Hasn't Pfizer made enough money?

Full-year 2021 revenues totaled $83.1 billion, an increase of $39.6 billion, or 95%, compared to full-year 2020, reflecting operational growth of $38.4 billion, or 92%, and the favorable impact of foreign exchange of $1.2 billion, or 3%


A friend was recently diagnosed with #ATTRCM, which stands for transthyretin (pronounced trans-THY-re-tin) amyloid cardiomyopathy, is a serious and underdiagnosed type of amyloidosis that primarily affects the heart and leads to heart failure.


The back story my friend has had congestive heart failure for over 17 years, received three and a half stints and has been doing great. This summer some symptoms of #CHF (congestive heart failure) came back and after a hospitalization, and a couple of tests his cardiac catheterization came back without blockages. Great news!!


Cardiac catheterization (kath-uh-tur-ih-ZAY-shun) is a procedure in which a thin, flexible tube (catheter) is guided through a blood vessel to the heart to diagnose or treat certain heart conditions, such as clogged arteries or irregular heartbeats. Cardiac catheterization gives doctors important information about the heart muscle, heart valves and blood vessels in the heart.


We thought we were out of the woods but he became symptomatic again this winter and he was sent to a #CHF specialist and a nuclear stress test showed ATTR-CM.

What Is ATTR-CM?

ATTR-CM is inherited as an autosomal dominant trait caused by mutations in the transthyretin gene (TTR) or by the deposition of wild-type transthyretin proteins. Tafamidis slows the progression of ATTR-CM—it doesn’t cure it—but experts have cautioned that a delayed diagnosis typically leads to worse prognosis. The average life expectancy from the time of diagnosis until death is roughly 2 to 6 years.


That quarter-of-a-million dollar per year price tag might be justified if ATTR-CM was an extremely rare condition, but experts say that just isn’t the case. To TCTMD, Ronald Witteles, MD (Stanford University Medical Center, CA), who is co-director of the amyloid program at his institution, said he was “surprised, and not happily so” when Pfizer announced the price of tafamidis following the FDA approval.

“It was priced like a drug is typically priced for a truly rare disease, which this simply isn’t,” he said, adding that if there were 1,000 people or fewer in the country with ATTR-CM, the inflated price tag might be expected. “It’s not common like high blood pressure or coronary artery disease, but it is definitely not truly rare.”

Like Maurer and Gurwitz, Witteles pointed out that Medicare Part D patients in the coverage gap can be responsible for up to 5% of the drug costs. “For a drug that’s $1,000 a year that isn’t too big a burden,” he said. “For a drug that’s $225,000 a year, that’s a very different story.”


That translates to $25,000 a year out of pocket for Medicare patients that are on a fixed income.

Maurer said the prevalence of ATTR-CM is not truly known, noting that there are few population-based #epidemiological studies documenting the #disease. Pfizer estimates the prevalence of ATTR-CM to be approximately 100,000 people in the United States and that approximately 4 to 5% of people are diagnosed, but Maurer and Gurwitz highlight one study suggesting a prevalence of 13% among patients with heart failure with preserved ejection fraction (HFpEF) and increased wall thickness.


"Several heart failure physicians, specifically those who treat patients with cardiomyopathy caused by transthyretin amyloidosis (ATTR-CM), are calling attention to the extraordinarily high price of tafamidis and tafamidis meglumine (Vyndamax and Vyndaqel; Pfizer), both of which received orphan drug designation and were approved by the US Food and Drug Administration in 2019."


With a list price of $225,000 per year, tafamidis is the most expensive cardiovascular drug on the market. Mathew Maurer, MD (Columbia University Irving Medical Center, New York, NY), who published his views along with Jerry Gurwitz, MD (University of Massachusetts Medical School, Worcester), January 8, 2020, in JAMA Cardiology, told TCTMD the high prices for tafamidis “are not justified and appear to be a particularly egregious example of price gouging.”


Source: https://www.tctmd.com/news/outrageous-225000-year-list-price-tafamidis-draws-outcry


While #Pfizer offers #financialassistance there is still out of pocket costs that many can't pay and therefore can't afford the medicine and suffer. (See above link written by prescribing doctors). https://www.vyndalink.com/patient/financial-support#government-insurance

When this drug is put through reduced pharmaceutical discount services like #GoodRx Gold here are the results:

Yes, you are reading this correct. The average retail monthly cost for this medicine is 34,160, but you can get it "cheaper" for $19.968.25 if you have a subscription to this discount plan. I don't know about you but


I don't know anyone that can afford this or a quarter million dollars a year on a life saving, cardiac medicine.


#Pfizer is calling this diagnosis rare but top #cardiologists do not agree. They also say that the price is this high due to research costs, but clearly Pfizer can offset these costs with a 2021 revenue of 83.1 Billion and projecting 100 Billion for 2022.






https://www.marketwatch.com/story/pfizer-expects-a-record-100-billion-in-revenue-this-year-thanks-to-covid-vaccines-and-treatments-11644356651


That said, all signs point to a record financial year for Pfizer in 2022. The company said it expects Comirnaty revenue of $32 billion and Paxlovid revenue of $22 billion this year. This means that Pfizer expects to generate revenue of $98 billion to $102 billion this year, marking the first time in the country’s history that forecasted revenue crossed the $100 billion mark, executives said. That’s up from $83.1 billion in revenue in 2021 and way up from $41.9 billion in revenue in 2020.


Many people have the incorrect assumption that when someone retires they have a lot of money to spare. This is the farthest thing from the truth. The majority of retirees are on fixed incomes from a pension, disability, and or combination with social security income.


According to U.S. Census Bureau data, the median average retirement income for retirees 65 and older is $47,357. The average mean retirement income is $73,228. These numbers are broken down into median and mean to more fully understand the average retirement income. The most recent data available is from 2019.


The Difference Between Mean and Median Income

Obviously, there’s a big difference in average retirement income based on whether you’re talking about the median or the mean number. The mean retirement income is about one-third higher than the median retirement income. So what’s the difference?

Median retirement income is calculated by listing every retirees’ income in order, from lowest to highest. The number right in the middle — with half of retirement incomes higher and half lower — would be the median.

The average or mean income is calculated by adding all retirement income and dividing this by the total number of U.S. retirees or households. According to statisticians, the median number is probably more representative of the actual average retirement income in the U.S. than the mean number. This is because households with higher retirement income tend to skew the mean calculation toward the high side.


Source: See the link attached for 2021 estimates You will note as you get older both the mean and median decrease. COLA (cost of living) differences are not incorporated into these numbers For example, a median income of $54,000 for a retired 65-year-old couple living in the rural Midwest would probably allow for a more comfortable retirement lifestyle than the same income would for the same age couple living in a high-cost metropolitan area like New York City or San Francisco.


https://www.personalcapital.com/blog/retirement-planning/average-retirement-income/


Source: #AARP



The Pension Rights Center reports that half of all Americans age 65 or older have incomes less than $24,224 a year. That number is lower because it’s only individual incomes of those above the age of 65, not household totals. As you can see from the numbers above, the median household income falls as you move farther up in age.






Given the above date on retiree income, how does Pfizer think those in the population that are at the most risk of cardiac issues could possibly afford a medication that costs roughly $21,000 per month to stay alive, suffer less or maintain the heart muscle from further atrophy and heart wall thickening?


I'd say that the estimate of making between 100 and 103 billion in 2022 could offset the expense of research on Vyndamax and Vyndaqel.
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