British Medical Journal editor, Dr Fiona Godlee, has called for doctors’ leaders to “sort out the web of misinformation about drug prescribing that has been generated behind closed doors and is costing the NHS hundreds of millions of pounds a year by scaring doctors from using cheap and effective medicines”.
Her comments follow an article published in the BMJ in which there were claims by the lead investigator of a comparative trial between a drug (Avastin) costing £34 per dose and Novartis’s Lucentis – costing £742 per dose – that Novartis refused to supply Lucentis for the study and argued that the trial protocol was seriously flawed. Another trial’s chief investigator alleged that a sales rep had told him they would do all they could to stop the trial and would particularly challenge its ethics, and indicated they were lobbying with the RNIB.
If the trial succeeded, Avastin could save the NHS £100m per year in treating wet age-related macular degeneration (wet AMD). The General Medical Council discourages use of Avastin as an off-label alternative to Lucentis. The BMJ claims this was after lobbying by the ABPI, MHRA and Royal Institute for the Blind (which has links with Novartis). The allegations claim that internal emails have been released that show there were concerns that a head to head study would give doctors more confidence in Avastin and subsequently fought to show methodical problems with comparative trials.
Novartis said, “We are committed to high standards of ethical business conduct. We take any allegations seriously and are closely reviewing the content of the article. Novartis does not tolerate unethical behaviour by its associates in any country. We strongly believe that patients have the right to the highest standard of care and that this right should be defended to promote safety and quality as the key drivers of health policy.”