The new product – the role of marketing in the r&d
The 6th International Days of Statistics and Economics, Prague, September 13-15, 2012 THE BASIS OF THE DISCOVERY PROCESS FOR A NEW PHARMACEUTICAL PRODUCT Veselin Dickov Abstract
The history of pharmaceutical industry (and pharmacy) is measured from one discovery
of an innovative drug or approach to treatment of a particular disease to the next one. The
basis of the discovery process for a new pharmaceutical product is in understanding the
mechanism of action of a particular disease or processes in the organism related to the
disease and/or its symptoms. The essence of a pharmaceutical is in the active ingredient
capable of affecting processes within the organism beneficially.
Key words: Pharmaceutical market, New drug development, Pricing Regulations, JEL Code: A11, A13, D73, I18 , H51, H75 INTRODUCTION
Management logic require a certain level of certainty and measure time in terminal units,
whereas scientific research process is conducted with flexible timing in terms of
milestones determining: the beginning of particular activities, the need for corrective
actions, or the completion of particular processes. As a specific feature of biotechnology
sector (but also applicable to numerous innovative pharmaceuticals), states high risk
level, which ‘…confronts levels of risk and uncertainty well beyond what is entailed in
“normal” R&D.’ In pharmacy, especially biotechnology, problems in R/D often raise new
questions and a need to conduct further research so as to find appropriate solutions, and
more often than not research ends in a conclusion that there is no technically feasible
solution, or that the solution is inadequate by one criterion or another, which prevents the
commercialization of the product. Objectively, both specific features stem from the
‘conflict’ between business logic and scientific research approach and are related to high
The 6th International Days of Statistics and Economics, Prague, September 13-15, 2012
risk levels and long innovation cycles. Pharmaceutical industry’s decision to channel
R&D, in search of blockbusters, to drugs for chronic conditions, has result in the need to
observe drug safety over a long period, in view of the fact that these therapies are long-
term or life-long. The process of creating a new pharmaceutical begins with the process
of discovering an active ingredient with pharmacological attributes, followed by a long
development period, where the active ingredient acquires the formulation and form of
final pharmaceutical product, and paralleled by the commercial development process,
which is supposed to place the innovative scientific side of the discovery and
development into a pragmatic framework of unmet or inadequately met market needs [1]
[2][3]. Although the discovery and development processes follow a time sequence, it is
important to note the simultaneously conducted commercial development process, aimed
at channeling scientific research towards commercially attractive goals. In addition to
innovative pharmaceuticals, by the active ingredient’s level of novelty, the following can
a new salt of a drug which is already approved for sale; it is a chemical derivative
a new formulation of a drug already on sale, such as a new quantity of the active
ingredient (strength), new method of administration etc.;
a new combination of two or several drugs already on sale; a drug already on sale, a new manufacturer’s bioequivalent drug, such as generic
a new indication is a moment when the manufacturer of a drug already on sale
proves the therapeutic value of the given product in other situations, i.e. in other
diseases, and this also includes transferring drugs from the ethical into OTC drug
THE DISCOVERY PROCESS
‘The main business of the pharmaceutical industry is to provide drugs that save and
extend lives, cure diseases, and alleviate the burden of sickness or age.’ The history of
pharmaceutical industry (and pharmacy) is measured from one discovery of an innovative
The 6th International Days of Statistics and Economics, Prague, September 13-15, 2012
drug or approach to treatment of a particular disease to the next one. The basis of the
discovery process for a new pharmaceutical product is in understanding the mechanism
of action of a particular disease or processes in the organism related to the disease and/or
its symptoms. The essence of a pharmaceutical is in the active ingredient capable of
affecting processes within the organism beneficially [7][8]. The discovery process
includes a particular sequence of activities of various profiles of experts, about which
various authors agree. After selecting the disease, i.e. target identification, the subsequent
target validation, where a set of preliminary experiments aims to confirm therole
