posted
I'm on the mailing list for Random House books - think I got on it when I won a contest that resulted in me winning a free copy of the book Neanderthal.
Very interesting book announced this month. It's a real counter to the current media blitz drug companies are doing telling us how expensive what they do is and downplaying the payoff.
Here's the blurb:
quote:THE TRUTH ABOUT THE DRUG COMPANIES Former editor in chief of The New England Journal of Medicine and Polk Award winner, Marcia Angell, exposes the American pharmaceutical industry in THE TRUTH ABOUT THE DRUG COMPANIES. For more than two decades, Angell witnessed the influence of the industry on medical research and troubles the drug companies have encountered. Angell explores an industry that has moved away from its original purpose of finding and producing new drugs to a marketing machine that sells drugs of doubtful benefits. Here is a detailed look at an issue that has become one of great controversy in America today.
Some outrageous facts: * The pharmaceutical industry claims to be a high-risk business, but year after year, drug companies have higher profits than any other industry – by a long shot. In 2002, the top ten American drug companies had a profit margin of 17 percent, compared with 3.1 percent for the other Fortune 500 industries. The biggest drug company, Pfizer, had a profit margin of 26 percent.
* The industry claims to be innovative, but only a small fraction of its drugs are truly innovative. Of the 78 drugs approved by the Food and Drug Administration (FDA) in 2002, only 17 contained new active ingredients, and only 7 of those were classified by the FDA as likely to be improvements over drugs already on the market. Most of the others were just minor variations of old drugs.
* The most profitable drugs are variations of top-selling drugs already on the market – called “me-too” drugs. There are whole families of me-too drugs, and no good reason to believe one is better than another at equivalent doses. They cash in on already established, huge markets. The top-selling drug in the world, Pfizer’s Lipitor, is the fourth of six cholesterol-lowering drugs of the same type.
A couple of weeks ago, we were visiting Diane's mom in Michigan. Diane's sister works as a secretary at a very large clinic - I think it has 26 physicians in it. She says that lunch is provided for them all - on average - 4 out of 5 days in the week by various drug companies making pitches.
They don't mention that on the commercials, though. Posts: 4344 | Registered: Mar 2003
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posted
It's extremely high risk for a company starting out. You either strike gold quickly or you lose everything. Once you strike gold, you're set.
The problem with innovation is true of every industry, not just pharmaceuticals. The vast majority of new patents are for tweaks and not completely new things. Tweaks are cheaper, safer, hit the market faster and require less man power than a brand new invention. (Not that I'm not saying it isn't a real problem, it certainly is. But pharmaceutical companies, like everything else, take the path of least resistance).
The major reason why "mee too" drugs are so common is because of the flood of generics. The generic drug will also be patented and are necessary to bring the cost of a drug down. Again, not saying that this mentality isn't a problem, but the bullet wasn't telling the whole truth there.
The biggest problem with the actual development of drugs is that there is little to no interest in developing cures. The whole mentality of the industry isn't about making people better it's about milking people with an illness. It's becoming more and more like marketing cigarettes every year.
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posted
They had a thing on this about NPR earlier today. It seems as though many hospitals and doctors' offices are beginning to "fight back" against drug company reps by refusing to take free stuff, including meals. A division of Harvard medical school actually began their own program to educate doctors by training people to use similar techniques that drug reps do.
posted
I'm sure her information is accurate. The thing that makes the company high risk is that there's no guarantee on innovation. They may not discover anything this year, maybe nothing the next year and the year after that as well.
Now, I do think that the odds of this are pretty remote with the advent of brute force techniques. Once your company gets big enough and can afford the equipment (and patent lawyers) to churn through tens-hundreds of thousands of molecules per project you're going to hit something. Clearly playing the game of averages works or they wouldn't be doing it. So if a company strikes gold on its first few projects and gets to a sufficient size it goes from an extremely high risk industry to an much lower risk one. The current laws, however, do not reflect this.
Edit: That's Marcia Angell, not Marc as I originally read.
[ August 18, 2004, 04:07 PM: Message edited by: Bob the Lawyer ]
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I heard something on talk radio this morning (*wonders if I can find in in text on internet*) about how your state of Illinois is leading the way in making drugs affordable for people. I was pretty impressed, and it reminded me some of the conversation I had with Diane at KamaCon....
posted
Umm... You do realize I'm not trying to defend Big Pharma, right? I just don't think misinformation or being unclear helps anyone.
