I completely agree, Traci. Can't blame Novartis -- they are a publicly traded company and have to make a profit. New revenue streams need to be marketed and promoted to replace dying revenue streams. It's why banks are trying to tack on more consumer fees; their cap on merchant fees for debit cards was lowered, so they are motivated (profit) to replace the lost revenue -- either by cutting costs, adding value to existing products [good luck, banks!], or generating new forms of revenue -- or, all of the above.
Here is a link to a BusinessWeek summary about Novartis that I posted back in the summer:
http://community.lls...e/112451#112451
The key is to have 'definitive science' that proves the increased effectiveness of Tasigna over Gleevec on progression-free survival ... in my mind, that's the golden ticket that will move Tasigna (or Sprycel) to the de-facto first-in-line in hematology. Is the data collected to-date considered good enough to make this conclusion (Yes/No/Maybe)? The other factor that will have an impact is the ability for hematolgists to make even-better informed decisions at diagnosis on whether a patient will respond long-term to a lower-cost therapy. If they have enough information at diagnosis to know that the lowest-cost therapy will be effective for 5+ years, then clearly they will advise the patient based on cost. Or will they? Or will they be allowed to?
The irony is that I find this topic of business behavior so interesting, yet here I am as a CML patient who has to rely on a therapy manufactured and sold by Novartis. Fun fun....