of the selected target and its significance in disease causation, symptomsand
a process called High Throughput Screening (HTS), wherein numerous chemical
compounds are tested in relation to the biological target (computing technology
enables testing hundreds of thousands of compounds towards a single biological
target), with the aim to discover the lead compound that has the desired effect on
the selected target; at this stage it is important to view the chemical characteristics
such as the simplicity of compound synthesis, solubility, reactions with other
substances etc.,) as well as biological characteristics (such as selectivity of
impact, toxicity, activity in living organisms etc.);
the next stage after identifying the lead compound is creating a lead series of
compounds similar to the lead molecule or compound with a justifiable potential
of having a pharmacological effect on the selected target;
before entering the development stage, i.e. pre-clinical studies, the preceding step
is lead compound optimization, aimed at selecting (from the lead series) the
molecule or compound with the highest potential of developing into a successful
innovative pharmaceutical product, and this stage, practically, marks the
definition of the molecule or compound which is the potential future drug;
compounds from the lead series are subjected to a set of in vitro and in vivo tests
on animals, so as to establish the initial therapeutic activity and toxicity, i.e. safety
and efficiency. In addition to this molecule or compound, the pharmaceutical
The 6th International Days of Statistics and Economics, Prague, September 13-15, 2012
company may select several ‘substitute’ compounds (from the same or different
At a certain point during the discovery process, the pharmaceutical company that has
identified the lead series of molecules/compounds must protect its discovery with a
patent, either as a new chemical entity (NCE) or a new molecular entity (NME), or the
patent protection may refer to the process of compound production. The development
stage is aimed at developing the ‘ideal profile’ of the active ingredient – indications,
formulation and other attributes of the new drug with a task to create the product’s
clinical, and therefore market values. In practice, achieving the ideal profile results in
adopting the new drug as the ‘gold standard’, acknowledged as the best available therapy
for a particular disease. From the business development aspect, the choice of disease is
defined by the company’s specialization in a particular therapeutic area, potential market
size, but also the assumed existence of significant advance in the treatment of the disease
(which is related with subsequent possible differentiation of the product in relation to
competitors). The complexity of defining the potential market size once again confirms
the significance of a time gap between the discovery and the launch of an innovative
pharmaceutical, as projections are made for a product which still does not exist on the
market, or it is simply about forecasting potential markets after 8 or 12 years, that it takes
to develop (which raises the issue of the structure of the competitive environment at the
moment of product launch). An innovative pharmaceutical may be the result of work of a
pharmaceutical company’s in-house R&D team, may come as the result of work of
scientists and experts at universities, or be acquired from other companies in various
As the source of the innovative pharmaceutical product is within the R&D process, this
leads to the conflict between the logics of scientific work and business, manifested as:
problems related to patenting certain primary discoveries; and/or the fact that scientific norms highlight sharing discoveries, publishing scientific
work and knowledge diffusion, while business logic rests on the positions of
protecting patent rights and limiting information diffusion to enable capitalization
The 6th International Days of Statistics and Economics, Prague, September 13-15, 2012
Confrontation of two different logics significantly impacts the pharmaceutical discovery
NEW PHARMACEUTICAL PRODUCT DEVELOPMENT New drug development is defined as a ‘. set of interdependent tasks with the intended
purpose of marketing a new chemical or biological entity.’, i.e. a new active ingredient.
compounds/molecules with a reasonable potential of becoming a new successful
pharmaceutical product. Developing a new pharmaceutical product is a time-consuming
process, engaging a considerable share of the pharmaceutical company’s resources. [16].
Pre-clinical studies are the initial stage of new pharmaceutical product development.
First of all, it is necessary to establish the pharmacological profile of a future new drug
by gathering information on the pharmacokinetic and pharmacodynamic properties.
