[Reporter's View] ‘Tyranny of Drug Committees persist'

Pharmaceutical companies are still wary of Drug Committees that decide what drugs can be prescribed in each institution

Even after a drug is approved by the Ministry of Food and Drug Safety and listed for reimbursement, the drug cannot be prescribed immediately by medical staff at general hospitals.

 

A drug can only be prescribed at each hospital after a prescription code is generated upon review by their respective drug committees (DCs).

 

The process, in itself, is quite systematic.

 

Rather than allowing prescriptions of all drugs that are commercialized, an expert meeting is held internally to discuss the need to introduce the drug to each medical institution.

 

DCs have long been regarded as powerful sales targets within the pharmaceutical industry.

 

When it's time for each hospital's DC, a war ignites between pharma companies to land their products.

 

Like all wars, there are winners and losers.

 

The problem is that the winner is not necessarily the company that deserves to win, and the loser is not necessarily the company that deserves to lose.

 

Landing a drug in some hospitals still often depends on the deals made, rather than good clinical results that prove the drug's efficacy and effect.

 

Such cases are especially prominent when the patent of the original drug expires and generics are launched.

 

The DC of a hospital is mostly composed of professors (doctors) in each medical department, except for the head of the pharmaceutical department (pharmacist).

 

Naturally, they are the first targets in line if a company wishes to generate prescription codes for their newly launched drugs.

 

Add to that the medical institution’s foundation’s influence and unexpected code-ins and code-outs do occur.

 

A hospital with a strong DC still calls up the pharmaceutical companies of original drugs when the drug’s patent expires and requests so-called ‘code maintenance fees.’ In fact, over the past 2-3 years, the hospital has gone without some of the most popular original drugs for hypertension, hyperlipidemia, and antithrombotic medications that anyone in the industry would know.

 

This is because the companies that own them refused to pay the code maintenance fees requested by the foundation.

 

DC lobbying also occurs between original drugs when new drugs of the same generation, or same-class drugs, are introduced one after another.

 

This means that pharmaceutical companies are at the mercy of foundations and professors alike to get a drug ‘coded in’ in these hospitals.

 

However, with the recent trend of new drugs being released for cancer and rare diseases, the proportion of drugs that hold a unique position rather than having competitors is increasing, reducing the DC's power.

 

However, industry representatives say ‘it still exists.’ The end consumer of the drugs is the patient, not the doctor or the foundation.

 

It is now time to examine whether the introduction of drugs is being done properly.

 

Isn't it time that drugs are prescribed in hospitals based on fair value assessments?