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COPD spurs drug development

BY Alaric DeArment

Taken together, asthma and chronic obstructive pulmonary disease — which includes chronic bronchitis and emphysema — affect nearly 50 million Americans, or about 15% of the total U.S. population, according to statistics from such organizations as the Centers for Disease Control and Prevention. And combined, the two diseases cause more than 100,000 deaths per year. Fortunately, however, there is a wide range of treatments available for both, many of which work for both diseases.

According to the Pharmaceutical Research and Manufacturers of America, an industry group for branded drug companies, the number of people living with COPD — which, according to the National Institutes of Health, includes 13 million who have it but don’t know it — has spurred a large amount of drug development around the disease. A PhRMA report released in February found that more than 50 drugs currently are in clinical development for treating COPD, ranging from pharmaceutical drugs to stem-cell therapies that attack the biological mechanisms behind the disease. Decision Resources, a market research firm, predicted that the COPD market will grow from $8 billion in 2010 to $13 billion in 2020 in the United States, France, Germany, Italy, Spain, the United Kingdom and Japan.

Some new drugs for the condition already have hit the market. In October 2011, the Food and Drug Administration approved Boehringer Ingelheim’s Combivent Respimat (ipratropium bromide and albuterol sulfate), which is delivered in a propellant-free inhaler that uses a slow-moving mist to deliver the same active ingredients as the Combivent Inhalation Aerosol. The company expects to launch the drug in the middle of this year. In November, generic drug maker Mylan bought rights to a drug delivery platform made by Pfizer that would allow it to manufacture and commercialize generic versions of GlaxoSmithKline’s Advair Diskus and Seretide Diskus (fluticasone propionate and salmeterol).

Meanwhile, despite growth in the COPD market, the asthma market is expected to decrease slightly and remain basically flat. According to another Decision Resources report, the asthma market in the same seven countries the firm used to measure the COPD market is expected to decline from $14.6 billion in 2010 to $14.4 billion in 2020. In contrast with the plethora of new drugs for COPD, the asthma market will see increased competition and generic erosion. For example, Merck’s Singulair (montelukast) had sales of $3.3 billion in 2010, but that figure is expected to drop to $2 billion in the United States, Europe and Japan due to generic competition.

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CDC: Asthma hits all-time high

BY Alaric DeArment

Coughing, wheezing, difficulty breathing — many people have symptoms like these for a variety of reasons, ranging from common colds to smoke inhalation to running. While unpleasant, they’re usually not serious. But for many Americans, they’re the result of medical conditions that are chronic, dangerous and sometimes fatal.

According to the Centers for Disease Control and Prevention, 1-in-12 Americans has asthma, a lung disease that causes repeated episodes of breathlessness, tightness of the chest and coughing at night and in the morning. This includes 18.7 million noninstitutionalized adults, or 8.2% of that population. Meanwhile, 7 million children, or 9.4%, have the disease. The disease is ranked among the most common in children, with attacks usually triggered by something that bothers the patient’s lungs. During an attack, the airways that lead to the lungs swell and tighten, thus blocking air from entering and causing fits of coughing and chest tightness, while mucus can exacerbate the problem. Common triggers for asthma attacks include secondhand smoke, mold, outdoor air pollution, dust mites, pet allergies and even some foods.

In 2007, according to the CDC, there were about 17 million visits to physicians’ offices, hospital outpatient wards and emergency rooms in which asthma was listed as the primary diagnosis. In 2009, there were 479,000 hospital stays that resulted from the disease, with patients staying in the hospital for an average of more than four days. That year, the disease resulted in 3,388 deaths, or 1.1 deaths per 100,000 people.

Another disease that causes symptoms often similar to asthma is chronic obstructive pulmonary disease, or COPD, which includes the diseases of emphysema and chronic bronchitis. Most COPD in the United States results from smoking, emphysema being a leading and well-known illness associated with tobacco use. However, other causes — such as exposure to indoor and workplace pollutants, respiratory infections and genetic factors — play a role as well; in the developing world, indoor air quality is said to play a greater role in COPD than in the United States, according to the CDC. In addition to its similarities to asthma in terms of symptoms, COPD also is similarly widespread but much more deadly.

According to Drive4COPD, a campaign run by the COPD Foundation, the disease affects some 24 million Americans, and according to the CDC, it causes more than 100,000 deaths per year. In 2000, for example, 116,494 Americans died from COPD, a number that increased to 126,005 in 2005. The number of women dying from the disease was higher than the number of men, with 65,193 women dying in 2005, compared with 60,812. Meanwhile, while death rates for COPD declined from 57-per-100,000 in 1999 to 46.4-per 100,000 in 2006 for men, there was no significant decline in death rates among women, which went from 35.3-per-100,000 to 34.2-per-100,000 during the same period.

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MinuteClinic, Hackensack University Health Network sign clinical affiliation

BY Antoinette Alexander

WOONSOCKET, R.I., and HACKENSACK, N.J. — Retail-based clinic operator MinuteClinic, which is owned by CVS Caremark, is partnering with Hackensack University Health Network, the largest provider of inpatient and outpatient health services in New Jersey, in a clinical affiliation that expands access to healthcare services in northeast New Jersey.

Under the agreement, HackensackUMC physicians will serve as medical directors for six MinuteClinic walk-in medical clinics inside select CVS/pharmacy stores in Bergen, Passaic and Hudson counties and parts of Essex County. MinuteClinic and HackensackUMC also will collaborate on patient education and disease management initiatives, and refer patients to one another when clinically appropriate. HackensackUMC will accept patients requiring a level of care not provided by MinuteClinic; while MinuteClinic will offer patients walk-in services for common family illnesses and wellness and prevention services, such as health condition monitoring.

Signage at MinuteClinic locations will inform patients that each site has a clinical affiliation with HackensackUMC.

"MinuteClinic’s HackensackUMC affiliation will enable both organizations to capitalize on our strengths and share valuable knowledge as we continue improving our patient-centered approach to high quality healthcare services," said Andrew Sussman, president of MinuteClinic and SVP/associate chief medical officer for CVS Caremark. "We look forward to having HackensackUMC physicians collaborate with our nurse practitioners to provide quality oversight, teaching and back-up so we can provide the best care at the lowest overall cost."

HackensackUMC has more than 1,600 physicians providing a range of healthcare services to patients in northeast New Jersey.

"We are pleased to partner with MinuteClinic on this important clinical affiliation," added Robert Garrett, president and CEO of HackensackUMC. "Combining our award-winning clinical expertise with the trusted reputation of MinuteClinic will undoubtedly serve as an asset to members of our local community. This affiliation is another demonstration of our commitment to providing patient-centered, efficient care, and we look forward to a longstanding relationship with MinuteClinic."

In addition to collaborating on patient care and education programs, MinuteClinic and HackensackUMC will work toward fully integrating electronic medical record systems to streamline communication around all aspects of patients’ care. With patient permission, MinuteClinic will electronically share medical histories and visit summaries with HackensackUMC locations in northeast New Jersey. In the meantime, MinuteClinic will continue its standard practice of sending patient visit summaries to primary care providers via fax or mail, typically within 24 hours of the visit.


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