Pharmacokinetic properties are usually tested through ADME tests, designed to establish:
the path and degree of drug absorption; the drug’s distributions through liquids and
tissues; successive transformation through metabolic processes; as well as its elimination
and accumulation in the organism. Pharmacodynamic studies refer to the drug’s
biochemical effects, the mechanism of its activity in the organism (how it acts), as well as
the relation between the concentrations and effects of the drug, which also affects the
development of drug formulation. Drug formulation refers to the drug’s dosage and
appearance, primarily the administration route. An integral part of pre-clinical studies
also implies studying the toxicity of the future drug. The final stage of pre-clinical studies
is submitting applications for permission to test the new chemical or molecular entity on
human population. Test results in terms of the drug’s pharmacological properties and
toxicity are supposed to justify the initiation of therapeutic application, first on a group of
healthy individuals. Pharmaceutical companies have developed numerous, mostly
formalized methods for the commercial evaluation of the potential new product. Entering
the development stage also implies escalating costs, so that it is understandable that there
is a high degree of caution before the company decides to take that step. At this point of
the new drug discovery and development process, legitimate decisions imply the
continuation of pre-clinical studies or giving up the development of the given product due
The 6th International Days of Statistics and Economics, Prague, September 13-15, 2012
the lack of its compatibility with the company’s aims (where one of the solutions may be
to license this product), or the decision to formally enter the clinical trial study stage. Of
about 250 compounds entering the pre-clinical study phase, five on the average meet the
criteria qualifying them for clinical tests. ‘Clinical drug study is the study conducted on
humans with the aim of establishing and confirming the clinical, pharmacological and
pharmacodynamic actions of (a) studied drug(s), identifying each side-effect of the
studied drug(s), and studying the resorption, distribution, metabolism and discharge of
the drug(s) with the purpose of establishing its safety and efficiency [17] [18].
STRATEGIC POSITION ANALYSIS Stage 1 of clinical studies of the new pharmaceutical is supposed to prove that the new
drug is safe for human use, and which dose is considered to be safe for human use. As a
rule, this stage is conducted on a small group of healthy volunteers, usually 20 to 100
respondents. The law precisely regulates the rules of conducting clinical studies, which
are usually limited on young, healthy, adult males. Studies are conducted under strictly
controlled conditions, and each respondent is observed immediately upon drug
administration, over an appropriate time period ranging from a few hours to a few days.
The use of the drug on the healthy population and the results of the first stage of clinical
trials are a precondition for the first use of the innovative drug on people with the
disease/condition/indications for which the drug is being studies. [19]
Stage 2 of clinical studies is a small-scale study conducted on a smaller population of
100 to 500 patients. This stage should confirm that the innovative drug on trial really has
the desired effect on given indications, the so-called proof of concept (POC). Proof of
concept is established upon the completion of drug safety and efficiency trials,
determination of minimum and maximum efficient drug doses, and monitoring the
Stage 3 of clinical studies is a significant step for the pharmaceutical companies, as this
is the longest, and also the costliest stage of clinical development. Stage 3 includes
studies on a large group of patients, from 1000 to 5000 persons. Impartiality of studies,
resulting in objective evidence of the drug’s efficiency and safety, is based on ‘.
The 6th International Days of Statistics and Economics, Prague, September 13-15, 2012
randomized, blinded, placebo-controlled.’) trials. According to PhRMA publication,
Placebo controlled trials: a group of respondents/patients receives the new drug
under development, while another group is given placebo, or, in some cases,
recognized available therapy for the given indication;
Randomization : respondents are divided by random sample method into a group
receiving the innovative therapy and the group receiving placebo. So as to avoid
the risk of jeopardizing reproductive health in women. cases when this would
pose a risk for the patient’s health, alternative therapy), which provides having the
tested and control group with equal representation of respondents with varying
Blind (ed) tests, which can be single-blind(ed), when the respondents do not know
whether they are taking innovative therapy or placebo, and double blind ( ed),
when not even the testers (physicians) participating in the clinical trial do not
know which patients are being given therapy or placebo [21].
Basically, of clinical studies is a large-scale game, which is to result in statistically
significant evidence of drug efficiency and safety. The decision by relevant authorities to
approve the sale of an innovative drug depends, in essence, on the results that the
innovative therapy has shown during clinical trials, especially the final stage. The results
of clinical studies are intended to help balance the beneficial and side-effects of the drug.
