Home' Trinidad and Tobago Guardian : May 11th 2014 Contents Dr David Rodriguez, the cardiovascular medical
advisor for the regional office of drug company
AstraZeneca, is touting the drug Brilinta as
a solution to this country s problems with
Speaking with the Sunday BG, Dr Rodriguez said the drug
can cut down on the length of hospital stays for patients who
have had heart attacks and chest pain as a result of angina.
He said it also reduces the number of deaths due to heart
Quoting statistics from the World Health Organisation, the
cardiologist said around the world, someone dies of a heart
attack every 30 seconds. This, he said, is equivalent to some
seven million people every year.
Dr Rodriguez said this is an increase of a million individuals
when compared with figures in the year 2000, when six million
died from heart attacks.
Meanwhile, angina or an incomplete blockage of the heart s
arteries, is not as acute a condition as a heart attack, but its
treatment is expensive. Dr Rodriguez puts the cost of a single
angioplasty (widening of the artery) at between US$7,000-
Given the number of deaths caused by cardiovascular-related
illness, as well as the cost burden it poses to the health system,
Dr Rodriguez has proposed more widespread use of Brilin-
"Brilinta, compared with the previous standard we had,
improved survival rates about 23 per cent, when it is used in
the setting of a heart attack."
He said the drug has been tested among populations with
genetic similarity to those of Latin America and the Caribbean.
"With the previous medication we used to treat, around
25-40 per cent of our population had a resistance to it. We
did not find any resistance to Brilinta in the population."
Brilinta is already authorised for use in this country s private
healthcare sector and Dr Rodriguez said that AstraZeneca is
hoping its use in the public healthcare system will also be
Earlier this year, Dr Fuad Khan, the Minister of Health, esti-
mated that the treatment and after care of people with chronic
non-communicable diseases or CNCDs cost the public health
sector $5 billion.
At the time, he said the figure was very likely higher, since
this did not include the private health sector.
However, when he was contacted about the use of Brilinta
in the public system, he said Brilinta "was simply a drug that
prevents platelet aggregation" and he did not see it doing
"much more than similar drugs" that were currently being
Premier Heart Care Ltd, a company of doctors specialising
in cardiovascular issues indicated that Plavix and Prasugrel
are drugs considered to be in same class as Brilinta. Plavix is
manufactured by Bristol Squibb Myers, while Prasugrel, mar-
keted under different brand names, is produced by Eli Lily
The health minister added that "to combat CNCDs drug
usage is not the answer. The drug has to be assessed by the
ministry s FDA and committee before any placement on the
According to a release from AstraZeneca, "the new anti-
platelet agent Brilinta, works by interrupting the process of
ADP receptor activation, thereby preventing the platelets from
ADP or adenosine diphosphate attaches to the surface of
platelets. This causes the platelets to clump together, which
leads to blockages in blood vessels, a contributory factor in
angina and heart attacks.
There is currently controversy brewing over a possible take
over of AstraZeneca, by the American drug company, Pfiz-
er.On Friday, the Associated Press reported:
Pharmaceutical company AstraZeneca flatly rejected drug
maker Pfizer s sweetened takeover bid---worth $106 billion---
just hours after it was levelled, describing it as inadequate.
After being rebuffed twice, Pfizer Inc, the maker of Viagra,
made a third attempt for the London-based rival on Friday,
offering 50 pounds ($84) a share in cash and stock, a 7.3
increase on its last bid. The deal would be the biggest-ever
foreign takeover of a British business.
But AstraZeneca s board said the terms were not right and
the price substantially undervalued the company. The Anglo-
Swedish firm said the potentially lucrative "pipeline" of new
drugs it is developing would be disrupted by a takeover and
its possible consequences.
"Pfizer s proposal would dramatically dilute AstraZeneca
shareholders exposure to our unique pipeline and would create
risks around its delivery," said Leif Johansson, the chairman
of AstraZeneca. "As such, the board has no hesitation in
rejecting the proposal."
Pfizer s bid early Friday comes amid a spate of mergers and
acquisitions in the pharmaceutical industry, which is moving
to consolidate gains as the patents on some top earners expire.
Besides getting access to a pipeline with promising assets,
particularly in immuno-oncology, analysts suggest that the
deal gives Pfizer tax advantages.
"There is a highly compelling strategic, business and financial
rationale for combining our businesses, with significant benefits
for shareholders and stakeholders of both companies," Pfizer
CEO Ian Read said in a statement announcing the offer.
But the move quickly became political in Britain. Critics fear
the takeover could mean big job cuts, and the potential loss of
stature in the country s science sector.
Cognisant of the concerns, Pfizer sent a letter to Prime
Minister David Cameron, promising to keep the company s cor-
porate and tax residence in England. It said that the "golden
triangle of Oxford, Cambridge and London"---where a significant
portion of British scientific research is based---would represent
a vital component of the deal.
Cameron responded within a few hours, declaring that while
the government regards the potential takeover bid as a matter
for the respective boards, the government was "determined to
secure great British science, research and manufacturing jobs
in the life sciences sector."
"The government will consider these proposals carefully as
to whether they offer sufficient protection of our priorities,"
Britain is investing millions of pounds into boosting science
in the so-called "Golden Triangle" in the country s southeast.
Only last month, London Mayor Boris Johnson announced a
new investment organisation meant to attract life sciences cor-
porations and to facilitate collaboration between companies and
Besides access to the intellectual capital, some analysts say
the main impetus for Pfizer s interest in AstraZeneca is a wish
to limit a potential tax hit. They suggest Pfizer has earned
and held billions of cash overseas that it would have to pay
taxes on at relatively high US rates should it be brought back.
"Once the cash is offshore, the potential tax cost of repatriating
it to the US makes it much more attractive to find other homes
for it such as making foreign acquisitions," said tax specialist
Heather Self of the law firm, Pinsent Masons.
Other observers, like Alex Arfaei, the pharmaceutical analyst
for BMO Capital Markets in Toronto, said that regardless of
whether Pfizer may be doing this from a position of strength
or weakness, the deal represents a unique opportunity.
"It allows Pfizer not only to significantly lower its taxes ...
but also to optimise its vast commercial infrastructure following
the loss of exclusivity of some big blockbusters like Celebrex
and significantly boost its pipeline with some very promising
assets, particularly in immuno-oncology," he wrote.
Pfizer is the world s second-biggest drugmaker by revenue,
with sales of US$51.6 billion last year and staff of 77,700.
AstraZeneca PLC ranks eighth, with sales of US$25.7 billion
last year and 51,500 employees worldwide. AstraZeneca was
created in 1999 through the merger of Sweden s Astra and
Britain s Zeneca.
Paul Nurse, the president of the Royal Society, said that what-
ever the outcome of the takeover bid, it remains vital to the
UK economy to invest in research.
"Sadly, too much of the focus of this debate has been on
current share values, tax breaks and the short term profits that
can be made on the deal," Nurse said. "This is exactly the sort
of get rich quick culture that brought the global economy to
its knees a few years ago."
Cardiologist says new
drug to have positive
impact on health sector
Earlier this year, Dr Fuad Khan, the Minister of Health, estimated that the treatment and after care of people with
chronic non-communicable diseases or CNCDs cost the public health sector $5 billion. At the time, he said the figure
was very likely higher, since this did not include the private health sector.
DR DAVID RODRIGUEZ
PHOTO: ROBERTO CODALLO
SUNDAY BUSINESS GUARDIAN www.guardian.co.tt MAY 11 • 2014
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