Ross
Well-known member
Oooo, if you want to get rich, right there is a lawsuit waiting to be brought to court.hpuehler said:
Coumadin vs generic warfarin
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dkapuscik
New Hope?
New Hope?
Just got back from my GP, was getting some anti depressant stuff, this surgery combined with my two teenage daughters and my business has stressed to the max. However, I told him the thought of life on coumadin was not real great for me as I am very active and never worried about getting hurt. He said there were new drugs on the horizon of the next couple years that should relieve some of the issues with the bleeding things of cummadin. I did not ask him to elaborate on the name.
New Hope?
Just got back from my GP, was getting some anti depressant stuff, this surgery combined with my two teenage daughters and my business has stressed to the max. However, I told him the thought of life on coumadin was not real great for me as I am very active and never worried about getting hurt. He said there were new drugs on the horizon of the next couple years that should relieve some of the issues with the bleeding things of cummadin. I did not ask him to elaborate on the name.
G
Guest
There are NO, NO and I repeat NO drugs in testing to replace warfarin for people with mechanical heart valves in the next 5 probably 10 years.
There are two drugs that are in phase III (final) testing that are seeking approval to replace warfarin for short term use to prevent clots after hip and knee surgery. That is IT, ALL, THE FULL EXTENT of it.
Please look at my web pages
http://warfarinfo.com/ximelagatran.htm
http://warfarinfo.com/dabigatran.htm
http://warfarinfo.com/rivaroxaban.htm
I just updated the last two this weekend in preparation for a series of seminars that I am going to give.
The first one is informative because it shows the perils of bringing a drug to market. I testified at the FDA hearing on its approval. AszraZeneca had the champagne on ice and it got voted "not approvable" be the margin of 3 yes votes to 152 no votes and 1 abstention.
It was also estimated that AstraZeneca was going to price Exanta at $10 to $15 per pill. At that rate many insurance companies would not have covered it.
Personally, I have supervised the switching of about 1,000 people between Coumadin and generic. Many have switched between different generics. A very few have gone back to Coumadin. We do between 600 and 725 INR tests per month. Every month we have about 58% of the people in range. So if switching (in any order) makes any difference, it does not show up in our numbers. I used to make good money giving talks for DuPont when they owned warfarin. However, they wanted me to say that Coumadin was a better product. There is stll not even one published study that shows anything in favor of warfarin. When they couldn't show me anything other than their marketing department's dreams I refused. It cost me a bundle of money but I had to live with myself. Years later they still could not pay me enough to say that sticking with Coumadin is based on even the tiniest bit of reality.
It doesn't hurt to take Coumadin. If you feel better spending your money on it, fine. But nobody can say that it is based on science.
The name of th institution makes no difference to me. I was an expert witness in a lawsuit against the NYPD where the head of a department at a New York medical school gave a sworn deposition that a police officer taking warfarin couldn't even be on duty at a parade because he could bleed to death from from someone punching him in the stomach. It shows that misinformation can come from big name institutions, too.
The bottom line is that you cannot base a decision on what might come along to replace warfarin. If there is not enough market to be profitable, it will never happen
There are two drugs that are in phase III (final) testing that are seeking approval to replace warfarin for short term use to prevent clots after hip and knee surgery. That is IT, ALL, THE FULL EXTENT of it.
Please look at my web pages
http://warfarinfo.com/ximelagatran.htm
http://warfarinfo.com/dabigatran.htm
http://warfarinfo.com/rivaroxaban.htm
I just updated the last two this weekend in preparation for a series of seminars that I am going to give.
The first one is informative because it shows the perils of bringing a drug to market. I testified at the FDA hearing on its approval. AszraZeneca had the champagne on ice and it got voted "not approvable" be the margin of 3 yes votes to 152 no votes and 1 abstention.
It was also estimated that AstraZeneca was going to price Exanta at $10 to $15 per pill. At that rate many insurance companies would not have covered it.
Personally, I have supervised the switching of about 1,000 people between Coumadin and generic. Many have switched between different generics. A very few have gone back to Coumadin. We do between 600 and 725 INR tests per month. Every month we have about 58% of the people in range. So if switching (in any order) makes any difference, it does not show up in our numbers. I used to make good money giving talks for DuPont when they owned warfarin. However, they wanted me to say that Coumadin was a better product. There is stll not even one published study that shows anything in favor of warfarin. When they couldn't show me anything other than their marketing department's dreams I refused. It cost me a bundle of money but I had to live with myself. Years later they still could not pay me enough to say that sticking with Coumadin is based on even the tiniest bit of reality.
It doesn't hurt to take Coumadin. If you feel better spending your money on it, fine. But nobody can say that it is based on science.
The name of th institution makes no difference to me. I was an expert witness in a lawsuit against the NYPD where the head of a department at a New York medical school gave a sworn deposition that a police officer taking warfarin couldn't even be on duty at a parade because he could bleed to death from from someone punching him in the stomach. It shows that misinformation can come from big name institutions, too.