Clinical studies will also shape the market lifespan of the pharmaceutical product, and it
will be placed on the market as a therapy for those conditions/diseases for which the
clinical trials have proven to be influenced beneficially. After launching the new drug on
the market, most pharmaceutical companies continue to monitor the drug on the market
in order to obtain additional information regarding the drug’s safety and efficiency, its
impact on the quality of patients’ lives, but also in search of new indications. [22]
Stage 4 of new drug study is voluntary, but in practice, regulatory bodies may request its
conduct. Monitoring the drug’s performance in real-life environment over a long period
of time is gaining significance. makes a distinction between the efficiency and
The 6th International Days of Statistics and Economics, Prague, September 13-15, 2012
effectiveness of therapy, referring to efficiency as the degree of success of the therapy in
ideal conditions (such as those in clinical trials), while effectiveness is the measure of its
success in real life. Gathering continuous data on the use of the drug in real-life
environment requires patient registers which are ‘.an organized system that uses
observational study methods to collect uniform data (clinical and other) to evaluate
specified outcomes for a population defined by a particular disease, condition or
exposure, and that serves a predetermined scientific, clinical or policy purpose(s).’[21].
The success of generic drug manufacturers does not depend on developed R&D
capacities. Their key strategy is successful imitation – proven through drug
bioequivalence – as the proof that a generic drug is ‘…comparable in dosage, form,
strength, route of administration, quality, performance characteristics, and intended use as
the original drug.’ Due to the burdened budgets of healthcare payers, generics become
‘instant hits’ and easily find the way to drug formularies or preferential status when
therapy is prescribed. To sum up, R&D process in pharmaceutical industry is
characterized by long time horizons, high capital intensity, and high risk levels,
especially from the aspect of the drug’s pharmacological effectiveness and efficiency,
and its safety of use, and qualify the circumstances around innovation in pharmaceutical
industry as extreme. point to escalating investment requirements (or development costs)
of a successful pharmaceutical, from its discovery to launch. The long R&D process in
pharmaceutical industry must also be viewed from the aspect of lost days of sale,
although not a precise measurement. Each day of delayed launch of a potential
blockbuster may cost the company up to several million dollars (e.g. according to data
given for Prilosec it is 11.2 million US dollars, while daily sales of Zocor amounted to
nearly 8 million USD). Cteristics of scientific research, but its objective is to launch a
successful new product [14]. ‘Ideally, marketing is involved and provides a commercial
perspective early in the discovery and development process. In this context, its mission is
to marketplace – and to spotlight important product characteristics and differentiated
attributes that should be evaluated during trials.’ From the commercial development
aspect, the impact of economic logic on pharmacy is manifested through the allocation of
the organization’s resources through ‘.three key decisions.’
which drugs to develop (portfolio management);
The 6th International Days of Statistics and Economics, Prague, September 13-15, 2012
the best development path/method through development process design; and planned product price (pricing strategy)
The role of marketing in R&D in pharmaceutical industry differs from its role in
consumer goods industry. Key differences stem from:
1.different roles in understanding consumer needs, which do not depend on culture,
fashion or taste, but are medical or health-related;
2.the nature of innovation, which is a result of scientific research, which puts the role of
marketing as information source into perspective, in terms of proposing new products or
specifying the attributes of future products;
3.direct participation of marketing in pharmaceutical R&D is limited; once again it is
about the complexity of R&D and high uncertainty levels – ‘.marketing can diminish
market uncertainty, its powers in dealing with technical uncertainty are clearly limited.’.
4.testing new pharmaceuticals is possible only at later development stages, and even then
they are conducted under controlled conditions and by experts, while in the consumer
goods industry this is normally the task of marketing; and
5.limited sales forecasts for innovative pharmaceuticals affect marketing’s ability
to validly assist in selecting development projects by forecasting sales at the point of
transition from discovery to development phase[10].Instead of looking for the widest
possible target market, with the objective problem of confirming the drug’s efficiency
and safety, the author proposes gradual development (expansion) of target market from a
very narrow, specific group of patients. With respect to various authors conclusions on
the place and role of marketing in R&D, as well as the specific features of the market and
the product, we can draw the following conclusions:
1. The influence of marketing on pharmaceutical R&D has a strategic dimension;
assessing the market and the company’s inner potential result in decisions on which
research paths are considered to be compatible with the company’s business (market)
objectives, which, in turn, results in the decision to support particular products in further
development, prepare some for licensing, and abandon the others. This task also requires
assessing the future drug’s market potential [17].
