Avastin price issue complicates PR's role amid rising drug costs

SAN FRANCISCO, CA: Genentech has established the price for the off-label use of its colorectal cancer drug Avastin at $100,000, but what has critics up in arms is not only the cost, but also the message behind it.

SAN FRANCISCO, CA: Genentech has established the price for the off-label use of its colorectal cancer drug Avastin at $100,000, but what has critics up in arms is not only the cost, but also the message behind it.

The annual cost of the drug to treat breast and lung cancer, for which it is not yet approved by the Food & Drug Administration, would be roughly double that of a yearlong treatment with Avastin for colorectal cancer. Based on clinical studies, the drug is expected to extend life by several months.

The biotech company has argued that breast and lung cancer patients require higher doses of Avastin, but critics countered that it is already priced above its production cost.

Mary Stutts, head of corporate relations at Genentech, pointed out that the message is multidimensional.

"The only strategy we have is to tell the full story of Genentech's business model and how we approach drug development," she said via e-mail. "We believe there are many facets to the pricing story, one of which is the value of our therapies to patients today as well as to future patients."

The debate over Avastin's price has also revealed the larger PR challenge of communicating to the public about the politically charged issue of drug costs.

Indeed, Dr. Susan Desmond-Hellmann, the president of product development at Genentech, raised eyebrows when she told The New York Times that the price reflects "the value of innovation and the value of new therapies."

The argument diverges from the standard message about the high R&D costs companies incur when bringing a drug to market.

Alex Sugerman-Brozan, director of the Prescription Access Litigation Project (PAL), is one industry critic who doesn't buy the argument about the "value of innovation."

"The title of your piece could be, 'Your money or your life' - because that's what it boils down to," he said. "It seems to be motivated by profits and greed."

PAL is a watchdog group for drug pricing issues whose membership includes such organizations as the AFL-CIO and the Alliance for Retired Americans.

Sugerman-Brozan noted that the PAL has not planned a formal outreach response, but that Avastin has received a number of nominations by member groups for its "Bitter Pill" award, which "expose[s] marketing hype... and consumer manipulation."

But Ken Johnson, SVP of communications at industry trade group Pharmaceutical Research and Manufacturers of America (PhRMA), noted that there has been too much emphasis on trying to explain R&D costs and not enough on the immediate benefit drugs provide to patients - like their contribution to longer life expectancies and lower disability rates.

"Everyone lives in the here and now," Johnson said. "We have to do a better job of explaining that innovation is in-deed paying off."

PhRMA recently launched an advertising campaign on cable news networks that discusses the value of medicines and directs people to its Innovation.org Web site. The campaign comes on the heels of a complementary outreach effort around its patient assistance programs.

"We need to remind people that you cannot put a price tag on the value of a drug," Johnson said.

Like PhRMA, Genentech has not abandoned its R&D argument, and it is also stressing that the company is working to increase access for people who have no or inadequate insurance.

"We realize that even the best therapies are valuable only if they are accessible," Stutts said. "Genentech has always believed that no patient should go without one of our therapies for financial reasons alone."

Russell LaMontagne, president of Corinth Group Communications, noted that patients are "skeptical" about the value message because of how drugs are paid for in this country.

"That argument is going to hit a wall," he said. "The problem is that we don't have a free-market reimbursement system for drugs."

But LaMontagne also noted that drug companies contribute to patient assistance programs.

"I don't think Genentech's to blame," he said. "I think the system's to blame."

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