guarantee, but to get people to get help for themselves,” said Doris Wissler, spokeswoman for Basel-based Novartis.

Heart disease

Some 60 million Americans suffer from high blood pressure and an estimated two-thirds of those do not have it under control, leaving them at higher risk of stroke and heart disease.

Medical experts say the problem has partly to do with reluctance on the part of doctors to prescribe multiple drugs for the condition, and because patients often stop taking medication once their symptoms disappear.

The money-back incentive was launched as a pilot project earlier this month, and has the backing of the US government, the American Nurses Association, the American Heart Association and the National Heart, Lung and Blood Institute.

Critics say Novartis’s programme is likely to lead to the drugs being prescribed too early and that many of those who suffer from high blood pressure do not need such strong and expensive medication.

The Novartis drugs cost around $2 (SFr2.50) per day.

Beta blockers

US federal health guidelines recommend that patients with high blood pressure begin treatment with simple remedies such as beta blockers and diuretics, which typically cost a few dollars a month.

Doctors are advised to prescribe these before resorting to combination drugs such as Diovan and Lotrel.

“Recent studies have shown that... inexpensive generic medications work well for most people,” said James Winshall, a US doctor writing in the Harvard News Review.

Winshall, of Harvard’s Brigham and Women’s Hospital in Boston, said patients pay more even with the incentives offered by Novartis, which include a free 30-day trial and a complimentary blood pressure monitor.

“Patients on a full prescription plan will have a substantial [bill] for the name brands included in the Novartis programme”.

Looking to Europe

Novartis says that if the US pilot programme proves successful, it may seek to offer the same incentives in Europe.

However, Wissler told swissinfo that offering incentives for drugs, such as money-back guarantees, could be difficult in Europe because of cultural and regulatory barriers.

“I think this will dictate how we might implement such a programme in Europe,” she told swissinfo.

She added that a country-by-country evaluation of the regulatory differences would be needed, and said this would only begin once the US pilot study was complete.

Correspondents say many European governments are likely to resist the use of incentives in the sale of drugs, seeing money-back guarantees and the like as more appropriate for consumer goods.

swissinfo, Elizabeth Meen

Patients who buy Novartis high blood pressure drugs receive:

Patients who buy Novartis high blood pressure drugs receive:
A free 30-day trial of the company’s biggest-selling antihypertensives.
A free blood pressure monitor.
A money-back guarantee.

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In brief

Doctors say combination drugs like Diovan and Lotrel, Novartis medications which cost $2 (SFr2.50) per day, should be used only after simpler and cheaper generic remedies fail.

High blood pressure is often called the silent killer because it may not cause noticeable symptoms until the patient has suffered serious damage leading to heart attacks, strokes, kidney failure, blindness and even dementia.

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