2. The complex nature of R&D itself limits the role of marketing to conditionally
advisory; marketing may propose elements of ‘design’ (including the effect) of a drug
The 6th International Days of Statistics and Economics, Prague, September 13-15, 2012
that stakeholders are interested in, but it is up to R&D to evaluate the justifiability of
these claims from the aspect of available know-how and possibilities [13].
3. The role of marketing is strengthened at later stages of clinical development, notably
for the purpose of informing the expert public on the potentials of the innovative drug,
which should enable a fast diffusion of therapy in proportion with its therapeutic
superiority in comparison with existing therapies [12].
Economic justifiability is not the only criterion for developing innovative
pharmaceuticals. First of all, this refers to rare diseases affecting proportionately low
percentage of population. For instance, the USA offers pharmaceutical companies various
benefits for developing orphan drugs, in an attempt to encourage research and
development in the areas without commercially justifiable investment logic. Typical
diseases of developing countries are another example, where morbidity statistics are
totally different from economically developed countries. A special significance belongs
to the ‘relocation’ of R&D from highly developed Western countries to Eastern Europe,
China, India, Latin America etc., as pharmaceutical houses want to exploit lower costs
not only in the production process, butalso in R&D.A top academic medical centre in
India charges between 1500 and 2000 USD per clinical study report related to a single
patent, while at the same time a ‘secondclass’ centre in the US charges 20,000 USD for
PRICING (COST)
The cost of pharmaceutical products is one of the key causes of controversy related to
this industry. Numerous cultures have proverbs expressing the opinion that health is
priceless or that health is the greatest wealth. What if health does have a price? One of the
basic premises of marketing is that price should reflect consumer value. How can one
measure the value of keeping good health or gaining it back? The objective need for
health does exist. ‘It’s not like buying a Lexus-it’s not something where you have a
choice. People get angry because this is something that is critical, that they need, and
companies are raising the prices so much.’ The value of a pharmaceutical product is a
complex category exceeding the level of physiological needs, although it stems from
maintaining or re-establishing the organism’s normal functions. Moreover, not only does
The 6th International Days of Statistics and Economics, Prague, September 13-15, 2012
humanity’s need to keep good health and extend their own lifespan exceed the resources
that an individual or society can allocate, but also the quantum of human knowledge
about the ‘mystery of life’ does not suffice to safeguard people from biological
vulnerability and impermanence. The controversial issue is that there is no price we
would not pay to stay (or become) healthy, as opposed to the fact that any price a
company charges for its pharmaceutical product is excessive. Why? Because
‘…particularly in the case of health-care sector, where many persons consider access to
health care a right of citizenship rather than an ordinary service (health service
themselves) or an ordinary commodity (pharmaceuticals and medical devices).’ Between
the objective R&D cost of innovative pharmaceutical products and the subjective
perception of their value and the company’s right to make a profit on them stands the
pharmaceutical product’s market price. Marketing has the responsibility to capitalize on
the newly discovered knowledge translated into an innovative product, enable future
R&D and achieve the pharmaceutical company’s business objectives, bearing in mind the
availability of the pharmaceutical and the public opinion (which is not favorably disposed
to pharmaceutical industry’s pricing policies). ‘Drug costs (and change in drug costs) are
visible to naked eye; identification of drug benefits requires careful analysis of good
data.’ Advances in the quality of life, extended life expectancy and medical/therapeutic
advances are undoubtedly evidence pro industry, but there is also the evident critical
attitude to ‘… monopolistic pricing and high profits…’[3]. Pharmaceutical industry and
its products are an inseparable part of the healthcare system in which they function. In the
opinion of the past few decades of discourse on healthcare system are marked by three
key issues: quality, cost and availability. The price of pharmaceuticals makes a direct
impact on all three. The apparent logical response is to control prices of pharmaceuticals,
i.e. to lower them. However, such a response is only a part of a complex equation which
is supposed to provide a wide range and adequate quantities of pharmaceuticals, which
requires maintaining the economic logic in their production, and at the same time, certain
advances in finding more efficient, safer (and why not more agreeable) therapies. Such a
requirement is objectively feasible in encouraging R&D within pharmaceutical industry.
