Pharamaceutically Insane
Can we take a look at the big “buying drugs from Canada” debate? For a minute? Please? Okay great. Thanks. I’ll just be a minute.
Let’s look at this completely logically, because right now, it seems like the debate couldn’t be any more ludicrous.
* Big Pharma is, of course, trying to keep this from happening. The US is the only developed country that doesn’t have some sort of bulk-purchasing plan. Hence, Americans pay a hell of a lot more to American companies for their prescription drugs than any other non-American does. (You’d think the way the political climate is, they’d try to overcharge France or Germany. But no.)
* Lawmakers Are Negotiating Import of Prescription Drugs (NYT link) from Canada, and of course, Big Pharma is trying to fight it. (They claim to be concerned for Americans’ safety, since there have been ALL those outbreaks in Canada of fake pills being distributed. Nice try, Pharma.)
* Americans (or our legislators) seem to think we’re so entirely anti-government that we’re willing to buy from for-profit pharmacies in Canada instead of just instituting a nation-wide bulk-purchasing plan here in the US. Note: We already have several, through the VA and the Department of Defense. I’d argue Americans are more anti-getting-ripped-off than anti-government, and if the US government could get us drugs even cheaper than Canada (since we have a larger population base), and have them closer to people (instead of having them shipped from Canada, being able to pick them up down the block), this would be a Good Thing.
What the hell is going on here? We trust the Canadian government, but not our own? We wouldn’t even have to create a new program–just expand one of the current ones. Could we be logical about this? Or even economical? Unless I’m missing something, I’m having a really hard time seeing how buying drugs from Canada, and exporting a gigantic sum of money to their economy is as useful as establishing a similar bulk program here, and keeping the money in our own country. (Sorry, Canada.) And if there’s some sort of “socialized medicine” argument here, hanged if I know where to find it. This is pills, not people.
Oh, the explanation is very simple.
Americans are stupid.
:)
Americans are paying (through the far higher Rx med costs) for the R&D (and advertising and training) that the rest of the world is taking advantage of.
The “correct” solution would be to make these other countries pay their fair share – but, as long as the “evil drug companies” and “evil US” agree to let Canada and the other socialist paradises have the drugs at less than fair cost the US taxpayer will continue to subsidize them.
If somehow the drug companies (especially the non-US based ones) actually charged EVERYONE a fair (not fiat) price, we might have a drug plan for all US Citizens.
I’m more apt to believe that Americans are paying more for the extensive marketing here and legal tactics to extend patent life than I am to believe the R&D Myth – take a look at Rx spending breakdowns (PDF). And just for good measure, here’s how the patent loopholes work (PDF).
And I’m more apt to use my experience in the pharm and health care industries. The biases in the reports you cite are obvious – for example, if the $500 mil cost per drug is highly misleading, then what exactly is the correct cost? (Hint, closer to a billion). Costs that are tax deductable are still costs – the deduction is not a tax credit, it’s simply a deduction from taxable income, and every business (and most other taxpayers) can use some sort of tax deduction (for example, ask your parents how much their home mortgage deduction actually reduces their taxable income each year).
Pharm companies do spend a lot on advertising – no doubt about that. The Bagel affect is well understood, and how many pharm pens, clipboards and do-dads do you have? But, advertising costs are still a necessary part of doing business. Do drug companies take it to the legal extreme? Of course, but why are drug companies expected to be poorer stewards of their shareholder (ownders) money than car companies?
If physicians had any ethical concerns about the pharm give-aways, they should take the “just say no” pledge from AMSA.
The federal government (through the incompetents at NIH) allowed some drugs developed with government funding to be brought to market without adequate return – taxol is a good example. But, until the government granted the patent, no drug company was willing to take on taxol development. The drug may have been developed with government funds, but the government would be first in line to delay approval, and blame the company who brings it to market for any problems or suits for problems, real or imagined that might develop out of it.
Looking at the way drugs are developed in the US, what exactly would you propose? What drugs have been developed in Candada lately, or with funding from the European Union? The profit motive is what drives pharm development in the US, and pharm development in the US is what drives the rest of the world to a large extent. Yes, some of the european (only) companies produce drugs (which for various reasons the FDA delays in the US), but mostly it’s US development for US consumption.
What other changes would you make in the system? Unless you’re going to be a pathologist, you should work up a plan to fix the problem after the assessment. I hope your plan isn’t for governmental control of anything, the historical record of government involvement in just about everything is a disaster.
You make some good points that I hadn’t considered, Rirchard. Thanks.
I still can’t help but argue that the costs are peanuts for drug companies–they’re by far the most profitable corporations on Wall Street.
And if we want to be fair about it, I’d argue that a great deal of the basic, bench research that’s required for the basic scientific discoveries that uncovered the secrets of our bodies (and therefore, how to alter them with drugs) are done with money given out by “the incompetents at NIH.”
If you’ve got research showing the percentage of drugs developed by the US versus other countries, I haven’t seen it yet. Just because it doesn’t make the news that some other country developed a drug (or did some fundamental research to contribute to it) doesn’t mean it doesn’t happen.
It’s interesting that you’re so anti-NIH. Every single person I’ve ever talked to thinks that the NIH is one of the country’s *best* government programs. Not to mention public libraries, the national highway system, the CDC… I’d argue that there’s a fairly substantial list. Governments are good at some things, corporations are better at others.