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CT, I totally get it, although I'm looking at it from the other side of the coin (get it? Coin? Ha ha?). I just feel squicky saying bad things about Big Pharma from my beautiful terminal at my cushy desk in my cozy office at my comfy Big Pharma job. Ask me when my term ends on September 3rd Posts: 3243 | Registered: Apr 2002
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Farmgirl asked about the new Illinois plan to lower prescription costs. One of the underreported parts of the new Medicare regs coming into effect is that states will be prohibited from negotiating lower prices for medications - something they've been able to do in the past to keep costs down.
Our governor is just the latest to attempt to get around this - by ignoring yet another set of rules set to favor the industry.
quote:Gov. Blagojevich drew the national spotlight Tuesday by announcing the most ambitious effort yet by a state to quell the rising cost of prescription drugs.
And while the savings might be substantial for some consumers, the governor's plan to break new ground by looking across the Atlantic for a reliable, safe and cheap drug supply faces potential pitfalls.
Blagojevich -- appearing with Rep. Rahm Emanuel (D-Ill.), a champion of drug importation -- brimmed with optimism during an afternoon news conference as he touted savings of 25 to 50 percent if consumers take advantage of the program to contact 35 pharmacies and drug wholesalers in Canada, Ireland and the United Kingdom approved by state health inspectors.
Here are some of the 100 drugs that Illinois plans to offer through a first-of-its kind program that would allow people to buy prescriptions on the Web or by phone from Canada, Ireland and the United Kingdom. The following prices are for a 3-month supply:
They said the program is especially needed by the estimated 23 percent of the state, including 500,000 seniors, who lack prescription drug coverage.
"We've turned our senior citizens into coyotes," Emanuel said. "They're running over to Canada to get drugs."
While Blagojevich asserted that imported drugs are "as safe or even safer" than buying medications at the corner pharmacy, the federal Food and Drug Administration opposes bringing in drugs from other countries because of safety concerns. Beyond that, similar programs in other states aren't proving particularly popular with consumers.
What's more, the state hasn't inked a contract with a company that will oversee the network of foreign pharmacies and drug wholesalers. And the list of the roughly 100 brand-name medications eligible for purchase hasn't been finalized.
Still, Blagojevich said the program should be up and running in about a month.
The governor could be headed for a showdown with the FDA, which has stopped short of pulling the plug on other states' efforts to link consumers with Canadian pharmacies. Illinois would be the first state to reach beyond Canada for drug savings -- and that might be the trigger that forces the FDA to act.
"As long as they're coming from Canada, and as long as they're from drug stores that we have some experience with, then we would have a lighter touch probably," acting FDA Commissioner Lester M. Crawford recently told the Associated Press. "But if it escalates and there are other countries or if there are some events that occur, that could change overnight."
Even if the FDA allows Blagojevich to go ahead with his plan, it remains to be seen if consumers will buy into it. Some states that have created Web sites to help consumers buy cheaper drugs from Canada haven't seen a huge demand.
Minnesota's Web site, which debuted in January, has taken in about a thousand drug orders so far. Minnesota officials say they haven't aggressively marketed their site, which may account for the somewhat lackluster response. Minnesota pharmacists chalk it up to a lack of trust on behalf of consumers.
"It's our opinion that people just aren't comfortable with it," said Liz Carpenter, spokeswoman for the state's pharmacists association.
Blagojevich insists Illinois' program will be different because it will include both a Web site and 24-hour toll-free hotline, and draw from a wide array of drug suppliers who would be subject to annual state inspections. The governor noted Illinois has been forced to look to Europe because at least five major drug makers have begun limiting supplies to Canadian pharmacies that Americans use.
The program would be limited to Illinois residents and to prescription refills. Generally speaking, consumers could compare drug prices by phone or online and place orders with the yet-to-be-named Canadian contractor who will oversee the program for the state.
The governor said the state is prepared to fend off legal challenges to the program, either from the FDA or the pharmaceutical industry.
"There is nothing in the law that prohibits us from doing this. The FDA simply said we shouldn't do it," said Blagojevich, who explained the program on CNN Tuesday afternoon. "I believe it's not only legal, but more importantly it's the right thing to do for our senior citizens, for working families, for kids who need medicine."
You really should check this article directly - it includes a comparison chart of the costs of common prescription drugs by country. The cost differences are amazing! (It didn't read too easily when cut and pasted so I left it out)And of course US consumers pay the highest prices - by far.
Please remember this was just the promotional blurb. Angell's someone I disagree with on a number of issues, but I actually expect her to have done the required work on this.
And I'm probably not as bothered by the possible distortions and oversimplifications in this blurb - not when I try to gauge its impact against the steady stream of advertisements I'm getting from Big Pharma companies that attempt to paint a picture that is even less accurate.