Most authors propose the unequivocal position that the past decades have seen a rise in
the share of pharmaceutical costs in the total healthcare system. The rise in the total
The 6th International Days of Statistics and Economics, Prague, September 13-15, 2012
expenditure on pharmaceuticals results from the introduction of more effective
(therapeutically superior) products and increased use of drugs
for diseases for which adequate/appropriate therapy did not exist; and preventive therapies.
The most successful pharmaceutical companies operate globally, so that it is logical to
expect that they will encounter different attitudes of both regulatory bodies and the
general public to their product pricing. The analysis of various factors influencing prices
and pharmaceutical companies’ pricing policies must always be viewed from the aspect
of seemingly conflicting positions of different stakeholders [3].
SPECIFIC PRICING FACTOR
At the same time, pharmaceutical marketers try to appreciate the internal factors, notably
marketing objectives, the appropriateness of pricing policies in relation to the total
marketing mix, and, of course, the aspect of costs. A significant factor determining any
discourse on the nature and movement of pharmaceutical prices is the issue whether they
are patent protected innovative drugs or generic medicaments. The domination of
external factors demands that the prime attention be paid to them , but in view of the fact
that the influence of individual factors is not linear and unambiguous, we shall attempt to
encompass the key aspects of the complex mutual influences [12][19].
Pricing Regulations
Pharmaceutical product pricing depends primarily on whether they are placed on markets
with legislatively regulated prices in one form or another, such as the markets of the EU,
including Serbia, or markets where prices are formed freely, with the US as a relatively
isolated example. The basic idea of legislative bodies is to prevent the prices of
pharmaceuticals growing above the rise in prices of consumption goods, the so-called
zero real pharmaceutical price inflation Discussion on pricing regulations primarily refers
to branded, patent protected drugs, although the impact on the generic drug market is also
evident. .where one must bear in mind that it is the most significant pharmaceutical
market, consuming almost a half of the world’s total sales of drugs, and the fact that the
The 6th International Days of Statistics and Economics, Prague, September 13-15, 2012
USA is a leading country in terms of pharmaceutical companies’ investment in R&D [15]
[16]. Attempts to control the prices of pharmaceuticals may be interpreted as efforts to
substitute for monophony, where the state (or one of its bodies) acts as the only or
exclusive buyer, for the relatively monopolistic position of innovative drug
manufacturers. Pricing regulations on a national market are aimed at accomplishing the
social objective of availability of adequate quantities of safe and effective drugs, while,
on the other hand, one finds the objectives of pharmaceutical industry .Efforts to assess
the efficiency of pharmaceutical pricing control systems from the aspect of
accomplishing the goals of both society and industry have produced a voluminous body
of research. Sources are dominated by authors advocating the position that long-term
pricing regulations are a sub-optimum strategy for accomplishing the desired goals view
the difference between the two systems, free (unregulated) pricing and externally
(government) regulated pricing in relation to two key determinants: the system’s ability
(or perhaps eligibility) to reward investment in innovative pharmaceutical R&D, and the
role of pricing as a market competition tool. Point to the opinion that free pricing does
not satisfy the social aspect, but Vogel also argues that government control can be
equally unsuccessful in their accomplishment. Pharmaceutical patent protection can also
be regarded as a specific form of government intervention, as the state legislation
provides relative monopolistic position for a certain period, as some kind of
compensation for resources invested in R&D. However, ‘patents do not guarantee profits’
and unless consumers recognize product value, it is hard to expect that they will be
willing to pay any price [8]. Methods of controlling public expenditure on
pharmaceuticals can be divided into two basic groups:
1.methods focused on the pharmaceutical supply side:
- directly controlled prices of individual products;
- reference prices, where prices are set based on the prices of the same or
- similar products on reference markets;
- curbing the margins of wholesale and retail pharmacies; and
- positive and negative drug lists (where the payer, i.e. the state, defines
The 6th International Days of Statistics and Economics, Prague, September 13-15, 2012
- which drugs are to be dispensed at the cost of the healthcare system).