The bottom line is that you cannot base a decision on what might come along to replace warfarin. If there is not enough market to be profitable, it will never happen
Ross
Well-known member
dkapuscik said:
We hear this from every new person that comes in. I can only wonder what fairy tales you've heard about Coumadin. If your interested in really learning about the drug, see Al Lodwicks site at www.warfarinfo.com . Many of these fairy tales will be debunked.
allodwick said:
Al:
My PCP is OK with my taking generic. However, he said he hopes the generic is consistently from the same company (yes, Taro).
I would think that would not make much difference, whether it's from Taro or Barr.
Am I right?
D
dkapuscik
Thanks, that realy burst my bubble
Thanks, that realy burst my bubble
Thats one of the reasons that I like this site. At lest everyone is honest.
Thanks, that realy burst my bubble
Thats one of the reasons that I like this site. At lest everyone is honest.
Ross
Well-known member
Ah, it wasn't to burst your bubble, just to educate and cast out the B.S. that so many people are told about the drug. It's a shame that in this day and age, with all the advances in medicine, that the medical profession and many people are still spreading misinformation about the drug.dkapuscik said:
ALCapshaw2
Well-known member
Well, I guess I will get the 'opportunity' to compare different manufacturers of Generic Warfarin.
My company has changed providers for our mail-order maintenance drugs. The previous company sent generic warfarin ONLY from TARO. I had NO problems with their product (and liked how much easier their tablets were to split in half).
I called the new mail order company to inquire about their supplier(s) for generic warfarin and was told there were 3 or 4. When I asked for names, they only told me BARR and TARO, both well respected generic manufacturers.
I guess I'll see how they operate when my stockpile of TARO tablets begins to be depleted...
'AL Capshaw'
My company has changed providers for our mail-order maintenance drugs. The previous company sent generic warfarin ONLY from TARO. I had NO problems with their product (and liked how much easier their tablets were to split in half).
I called the new mail order company to inquire about their supplier(s) for generic warfarin and was told there were 3 or 4. When I asked for names, they only told me BARR and TARO, both well respected generic manufacturers.
I guess I'll see how they operate when my stockpile of TARO tablets begins to be depleted...
'AL Capshaw'
G
geebee
Al,
I use both Taro and Barr and have had no problems with either one.
I use both Taro and Barr and have had no problems with either one.
Ross
Well-known member
ALCapshaw2 said:
All I know of are Taro, Barr and brand name Jantoven.
G
Guest
I am sure that if your insurance company thought that it would cost them the price of one extra lab test to switch generics that they would never let it happen, much less require it. The insurance executives keep their jobs by making money for the stockholders. They do this by spending as little as possible. They are probably getting a price break of less than one dollar for each person per month that they buy the new generic warfarin. If everyone required one extra lab test because of this any savings would be way more than wiped out. They are not doing this to conduct research on you, they are doing it to pass more of the money that you pay for insurance to the stockholders.
John & Joann
Well-known member
Al,
There is no one that we respect more than you regarding Coumadin. I, however, must strongly disagree with your previous comment. In our retirement, the prescriptions are provided by Caremark, a PBM with very poor customer service. The IRN testing is provided by Medicare as primary and Medical Mutual as secondary.
Caremark could care less what Medicare and Medical Mutual pays for testing. Likewise, Medicare and MEdical Mutual is not aware what medication is provided by the PBM.
These groups do not talk, do not like each other, and are really only interested in their bottom line. As you know, the PBM makes a higher profit on generic medications due to their buying power and the higher co payment.
There is no one that we respect more than you regarding Coumadin. I, however, must strongly disagree with your previous comment. In our retirement, the prescriptions are provided by Caremark, a PBM with very poor customer service. The IRN testing is provided by Medicare as primary and Medical Mutual as secondary.
Caremark could care less what Medicare and Medical Mutual pays for testing. Likewise, Medicare and MEdical Mutual is not aware what medication is provided by the PBM.
These groups do not talk, do not like each other, and are really only interested in their bottom line. As you know, the PBM makes a higher profit on generic medications due to their buying power and the higher co payment.
G
Guest
John,
I have to admit that I did not consider your model of insurance in my thinking. Most of the people that I deal with have a Medicare HMO, so their expenses and lab testing all come from the same pocket.
However, I'll stand with what I wrote about this model. If they though that switching to generic would cost them $1.00 more per person they would have insisted that the change not take place.
When the change took place several years back this plan went to $20 for generics and $60 for brand names. For many of these people paying for Coumadin would have meant a dollar a day less for food. I switched all of them to generic. However, the percentage of people who were in range remained where it always does - between 58% and 60% each month. I could draw no other conclusion than it made no difference.
So far as I know, the people at Cleveland Clinic did not publish any study showing that they had any problem with people who switched. In the heirarchy of medical evidence, randomized, placebo-controlled, double-blinded studies are considered at the top of the heap. Experts saying, "In my experience..." is on the bottom of the heap. This applies to all fields of medicine. So far the Coumadin people have only had experts saying, "In my experience.." and this goes against all other evidence - there are even a few, small published randomized, placebo-controlled, double blinded studies that were conducted by HMOs to make sure that they would not lose money showing no difference in number of lab or doctor visits for INR adjustments.
