An Update on Roche Sliminess

When last we left giant drug manufacturer Roche Company, we saw how they decided to price their 2 breakthrough cancer drugs, Avastin and Herceptin, at $100,000 and $40,000 a year respectively, not because they say that they were so expensive to develop, but simply because they can. Today we'll see how the terminally ill evidently just aren't a big enough demographic to meet quarterly profit projections.

Let me be clear on one thing. Both Avastin and Herceptin are major breakthroughs in cancer therapy when used in the right patients. Across the pond in the UK though, The Guardian Weekly tells the tale of how Roche aggressively (and by aggressively I mean "acting like slimeballs") marketed Herceptin for cases where the benefits are a little more dubious. I'll let The Guardian set the stage.

Just a few years ago, nobody had heard of Herceptin, although stories about a new generation of "targeted drugs" had begun to circulate, raising hopes of medicines with better cancer-killing powers. In 2002, Nice (Drugnazi here: Nice = "National Institute for Clinical Excellence". Isn't it cool how Europeans try to put a happy face on their Government agencies?) licensed Herceptin for use on women with advanced breast cancer; it undoubtedly saved lives. But then Roche did trials on women who had just finished chemotherapy for early-stage cancer. The company had not yet applied for a licence for this change of use in this country, but it decided to announce interim results showing that the drug halved the risk of the cancer recurring. The clamour for Herceptin began, and amid all the noise, any chance of a reasoned debate about the drug was lost.

Well why wouldn't there be a clamor for a miracle drug that can "halve the risk of cancer recurring?" Maybe because "halving the risk" in this case means 17.2% of women in the placebo group had a recurrence of their cancer, as opposed to 9.4% in the Herceptin group. "Halving the risk" sounds way better than "going from 17.2 to 9.4" doesn't it?

And then there's the way those pesky side effects can get in the way of a good marketing plan. 8.5% of women in the trial stopped taking Herceptin because they couldn't tolerate it, including 2.2% that developed congestive heart failure or warning symptoms of heart failure. More women had to stop taking the drug than were helped by it. Again, not the best material for marketing your product.

That's not about to stop those can-do people who need to make sales projections though. First Roche made a big deal by declaring they were stopping the trials early because it would be (ahem) unethical to withhold the drug from the placebo group. In reality, the trials were stopped at the first possible moment that Roche could start shouting how wonderfully they turned out, and at a point where, according to The Guardian:

We cannot possibly know yet, from the data available, whether the drug stops people dying - and all the "Last chance for breast cancer victim" headlines (as in yesterday's Sun) do not change that. The published results spell it out clearly in the New England Journal of Medicine: "Overall survival in the two groups was not significantly different.

"Overall survival in the two groups is not significantly different!!!!!" probably wouldn't make the best marketing pitch I'm thinking. Better to recruit an army of Breast Cancer survivors to counter the science that isn't going your way. But c'mon, you might be saying, playing to people's raw emotions in such a way is surely beneath any reputable organization.

It would be beneath a reputable organization, but we're talking about drug companies. Back to the Guardian:

"Halfway through the following week, the phone goes at home," says Jardine, professor of Renaissance studies at Queen Mary, University of London, writer and well-known television presenter. "It's a really nice woman. She says to me, 'I read about you in the paper and I gather you'd like access to Herceptin and you can't get it.'"

By now, however, Jardine had decided that she did not want the drug. "I said, 'No - that's not the case with me. I have decided not to have Herceptin.'

"She said, 'Even if you don't want it yourself, would you come and talk to some of our seminars because we're running a big campaign to promote Herceptin? Either we could find funding for Herceptin or, if you really don't want it or decide against it, there would be fees for appearances.'

"I said, 'Could you tell me where you are from?' She said, 'We work for Roche'.

'"I wasn't feeling well. I said, 'Would you please get off the phone?' Then I hung up.

"There was no mistaking the directness of the approach - she said she would make it worth my while."

I couldn't say it any better than Jardine. Would you please get off the phone Roche?

Read the whole story here.