Product Tidbits January 2010

1.  Schering-Plough Corp. ceased to exist on 11/3/09, because of its acquisition of Merck & Co., Inc. and then renamed itself as Merck (a so called reverse merger). The fallout for drug reps was that most Schering-Plough employees were not offered any positions in the new Merck, whereas nearly all Merck employees stayed put.  The new Merck now owns and promotes: Asmanex, Avelox, the family of Clarinex products, Nasonex, Foradil, Proventil HFA, Singulair (originally old Merck's only respiratory product!).  Actually, this is a pretty all-round lineup.  Only a combination product, inhaled corticosteroid + long-acting bronchodilating agent (LABA), is lacking (i.e. Asmanex + Foradil) and this is actively being studied.

It was sad for me to hear this news about the reps.  I knew one of Schering's reps had spent 25 years with them - an absolute eternity in their topsy-turvy field, like 9-10 lifespans. This brings me to fallout item number two.  They were essentially not replaced.  There is only one Merck rep per territory, which contrasts with the former industry philosophy of having many reps per company promoting the same products to create constant noise for their products to stimulate sales at the doctor's offices.  I am seeing that all pharmaceutical companies are favoring employees with shorter experience in this field also.  I hope the companies can focus their resources on more research and holding down further price increases.
2.  The first product news of 2010 involves Sciele and its Adrenaclick.  This is essentially a single dose of epinephrine in otherwise the same delivery device as Twinject.

3.  Bepreve is the trade name of a new antihistamine eyedrop.  The FDA approved Bepreve (generic name bepotastine) on 9/9/09 for relief from ocural itching for adults and children down to the age of 2 years old.  Bepreve's pregnancy rating is C.  Bepreve is well tolerated, although 25% of people reported a taste in their mouth.  My physician's assistant and I just got through putting the drops in our eyes.  I have to say that this group includes us.  It's really very minor.  There's no burning or thick film, which other products have.  Being new, Bepreve will be a tier 3 medicine for a while.  The cost a pharmacies is about $120 for a 10 ml bottle.  This is steep, but the bottle is twice as large as most competitors, so keep that in mind.  If the others are working for you, at least there may be an alternative.

4. I had an opportunity to inspect Aperion's Insight product , which measures exhaled nitric oxide (eNO) from your breath.  eNO is produced when inflammatory diseases, including asthma, are present.  The more asthma, the higher the level.  This test is another marker for the inflammation of asthma.  Advantages: easier to use device and better graphics with larger screen.  Disadvantages: not covered by the vast majority of insurance carriers.  Hence, if you had the test, you would have to pay out of pocket, which may run $30-50.  My offices routinely use spirometry, the accepted gold standard, to measure lung function and inflammation.  I do not plan on having any eNO device at this time, because the advantages do not outweigh the disadvantages.

5. What is AllerNaze?  I honestly did not know.  I "stumbled" across it while surfing.  AllerNaze is triamcinolone acetonide 50 mcg nasal spray that was approved 1/7/09.  This is the same as Nasacort AQ.  AllerNaze is made by Collegium Pharmaceutical, Inc., (a U.S.-based company) and then on 6/30/09 its worldwide rights were bought by Lupin (an Indian-based company).  I have never heard of either, which means nothing.  However, as I have written earlier, in my subspecialty, there are less than 15 large pharmaceutical manufacturers, which is a relatively small number.  I can't comment on AllerNaze, because other than this, I know nothing about it nor have I any experience with it.  I initially was thinking that depending on price, Lupin might start selling at a low price to gain market share.  This would help many people in the U.S. who are experiencing higher and higher medicine co-pays.

6.  I want to correct my earlier blogs: there is one more product containing CFC-propellant still on the market - Maxair AH.  This was exempted from the rule that banned all other CFC-containing metered-dose inhalers as of 12/31/08.  The manufacturer Graceway Pharmaceuticals was allowed to continue to sell the product through at least 2010.  Sufficient stocks will available until at least 2013, perhaps 2015.  Graceway stated on its website that it is woorking on a CFC-free pirbuterol product and hopes to have it available by 2015.

7. Xlear nasal spray is another product encountered while surfing.  In theory, the xylitol, its major ingredient, may be helpful for dry noses.  This is one of many products sold over the counter that contain xylitol.  I have no experience with this product.  I am trying to get a sample of this product, so that I may share my review with my readers.

8. The Epipen device has been redesigned.  I apologize for not mentioning this.  I just looked back through my website.  The announcement was on 10/26/09.  I'd say the device is more patient friendly.  

9.  Check out every medication you take for coupons on the internet.

Again, I declare I don't own any stock in these companies!  THE Allergy Dude.