Case Summary
A general practitioner complained about a cost comparison bar chart for Cipralex (escitalopram) shown to him by a representative from Lundbeck. The bar chart showed the price of Cipralex on the left-hand side and then what appeared to be the price of the generic competitors. One had to look closely to see that the prices shown were in fact those of the branded products of those generic medicines mentioned. The prices of the generic medicines mentioned were on the whole much less expensive than those shown.
This gave a totally misleading impression of the cost of Cipralex compared to its competitors.
The Panel noted that the bar chart compared the cost of standard doses of Cipralex with eight products, all mentioned by generic name (*citalopram, duloxetine, *fluoxetine, mirtazapine, *paroxetine, reboxetine, sertraline and venlafaxine XL). The explanation for the asterisk next to citalopram, fluoxetine and paroxetine was given as ‘manufacturer’s branded price’.
The Panel considered that the basis of the comparison was not sufficiently clear. The cost of all the products was the manufacturer’s branded price not just those asterisked. The asterisked products were those where generics were available. The Panel considered that the comparison was misleading and ruled a breach of the Code.
CASE AUTH/1805/3/06 GENERAL PRACTITIONER v LUNDBECK
Cipralex cost comparison bar chart
A general practitioner complained about a cost comparison bar chart for Cipralex (escitalopram) shown to him by a representative from Lundbeck. The bar chart showed the price of Cipralex on the left-hand side and then what appeared to be the price of the generic competitors. One had to look closely to see that the prices shown were in fact those of the branded products of those generic medicines mentioned. The prices of the generic medicines mentioned were on the whole much less expensive than those shown. This gave a totally misleading impression of the cost of Cipralex compared to its competitors.
The Panel noted that the bar chart compared the cost of standard doses of Cipralex with eight products, all mentioned by generic name (*citalopram, duloxetine, *fluoxetine, mirtazapine, *paroxetine, reboxetine, sertraline and venlafaxine XL). The explanation for the asterisk next to citalopram, fluoxetine and paroxetine was given as ‘manufacturer’s branded price’.
The Panel considered that the basis of the comparison was not sufficiently clear. The cost of all the products was the manufacturer’s branded price not just those asterisked. The asterisked products were those where generics were available. The Panel considered that the comparison was misleading and ruled a breach of the Code.
A general practitioner complained about a cost comparison bar chart (ref 0205/ESC/525/176 (1342)) for Cipralex (escitalopram) issued by Lundbeck Ltd.
COMPLAINT
The complainant explained that, inter alia, a representative from Lundbeck had shown him a bar chart. This showed at the left-side the price of Cipralex and then what appeared to be the price of the generic competitors. Only on closer inspection was it seen that the prices shown were in fact those of the branded products of those generic medicines mentioned.
The prices of the generic medicines mentioned were on the whole much less expensive than those shown. This gave a totally misleading impression of the cost of Cipralex in relation to its competitors.
When writing to Lundbeck, the Authority asked it to respond in relation to Clause 7.2 of the Code.
RESPONSE
Lundbeck did not consider that the bar chart was misleading under Clause 7.3 of the Code as it compared standard doses of all medicines licensed for treating depression at a cost for 28 days’ medication as per MIMS February 2005, therefore like-with-like, and the supplementary information did not preclude – but did not mandate – the use of branded comparators.
It was clear that all the antidepressants in this cost comparison were referred to by their generic names and the branded prices were quoted from the source. Where both generic and branded products existed these were indicated with an asterisk and a footnote which explained that the price stated was that of the branded product.
PANEL RULING
The Panel noted that the bar chart compared the cost of standard doses (28 days) of Cipralex 10mg with eight products, all mentioned by generic name (*citalopram 20mg, duloxetine 60mg, *fluoxetine 20mg, mirtazapine 15mg, *paroxetine 20mg, reboxetine 8mg, sertraline 50mg and venlafaxine XL 75mg). The explanation for the asterisk next to citalopram, fluoxetine and paroxetine was given as ‘manufacturer’s branded price’.
The Panel considered that the basis of the comparison was not sufficiently clear. The cost of all the products was the manufacturer’s branded price not just those with an asterisk beside them. The asterisked products were those where generics were available.
The Panel considered that the comparison was misleading and ruled a breach of Clause 7.2 of the Code.
Complaint received 1 March 2006
Case completed 5 April 2006