2.methods focused on the pharmaceutical demand side:
- patient co-payment levels when purchasing drugs;
- advice and guidelines for prescribing physicians and limited budgets; and
- moving drugs from the ethical to the OTC product category.
The normal practice is to regulate markets with a combination of the above methods
rather than just one measure. Reviewing pharmaceutical prices in Europe, give an
overview of approaches to their formation. The regulatory body in Serbia provides that
the reference markets are those of Croatia, Slovenia and Italy [3][8]. In the case of
markets without external price level control, price levels are practically defined by the
supply/demand ratio on the given market. On the other hand, pharmaceutical supply is
also a category with high uncertainty levels, accompanied by the nature of discovery of
new knowledge in the entire scientific nexus surrounding the industry. In the case of
pharmaceuticals, the above mentioned consumers’ willingness to pay for an innovative
product refers to attempts to predict consumers’ willingness to pay for a product that will
appear on the market following at least eight to ten years of clinical studies [3][8]. As
public pressure has turned healthcare costs, and therefore pharmaceutical costs, into a
political issue, there is a permanent dilemma whether it is better to regulate drug prices or
let them form freely on the market. Practically, it is about social welfare on the one and
the issue of pharmaceutical industry development on the other side. The advocates of
pharmaceutical pricing control system highlight the issue of drug availability and criticize
the industry for high profits, often assailing marketing budgets as well. Opponents of
price control argue that pharmaceutical pricing control systems are short-term strategies.
‘Lower drug prices today will unequivocally improve access to currently developed
medicines and this will improve public health.’ Of course, no less important is the
question how much these lower drug prices will cost society. Considering this simplified
The 6th International Days of Statistics and Economics, Prague, September 13-15, 2012
model in which only monopoly or full competition exists, any intervention by the
government in a market mechanism would result in welfare loss. In case of
pharmaceutical products, three theoretical assumptions can be made:
Any form of monopoly pricing, as opposed to competitive pricing, will result in a
reduction of output, at a higher price, and will engender a loss in consumer
Society grants a monopoly to the inventor of a pharmaceutical for a limite amount
of time, willingly sacrificing short run welfare, expecting that, after patent
expires, new knowledge will contribute to greater welfare gain (above
Price controls generate welfare losses in the short run as well as the long run. Taxes (income, sales, or property) that are used to pay for publicly financed
health care (acute care, long-term care, or pharmaceutical care) generate welfare
losses in the short run as well as the long run, trough detrimental distortions in
CONCLUSION
Led by economic logic and in the absence of imposed pricing limitations, pharmaceutical
companies allocate their resources to projects with the ‘highest risk-adjusted expected
rate of return’. Imposing external pricing controls is a direct threat to R&D investment in
pharmaceutical industry, on at least three grounds:
External pricing control reduces the expected rate of return on investment, which
also means that projects become less attractive, and there is a real threat of losing
External pricing control and the need to negotiate the inclusion of drugs into drug
formularies with various government bodies, and also negotiations on drug prices,
Reduced pharmaceutical prices impact on reductions in future cash flow, and long
pharmaceutical development periods and high risk levels result in the fact that
pharmaceutical companies are especially sensitive to funding sources, as their
own funds have lower capital costs than external ones.
The 6th International Days of Statistics and Economics, Prague, September 13-15, 2012
One of the central ideas of marketing is channeling resources into the production of
products in demand on the market. The prices of given products are formed on the
market. The price should reflect the value comprised in the given product, and a market
with freely formed prices also provides feedback on the price that consumers are willing
to pay for the given product. Deems it unfeasible to make an analysis that would enable
an objective determination of pharmaceutical product prices by third parties (such as
regulatory bodies, governments etc.):
1. Application of value-based principle is impossible due to the fact that the regulatory
body’s interest is to keep prices down, and assessing the value of medicaments is left to
the regulatory body itself, with the assumption that it is capable of assessing product
value more objectively than users or prescribing physicians.
