Double-Dealing Drug Companies
By
Michelle Mairesse
The Food and Drug Administration’s decision to
let pharmaceutical companies televise prescription drugs ads released a
juggernaut that is still rolling over the medical landscape.
No sooner had Republican candidate for president
Bob Dole lost the election to Bill Clinton than he became the poster boy for
"erectile dysfunction" and top salesman for Viagra throughout the world. It was
an easy sell because Viagra had no competitors, but after several men died when
they combined Viagra with their heart medication, the manufacturer prudently
attached a brief warning label to its product.
Owing to fast-track FDA approval,
manufacturers have promoted a number of inadequately tested drugs. The infamous
diet drug Fen-Phen was recalled in 1997 after users sustained heart-valve
damage. Trovan broke all antibiotic sales records in 1998, but the FDA issued a
public health advisory that Trovan inflicted severe liver damage on some
patients and was implicated in six deaths. Rezulin, a heavily-promoted diabetes
drug that got fast-track approval in 1997, has been linked to over 215 reported
deaths, but it was not taken off the market until March 21, 2000.
Many of the highly advertised new drugs
were more expensive and less effective than compounds already on the market. A
thirty day supply of Claritin cost about $66 compared with $1.40 for
non-prescription chlorheniramine, but patients are still clamoring for Claritin
because they’ve been "educated" by advertisers.
All unwitting, the general public is now
subject to the same inaccurate and unbalanced advertising blitz pharmaceutical
companies impose on physicians. The medical journals themselves, dependent on
pharmaceutical advertising, cannot be trusted to present unbiased information.
 Professor Allan Detsky and associates from Toronto
Hospital conducted a study of seventy articles about calcium channel blockers
that appeared in the New England Journal of Medicine. They concluded that
two-thirds of the articles "had industry backing" and that all of the authors
who favored calcium channel blockers had "financial interactions" with at least
one pharmaceutical manufacturer.
It
certainly pays to advertise. In 1998, drug companies earned $22 billion,
chalking up a 5% greater profit margin than that of any other American industry.
They had a little help from their friends, of course. The Congressional Research
Service reported in 1999 that the drug industry paid 16.2% in taxes from 1993 to
1996, while all other major industries had an average tax rate of 27.3%. The
drug industry was able to reduce its tax bill by approximately $3.8 billion in
1996 alone, owing to tax breaks for research and development granted by a
Congress awash in drug company donations.
The National Institutes of Health donate
research to the industry, which patents the information, although it is acquired
at taxpayer expense. The FDA works hand in glove with the industry and too often
grants its seal of approval to drugs that have not been subjected to independent
testing.
Are the drug companies grateful for their
privileged status in the United States? Not at all. As early as 1992, a General
Accounting Office study concluded that drug companies charge Americans double
the price they charge Canadians. The explanation is simple: In Canada, the
Canadian Patent Medicine Prices Review Board regulates prices; in America, the
pharmaceutical companies regulate prices. Only large institutions, such as the
Veterans Administration, large insurance companies, and HMOs, can negotiate
prices with the drug companies in America. (Individual consumers, who have no
negotiating power, pay double, according to a staff report issued by Maryland
Representative Elijah E. Cummings in 1999.)
Since the GAO report appeared, the price
Americans pay for prescription drugs continues to exceed that of any other
industrial nation. In 1998, the Canadian Pharmaceutical Medical Review Board
compared American pharmaceutical prices with European prices. Prescription drugs
in the United Sates are 96% higher than in Italy, 75% higher than in France, 55%
higher than in the United Kingdom, 47% higher than in Sweden, 40% higher than in
Germany, and 26% higher than in Switzerland.
Several congresspersons have recently
issued staff reports documenting the blatant profiteering of American
pharmaceutical companies. The report prepared for Representative Bernard Sanders
in November 1998 found that the average prices senior citizens in Vermont paid
were 81% higher than the Canadian average and 112% higher than the Mexican
average.
Elderly Amercans, 12% of the population, use 1/3
of all prescription drugs. Is it any wonder, then, they have begun to organize
junkets to Canada and Mexico to take advantage of lower-priced pharmaceuticals?
Public Citizen’s President Joan Claybrook
believes that Congress must act to control runaway prescription drug expenditure
inflation because any Medicare prescription drug benefit plan is likely to cost
too much and offer too little in benefits. “Neither the seniors and people with
disabilities who rely on Medicare nor the taxpayers whose dollars will support
the drug benefit can afford to subsidize drug companies’ escalating prices and
profits," she said.
Senator Ted Kennedy and
several other liberals advocate tying Medicare prescription coverage to
discounted drug prices. They will need all the support they can get because drug
companies do not want Medicare prescription coverage. Such coverage would
eventually entail price ceilings, and why impose price ceilings when the sky is
the limit?
The drug industry’s advertising
barrage has already begun. They tell us that we don’t want the government in our
medicine cabinet; let the government regulate drug prices and the next thing you
know, you won’t have a choice, etc. Does anyone doubt that drug industry
lobbyists are pouring money into congressional coffers and attempting to build a
fence around their money tree? The FDA, a regulatory agency infested with
representatives from the industry, has warned Americans against purchasing drugs
from Canadian sources, but the warning hasn’t stopped the rush to the
border.
Mark Catroppa, vice president of
marketing and operations for CanadaPharmacy.com, fills around 600 prescriptions
daily online for more than 2,000
medications.
He discounted the risks the
FDA cited, saying Canadian and American standards for pharmacies are similar,
that in most cases, the drugs are manufactured in the same places, and that a
Canadian doctor and pharmacist review prescriptions to verify them and check for
possible drug interactions. The same amount of the breast cancer drug tamoxifen
that a major U.S. pharmacy sells for $340 costs only $56 at CanadaPharmacy.com,
Catroppa said.
The numbers speak for
themselves. We need a government that cares more for the general welfare than
for the particular campaign contributor. Maybe next year?