I have to admit that I did not consider your model of insurance in my thinking. Most of the people that I deal with have a Medicare HMO, so their expenses and lab testing all come from the same pocket.
However, I'll stand with what I wrote about this model. If they though that switching to generic would cost them $1.00 more per person they would have insisted that the change not take place.
When the change took place several years back this plan went to $20 for generics and $60 for brand names. For many of these people paying for Coumadin would have meant a dollar a day less for food. I switched all of them to generic. However, the percentage of people who were in range remained where it always does - between 58% and 60% each month. I could draw no other conclusion than it made no difference.
So far as I know, the people at Cleveland Clinic did not publish any study showing that they had any problem with people who switched. In the heirarchy of medical evidence, randomized, placebo-controlled, double-blinded studies are considered at the top of the heap. Experts saying, "In my experience..." is on the bottom of the heap. This applies to all fields of medicine. So far the Coumadin people have only had experts saying, "In my experience.." and this goes against all other evidence - there are even a few, small published randomized, placebo-controlled, double blinded studies that were conducted by HMOs to make sure that they would not lose money showing no difference in number of lab or doctor visits for INR adjustments.
afraidofsurgery
Well-known member
Studies on valve replacement patients unlikely
Studies on valve replacement patients unlikely
Yeah, and according to my cardiologist (and I concur) there is very little financial motivation for drug companies to perform clinical studies of new warfarin-replacement drug candidates on valve replacement patients. Despite our numbers, we represent a very small market in $$'s and we're a problematic group to perform clinical studies on - just think of the risk.
So even when/if a new drug does come on the market, there will likely be little or no information on its use in valve replacement patients, and I tell you I won't be the first guinea pig signing up.
Studies on valve replacement patients unlikely
allodwick said:
Yeah, and according to my cardiologist (and I concur) there is very little financial motivation for drug companies to perform clinical studies of new warfarin-replacement drug candidates on valve replacement patients. Despite our numbers, we represent a very small market in $$'s and we're a problematic group to perform clinical studies on - just think of the risk.
So even when/if a new drug does come on the market, there will likely be little or no information on its use in valve replacement patients, and I tell you I won't be the first guinea pig signing up.
afraidofsurgery
Well-known member
generics vs coumadin
generics vs coumadin
True, but I have to point out that the variation in active compound allowed by the FDA is higher for generics than for brand name
The AUC values for the generic and reference drug may differ by as much as 20% to 25% and still fall within the acceptable range for bioequivalence. (I looked this up), a difference that may not show up in clinical studies but could cause some imagined or real increased variance in INR for some patients. Also, pharmacies get generics from different manufacturers unpredictably, so there's company to company differences on top of batch to batch variations. In diseases sensitive to the maintenance of a therapeutic level of drug (such as in epilepsy) this has been shown to cause problems.
Just food for thought (and my cardio is 'old school' and does not like generics, so far he's been very conservative so I would tend to think there's something to it).
My new insurance doesn't cover coumadin so last month I paid $70.00 for my Rx. Might be switching myself to generics soon...
Patty
generics vs coumadin
allodwick said:
True, but I have to point out that the variation in active compound allowed by the FDA is higher for generics than for brand name
The AUC values for the generic and reference drug may differ by as much as 20% to 25% and still fall within the acceptable range for bioequivalence. (I looked this up), a difference that may not show up in clinical studies but could cause some imagined or real increased variance in INR for some patients. Also, pharmacies get generics from different manufacturers unpredictably, so there's company to company differences on top of batch to batch variations. In diseases sensitive to the maintenance of a therapeutic level of drug (such as in epilepsy) this has been shown to cause problems.
Just food for thought (and my cardio is 'old school' and does not like generics, so far he's been very conservative so I would tend to think there's something to it).
My new insurance doesn't cover coumadin so last month I paid $70.00 for my Rx. Might be switching myself to generics soon...
Patty
jeffp
Well-known member
Has anyone ever figured out why some drug benefits don't cover warfarin/coumadin?afraidofsurgery said:
(They cover things like Viagra, but not coumadin. Like there's a choice I'd have to take some time to think about
. Who comes up with these benefit lists?)
G
Georgia
Jeff, her company doesn't cover "coumadin"; they take the name brand off the formulary. Warfarin would probably cost next to nothing.
G
Guest
Actually Barr Labs warfarin tested at a tighter tolerance that Coumadin. That was one of the things that led to DuPont losing the lawsuit for saying that they were better. However, good news doesn't sell newspapers, so the media chose to ignore this.
K
Karlynn
jeffp said:Has anyone ever figured out why some drug benefits don't cover warfarin/coumadin?
(They cover things like Viagra, but not coumadin. Like there's a choice I'd have to take some time to think about
And some insurance companies will cover Viagra, but not birth control.
Al, is there any place I can get your Barr labs info in writing to take to my cardio?
