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Annual Tradition | | In an e-Alert dated exactly one year ago today ("More Bad News About Remicade and Enbrel" 1/29/02), I gave you the latest information on the disturbing side effects of two prescription drugs used to treat rheumatoid arthritis (RA) and Crohn's disease. Back then I said, "Unfortunately, the news gets even worse," and told you about research that showed both drugs may cause nerve damage that can lead to MS and other central nervous system disorders.
A year later, unfortunately, the news continues to get even worse.
Earlier this month Reuters Health reported that two large clinical trials evaluating Enbrel in the treatment of congestive heart failure (CHF) had been stopped after one of the trials revealed that Enbrel was suspected of causing CHF conditions to WORSEN in patients.
Enbrel (the brand name for etenercept) was approved by the FDA in 1998 to treat rheumatoid arthritis. Taken by injection (self-administered by the patient), the drug's label warns that "allergic reactions to Enbrel are not uncommon." These reactions include the risk of infections, swelling in the deep layers of the skin, and hives.
Now you might wonder why a drug, already known to have side effects ranging from the annoying to the severe, would be given two large trials, to test it for an indication it wasn't even intended for. The simple answer: money. And lots of it. A month's round of Enbrel doses costs each patient a staggering $1,500. No surprise then that sales of Enbrel grossed $907 million in 2001 - an increase of nearly 18 percent over the previous year. So, again, no surprise that the manufacturers of Enbrel (a company named Immunex, in partnership with Wyeth), would make every attempt to expand the market for their bread-winner, in spite of the fact that the list of unpleasant side effects seems to grow as fast as the yearly revenue.
And this is where Remicade comes in. Remicade (manufactured by Centocor, a subsidiary of Johnson & Johnson) is Enbrel's chief competitor. They were both approved by the FDA in 1998 to treat rheumatoid arthritis, they are both used to treat Crohn's disease (even though neither drug is approved for that), they have both been associated with disorders of the central nervous system (MS and Guillain-Barre syndrome), and now Enbrel joins Remicade in being known to worsen CHF symptoms.
Remicade, however, has one huge advantage over Enbrel: Remicade has to be administered intravenously in a doctor's office. Ironically, this apparent drawback has turned into a plus, because Medicare reimburses doctors 95 percent of the "average wholesale price" for drugs that have to be administered by a doctor. So in spite of the inconvenience, Medicare recipients receive a huge break on the exorbitant price. But guess what? Centocor reps are now being investigated for possible fraud in exploiting this system.
Some drug companies have boosted the Medicare reimbursements to physicians by inflating the average prices they report to the government. According to The New York Times, early last year Centocor posted a notice for physicians on its web site, detailing the "estimated revenue per patient" that doctors would reap by prescribing Remicade. It's easy to imagine how this sort of incentive might encourage a doctor to prescribe Remicade, before trying a low-cost generic drug called Methotrexate, which is also a standard treatment for rheumatoid arthritis.
Add to that the fact that Medicare paid out more than $140 million for Remicade in 2001 (almost a 300 percent jump over the amount paid out in 2000), and you don't have to wonder why Centocor has drawn a federal investigation.
Whew! That's a mighty tangled web of over-priced medications, dangerous side effects, and dubious drug company maneuvers. The good news is that the whole mess is avoidable for many who may find far less expensive relief from RA and Crohns's disease with two natural alternatives.
At HSI, we've written extensively about therapies for both RA and Crohn's disease. In the February 2001 Members Alert newsletter, we told you about an oral supplement from Germany called Wobenzyme, a blend of pancreatic enzymes that clears the body of the excess antibodies that characterize an autoimmune disease. Studies have shown that Wobenzyme can prevent RA flare-ups and help lower levels of these antibodies, called circulating immune complexes.
And in October 2000, we wrote about the therapeutic yeast saccharomyces boulardii (SB), which nourishes and protects the healthy intestinal flora. At least two clinical studies have shown that SB can significantly reduce Crohn's symptoms compared to placebo.
If you or someone you care about has been prescribed Enbrel, Remicade, or even the lower-priced generic Methotrexate to treat RA or Crohn's disease, ask your health care provider about the natural alternatives before signing on for involved pharmaceutical procedures and their growing list of side effects.
To Your Good Health,
Jenny Thompson
Health Sciences Institute |
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