A recent study has raised concerns that drug company payments might be influencing oncologists who prescribe Tasigna and other pricey cancer drugs.
The authors of the study, which was published this month in JAMA Internal Medicine, used the federal Open Payments database – which records any payment a physician receives from a pharmaceutical company – to identify oncologists who had filled a minimum of 20 prescriptions for certain cancer therapies in 2014.
The study focused on the following treatments for metastatic kidney cancer:
And three others indicated to treat chronic myeloid leukemia (CML):
The research team then linked the prescriptions to general and research payments determined by the Open Payments system.
General payments include sponsored meals, consultant fees, speaking honoraria, gifts, travel/lodging and educational grants. Research payments included any made to physicians who served as principal investigators on clinical trials.
During the study period, 354 oncologists prescribed drugs for kidney cancer and 2,225 prescribed drugs for CML. Those who received any industry payment had twice the odds of prescribing that company’s medications.
89 of the 354 doctors who prescribed kidney cancer drugs received general industry payments. That correlated with increased prescriptions for Bayer’s Nexavar and Pfizer’s Sutent.
Oncologists who treat CML had a29% higher likelihood of prescribing therapies marketed by the companies that paid them.
The research team also discovered that a decrease in physician payments for Gleevec correlated with a drop in prescriptions for the drug. At the same time prescribing of Tasigna grew 15.4% among physicians receiving payments from Novartis, vs. just 12.5% among those who did not.
Gleevec and Tasigna are both manufactured by Novartis. Gleevec – once the company’s best-selling drugs – was set to lose patent protection in 2015. The study authors speculated that the findings could reflect a Novartis strategy aimed at convincing doctors to switch their patients to Tasigna before the patent protection expired for Gleevec.
Novartis brought Tasigna to market in 2007. It now ranks among the top-ten selling cancer drugs worldwide, bringing Novartis more than $1.7 billion in sales in 2016.
The same year Gleevec lost patent protection, Novartis agreed to pay $390 million to settle federal allegations that it had paid illegal kickbacks to specialty pharmacies to push sales of certain drugs, including Tasigna. The U.S. Department of Justice had also accused the company of engaging in an aggressive marketing campaign that utilized false claims and omitted risk information to promote Tasigna over other leukemia treatments.
In recent months, several Tasigna lawsuits have been filed accusing Novartis of concealing the drug’s alleged association with atherosclerosis, a potentially life-threatening condition that causes hardening and narrowing of the arteries.
In February, for example, a Tasigna lawsuit was filed U.S. District Court, Eastern District of Washington, on behalf of a man who suffered a stroke after initiating treatment with Tasigna. The plaintiff claims that his use of the medication resulted in rapidly progressing atherosclerosis of the carotid arteries, which subsequently led to his stroke at the age of 66. (Case No. Case 3:18-cv-05149)
According to an earlier filing in the U.S. District Court, Eastern District of California, another patient developed peripheral artery disease shortly after he began taking Tasigna in 2012. He died of complications related to the condition 2014, even though his doctor changed his treatment after learning via a medical journal article that Tasigna had been linked to atherosclerosis. (Case No. No. 16-393)
The Canadian label for Tasigna was updated in 2013 to note a potential risk atherosclerosis. However, However, there were no similar warnings added to Tasigna labels or notifications made to doctors or patients in the United States.