The Medicines Company Case

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Value: Angiomax is a blood-thinning drug, or anticoagulant, used in emergency coronary heart care. Angiomax is positioned as an alternative to heparin, the most commonly used anticoagulant in emergency coronary heart care, so to assess Angiomax value to a hospital is required to compare these two drugs.

First of all is necessary to analyze the differences in effectiveness of the products in treatments. The use of heparin has associated some general disadvantages like: • Unpredictable effects: it is difficult to use properly since its effectiveness depends on achieving a certain level of anticoagulation of the blood, too much might lead to uncontrolled bleeding and too little might not prevent a blood clot • • High risk of uncontrolled bleeding: it is necessary a tight monitoring of patients in order to identify and control potential major bleedings after the use of heparin Risk of adverse reactions: the use of heparin could cause a thrombocytopenia (HIT) in some patients • Needs several hours to the observe the effects: cardiologists said that it might be necessary wait three or four hours to see if a dose of heparin has the desired effect In contrast, the effects of Angiomax were very accurate and predictable, since it works faster than Heparin so it is easier to know if the desired effect was obtained. Some studies conducted discover that the use of Angiomax in has associated at the same time a lower risk of major bleedings and risk of adverse reactions in patients. Angiomax is more effective than Heparin, especially in “high-risk” and “very high-risk” patients, that accounts for 50% of all the angioplasty patients (40% “high-risk” & 10% “very high-risk”). However, for the other 50%, the low-risk patients, Angiomax was also better, but the differences when compared wit heparin are not so significant as in the other half of patients. The higher quality and capabilities of Angiomax described create the Functional Value that the hospital could benefit through the use of the new drug. The doctors, who are the potential users, are more concerned with the results and performance of the drug in treatments. It is important to assess what economical/monetary value the Angiomax could offer to a hospital, especially to convinced the administrators to approve the drug for ongoing use within the hospital. Since the major disadvantage of Angiomax is its production cost of $40 per dose against the $2 per dose of heparin, that leads for sure the selling price of Angiomax to be higher. Hospital’s decision will depend on whether the cost savings compensate the higher price of not. Angiomax reduces the probability of complications during angioplasties that can cost on average $8000 for a patient who experienced complications or eventually die. These extra costs are not reimbursed by insurances, they absorbed by hospital. Therefore, the use of Angiomax allows the hospital to benefit from some cost savings since the use of Angiomax decrease the risk of complications after the treatment and consequently the extra cost associated, especially in high-risk patients (Heparin=16,5% Angiomax=9,5% Δ=7% means a saving of 560$) and in very-high risk patients (Heparin=21,4% Angiomax=7,8% Δ=13,6% means a saving of 1088$). At the level of low-risk patients the cost savings are not so significant, it only represent a half of the cost savings of high-risk patients, 280$.

Angiomax has associated lower risks both for patients and to hospital than the other alternative drug heparin, so Hospital could believe that they can trust Angiomax, since with this new drug hospitals can offer to patients a better, safety and reliable treatment, and consequently save more lives. Market: The Medicines Company initially will try to market the 700 centers across the USA responsible for 92% of all angioplasty procedures. Angiomax, as a prescription drug, appears to be part of a big market that move a huge value of 220 billion dollars in sales worldwide at the...
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