2. Pharmaceutical R&D costs are incurred much earlier than the product’s utility appears,
and the real ‘medical and economic benefits’ of the drug can only be viewed in post-
launch studies, when the drug has been on the market for a period of time.
Authors who dispute pricing controls argue that without free formation of market prices
resources will not be employed appropriately, which will primarily threat future R&D,
and the consumers will be deprived of innovative therapies. Pricing control positions, on
the other hand, are defended with the accomplishment of the social goal – availability of
therapies to a wide circle of users [3][8].
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approach,, International Journal for Agro Veterinary and Medical Sciences. IJAVMS,
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[4] Franklin J. C., Ravindra C., (2009) Segmentation Based on Physicians Behavior:
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[6] Dickov A. ,Vuckovic N., Dickov V., S.Martinović-Mitrović ,,POST TRAUMATIC
STRESS DISORDER (PTSD) AFTER TRAFFIC ACCIDENT - PTSD and traffic
accidents ,,. HealthMED - Volume 4 / Number 4 / Supplement 1 / 2010. pp.1037-1043.
[7] Dickov V., A.Dickov, S.Martinović-Mitrović., (2011). ,,The issue of applying
marketing on the pharmaceutical market in Serbia,, ,, European Review for Medical and
Pharmacological Sciences 15 (3): 275-283
[8] Dickov V., Nerandjic B. Perovic V., (2004): ,,Ekonomika moderna,, Stilos, FTN,
[9] Mitrovic-Martinovic S., Dickov A., Dickov V. Mitrovic D. ,,Reakciono vreme u
zavisnosti od dužine uzimanja heroina,, Srpski Arhiv za celokupno lekarstvo, Srp. Arh. Celok. Lek. 2011; 139 (1-2):69-75
[10] Dickov V., Kuzman B., Tomic S., (2011) ,,NEW PHARMACEUTICAL PRODUCT
DEVELOPMENT,, International Journal of Novel Drug Delivery Technology (An
official publication of Pharmaceutical Scientist Group) IJNDDT.; 1(1): 47-62
[11] Dickov V., Kuzman B., (2011) ,, Specific Features of Pharmaceuticals Marketing
Mix,, Journal of Management & Marketing in Healthcare Volume 4, Number 3 ,160-
[12] Dickov V., (2011).,,Pharmaceutical Market Is Directly Linked To The Healthcare
System In Some Countries. Journal of Medical and Pharmaceutical Sciences. ; 1(2): 15-
[13] Mitrovic-Martinovic S., Dickov A., Dickov V. Mitrovic D. Vuckovic N., "The impact of
heroin on visual memory" European Review for Medical and Pharmacological Sciences
,, Eur Rev Med Pharmacol Sci 2011; 15 (5) : 524-531
The 6th International Days of Statistics and Economics, Prague, September 13-15, 2012
[14] Dickov A.,Vuckovic N., Dickov V., S.Martinović-Mitrović “Disorder verbal
memory in alcoholics after delirium tremens” European Review for Medical and
Pharmacological Sciences . Reference number of the article is # 1.2198. SCI - in press
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Faculty of International Management, European University
Pharmacologic Agents Used in the Treatment of Persistent Pain Indications and Common Uses Class/Agent Indication Common (Off-Label) Use Level of Evidence Acetaminophen Multiple randomized controlled clinical trials for headache and non-neuropathic pain conditions Lidocaine patch 5% postherpetic neuralgia Moderate- Randomized trial for osteoarthritis; open-label
HT 201 – PHARMACOLOGY FOR ALLIED HEALTH Course Instructor: Erik Bailey, Pharm.D. An Important Note To All Students: It is your responsibility to read and comply with all regulations outlined below. Any questions regarding these regulations should be addressed to: Department of Health Information Technology Office Hours: HIT/CIM Office Hours will be held through email communication in class a