Sunday, January 27, 2008

Big Pharma

One thing that infuriates me is the way Big Pharma operates in this country. The costs for prescription drugs are completely out of control. This component is certainly helping to drive up the expenditures in an already overextended health care system in the US.

A few points that I want to make:

1. The common reason voiced for high prices by these companies is that they need the money for research and development. A recent study from York University found that only 13.4% of the money spent is on R&D. However, 24.4% is spent on advertising. That amounts to over $40 billion dollars spend on advertising. I cannot comprehend why drug companies need to advertise prescription drugs on television. Patients themselves cannot write their own prescriptions. The usage of suggestive imaging, and creative marketing platforms subtly shape the population's opinions about these drugs and bias them in a manner that has nothing to do with their true efficacy or cost-effectiveness.

2. Drug companies suppress information in order to continue to churn profits. Merck is at least a two-time offender. First, they knew of the increased risk for cardiovascular events associated with their arthritis drug Vioxx a few years before the information became public. There was suppression of data so that Merck could continue to sell it's blockbuster drug. Second, they also knew about the results of the recent study of Vytorin that demostrated that despite greater reductions in cholesterol, their drug Vytorin did not reduce the amount of plaque in coronary arteries (in fact, it may have increased the amount). If this result had been positive for Vytorin (reduction in plaque amount), these results would have been released immediately at a scientific conference and been propogated on the major news networks. Instead, the information was withheld for some time, so that sales could continue in the interim.

3. The proliferation of "me-too" drugs do little for advancing the practice of medicine and improving the health of our population. Millions of dollars are spent trying to tweak a drug to achieve an efficacy or side-effect profile that is just a shade better than a competor. How many proton-pump inhibitors are needed? How many ACE inhibitors are needed? Instead, these monies and efforts should be spent on disocovering new therapeutic targets.


kath said...

Amen, sister! I don't know if this still happens but in the late 90s big pharma used to shmooze MDs and spend absurd amounts of $$ on them (including international trips) counted as R&D because they would say this time with clinicians was essential to their R&D...

Will said...

What's this ?!?! another chink in the armor of the all powerful free market??!?! how many more ace inhibitors do we need? as many as the invisible hand can create -- say 2,000 or so? Steve, you've brought up another perfect example of free market failure -- a situation where consumers do NOT have perfect information and therefore cannot be rational actors in a market system. So who is brokering on the individual consumer's behalf? FREAKIN' insurance companies!!!!! tied for most abhorrent players (w/ pharma) in this entire health care crap fest. SINGLE PAYER! SINGLE PAYOR! healthcare is not widgets and the free market has no place in it . Sound healthcare is a public good just like nat'l defense and lighthouses and roads. good god, y'all there are direct-to-consumer adds for EPOGEN!!!!!!!!!!