They're well done, though. And they probably work.
Makes it hard for me to get to caught up with possible distortions in this material - it's guaranteed to reach a smaller audience.
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posted
I understand that argument, sndrake, it's the same one I hear from supporters of Moore's documentaries. But I suspect most people think pharmaceutical companies stink (especially those buying this book) and don't need anything more convincing than the truth. If you can paint a clearer picture with one or two more lines, shouldn't you?
But you're right, I shouldn't judge a book by its cover or its online promotional blurb Thanks for pointing it out to me though, I'll probably pick it up.
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Hmmmm... interesting viewpoint you linked to Stephen. The commentary on the radio sure made it sound like a good thing, just as your Governor's office is apparently trying to do, as well...
I personally don't have a problem with imported prescriptions if it saves money, and is regulated to be safe.
quote: The biggest problem with the actual development of drugs is that there is little to no interest in developing cures. The whole mentality of the industry isn't about making people better it's about milking people with an illness. It's becoming more and more like marketing cigarettes every year.
This is what worries me. When drug companies' bottom line is profit, then actually curing people is not in their interests.
I have to ask myself, what could they be curing, if that was their primary goal? And if someone did accidentally stumble on the cure for asthma, or diabetes, or some other condition that calls for sometimes lifelong pharmaceutical purchases, would they market it, or bury the details in a file cabinet somewhere in the basement?
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quote: I have to ask myself, what could they be curing, if that was their primary goal? And if someone did accidentally stumble on the cure for asthma, or diabetes, or some other condition that calls for sometimes lifelong pharmaceutical purchases, would they market it, or bury the details in a file cabinet somewhere in the basement?
That's one nice thing about a competitive market. Several drug companies are selling asthma and diabetes drugs. So if one of their research scientists discovers a cure, it's likely that the same discovery could be just around the corner for a competitor, which is the only incentive I can think of for releasing these types of discoveries. Greed exists everywhere, and if we have good and well-enforced anti-trust laws to keep them from colluding on secrecy, it's the best way to keep things like this from happening.
I'm on Bob's side... I don't want to sound like an apologist for the drug companies. I think if we let them do whatever they wanted, they'd feast on the blood of our children. And I'm not pro-status quo, either. I think there are definitely things that can be done to make the system more efficient, and an examination of Big Pharma is entirely appropriate. But you have to remember that their greed is responsible for a great deal of the gargantuan leaps medical science has taken in the last century. We can't let them run loose, but we're never going to pass a law that requires them to act totally altruistically either. And if we take away everything that's driving them to innovation, we're never going to have a new drug again. Regulation takes a light touch, and I don't think that a kind and caring drug industry is an achievable goal by any means.
[ August 18, 2004, 03:59 PM: Message edited by: Speed 2: Cruise Control ]
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Malaria is one of the most deadly diseases on earth.
Nobody is working on an immunization for it, though it would save tens of thousands of lives.
Why? Because such an immunization would be sold for pennies, once or twice in a life time to every person possibly infected.
While a "cure" for the symptoms of Malaria go for $20 on up, are taken often, by anyone infected. The profits are much greater. Why should a company not spend money developing something that will be more profitable.
Its not like they are killing people.
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quote:I have to ask myself, what could they be curing, if that was their primary goal? And if someone did accidentally stumble on the cure for asthma, or diabetes, or some other condition that calls for sometimes lifelong pharmaceutical purchases, would they market it, or bury the details in a file cabinet somewhere in the basement?
Who knows? A lot of the problems with the Big Diseases (cancer, AIDS, Alzheimer’s, Parkinson’s, etc) is that not enough is known about the disease to really know what you're trying to treat. Drug companies, by and large, aren't set up to do large-scale research into the causes of diseases. People do that stuff off of government grants at hospitals and universities. Could they? Well, they could probably afford to, but I can see it being awkward to fit it into a company.
Assuming it's possible to simply trip over a cure (which it really isn't. There were many, many years between the discovery of penicillin and its production as a drug) Yes, they would sell it. It's in their best interest to. They've spent nothing on the development and they're sitting on something that no other company in the world can provide for an illness that thousands/millions of people are suffering from. Even if it's just a one-time cash infusion it would make for astronomical profits.
Which kind of leads into another problem with drug development: There's no work being done on diseases that effect a small population. That's another setback with Dan's example of malaria; tens of thousands of people are a drop in the global bucket. It wouldn't even be worth treating if they were all in America willing to pay the ludicrous American prices.
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