Astra takes brand cancer drug straight to patients

(Reuters) - AstraZeneca Plc is selling breast cancer drug Arimidex directly to U.S. patients, offering an option for people who want to pay for the brand instead of generic versions.

Under the drugmaker's new program, patients with a prescription can pay $40 a month for Arimidex to be mailed to their homes.

That is less than patients would generally pay for the brand, but is typically more than the co-payment for generic versions of the drug, also known as anastrozole.

AstraZeneca said it started the program in response to patients asking for options to buy the brand, which are prohibitively more expensive compared with generics since the cheaper copies became available in mid-2010.

"We definitely got lots of calls every month to our information center on how they could get a branded option," said Steve Davis, Astra's executive director overseeing its mature brands in the United States. "There are patients that prefer not to be on the generic option."

Health plans generally try to steer patients to generic versions once they become available because they are significantly less expensive.

AstraZeneca's move is similar to one by Pfizer Inc, which has offered delivery of brand versions of its Lipitor drug to patients after the big-selling cholesterol treatment lost U.S. patent protection in November.

Arimidex was once a big seller for Astra. In 2009, the last full year before generics arrived, Arimidex sales reached $1.9 billion globally and about $880 million in the United States alone. Last year, Astra's U.S. sales of the drug fell 91 percent to $42 million, reflecting the toll taken by generic rivals.

In Arimidex's class of drugs, known as aromatase inhibitors, some 96 percent of prescriptions are generic, Davis said.

A major wrinkle in the Arimidex Direct program is that patients do not use their health insurance to get their pills, but pay out of pocket. AstraZeneca is contracting with Express Scripts Inc, a pharmacy benefit management company that mails the prescription to patients.

At $40 a month, the price is more than the usual $10 co-pay for generics, but less than insured patients would otherwise pay for the brand, which may only be available at close to the full price, according to Express Scripts.

Drugstore.com lists a one-month supply of Arimidex at $458.97 and anastrozole at $186.01.

"Given the seriousness of the condition, there may be individuals who are willing to pay $40 for the brand," said Everett Neville, chief trade relations officer Express Scripts. "That's completely different than you might see with some less emotionally charged conditions."

Aromatase inhibitors are used to treat breast cancer or help keep breast cancer from recurring after surgery, according to the American Cancer Society.

Davis said AstraZeneca started the program late last year, initially marketing it through brochures left in oncologists' offices and wanted to make sure it was working smoothly before publicizing it. About 300 patients are enrolled so far.

"This is a very emotional disease and it brings a lot of patient concerns," Davis added. "There is brand loyalty."

(Reporting By Lewis Krauskopf; editing by Andre Grenon)

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In Brazil, Protection of Amazon Rainforest Takes a Step Back

The rate of deforestation fell by 80 percent over the past six years, as the government carved out about 150 million acres for conservation — an area roughly the size of France — and used police raids and other tactics to crack down on illegal deforesters, according to both environmentalists and the government. Brazil’s former environment minister, Marina Silva, became an internationally respected defender of the Amazon. She ran for president in 2010 on the Green Party ticket and won 19.4 percent of the votes.

But since Dilma Rousseff was elected president in late 2010, there have been signs of a shift in the government’s attitude toward the Amazon. A provisional measure now allows the president to decrease the lands already created for conservation. The government is granting more flexibility for large infrastructure projects during the environmental licensing process. And a proposal would give Brazil’s Congress veto power over the recognition of indigenous territories.

“What is happening in Brazil is the biggest backsliding that we could ever imagine with regards to environmental policies,” said Ms. Silva, who now devotes her time to environmental advocacy.

Now, a bill seeking to overhaul the 47-year-old Forest Code, a central piece of environmental legislation, is the most serious test yet of Ms. Rousseff’s stance on the environment.

The debate over the law has revealed the stark disconnect between a population that is increasingly supportive of conserving the Amazon and a Congress in which agricultural interests in the country’s rural north and northeast still hold sway. The furor comes as Brazil is set to hold a United Nations conference on sustainable development in Rio de Janeiro in June.

Before taking office last January, Ms. Rousseff promised to veto any revision of the Forest Code that granted amnesty to landowners who had previously deforested illegally. Then her government negotiated a version of the code, approved by the Senate in December, that would give amnesty to farmers who broke the law before 2008 — provided they agreed to plant new trees. The House is expected to debate the legislation once again in March, with Ms. Rousseff holding final veto power.

The fight over the Forest Code has stoked the age-old struggle over development versus conservation in Brazil, a country that bears the weight of international pressure to protect the Amazon from deforestation because its sheer scale could affect global climatic conditions. Ms. Rousseff, a former energy minister, has so far flashed a more pro-development stance, environmentalists say, shifting the balance from the administration of her predecessor, Luiz Inácio Lula da Silva, who appointed Ms. Silva.

Agriculture represents 22 percent of Brazil’s gross domestic product. The so-called ruralists in Congress say that the old code is holding back Brazil’s agricultural potential and that it needs updating to allow more land to be opened up to production. Environmentalists counter that there is already enough land available to double production and that the proposed changes would open the door to a surge in deforestation.

Last May, the House approved a more sweeping amnesty for those who had illegally deforested, outraging environmentalists and scientists. It did not help that the deputies refused to receive a group of respected Brazilian scientists that issued a report condemning the changes.

“In the House, there was very little consultation with scientists,” said Carlos Nobre, a scientist at Brazil’s National Institute for Space Research who specializes in climate issues. Still, he said, scientists “waited too long to realize that the House wanted to radically change the Forest Code, creating a broad and unrestricted license to deforest.”

Ms. Silva, who was raised in the Amazon, resigned in 2008 after a backlash by rural governors to restrictions on illegal deforestation she had put in place. But she left what environmentalists consider an effective policy to control Amazon deforestation. Among other tactics, Mr. da Silva’s government used satellite images to home in on deforesters, organized police raids and blacklisted the worst offenders.

“The ruralists have pushed so much to change the Forest Code because the government actually started enforcing it under Marina Silva,” said Stephan Schwartzman, director for tropical forest policy at the Environmental Defense Fund in Washington.

The vote in the House showed how heavily represented the less developed north and northeast are in Brazil’s Congress, a relic of the military dictatorship.

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