Tuesday, March 25, 2014

NYT Editors Are Right -- PhRMA Is Running An Ill-Informed, Unfounded Scare Campaign

We all know that buying from just any online drug spam mailer would be stupid -- and dangerous. That's true. But this is not that. [Background here -- the latest one, of about twenty I've written on the topic. Search "reimportation" in the upper left-hand search box -- for the rest.]

This morning, the editors of The Gray Lady lay out a very calm, sensible, and data driven argument in favor of reducing the medicine costs for the lower one third of our population, by allowing reimportation -- sanctioned, licensed reimportation. [And I will offer that this is the logical implication of their well-taken argument.]

In the mean time, they advocate buying from reputable online pharmacies. In almost every case, the buyer is getting the very same drug, from the very same manufacturing line, at a plant in Puerto Rico or Costa Rica or New Jersey, from the very same branded drug maker, as they would obtain at the local brick and mortar Walgreens or CVS -- but at a mere fraction of the price.

Fifty million Americans a year do not fill prescriptions their doctors write, or do not pick them up, because they cannot pay for the drugs. That is a national tragedy, and likely increases the costs, overall, to the health care system -- when these very sick, unmedicated people finally present at -- you guessed it, the local ER. That, my dear readers, serves no one. Not even the PhRMA member companies. But from at least 2006 through 2008, that political hack Billy Tauzin, a Republican and former Congressman out of the Bayou State -- sitting as the head of PhRMA -- shoved that preposterous agenda down the throats of the American public.

It is time for the government payors to negotiate, en masse, with both generic and branded pharma and biologics makers -- with the goal of reaching sustainable pricing for people who qualify by lack of income for food stamps. It makes no sense that the poor in India and China and now Egypt are getting drugs at one-one-thousanth the price that people making less than $14,000 per year are charged here in the States. These drugs are as as far out of reach to poor Americans as they are for poor Indians or Egyptians. Here is the op ed -- do go read it -- and a bit:

. . . .There are no reported examples of Americans dying by taking real, but F.D.A.-unapproved, medication bought online from a foreign pharmacy that requires valid prescriptions. This is after tens of millions of prescriptions have been filled online and internationally over the past 15 or so years, since online pharmacies were created. . . .

But for drug makers, the overseas ordering means lost profits. In 2003, the drug companies were frustrated by growing numbers of Americans buying cheaper medications from Canada. The Pharmaceutical Research and Manufacturers of America [PhRMA] hired the Edelman public relations firm to figure out what to do. Using focus groups, Edelman surveyed Americans and discovered that the federal law was not a deterrent. The industry concluded that the fear of ingesting dangerous or counterfeit drugs would do more to deter people from buying overseas. Since then, the drug companies have tried to play up that risk through public education and media campaigns.

If the F.D.A. wants to protect drug makers from lower-cost imports then it should say so and tell Congress to more aggressively enforce the law. Its officials should not equate counterfeit and imported drugs. This erroneous conflation will make it more likely that regulators will seize and destroy people’s imported medication. Legal or not, that would be downright unethical. . . .

Indeed. Do go read it all -- there is a recommendation of a website from which safe meds may be ordered (shipped from Canadian sources). [This one is the result of my continued thinking -- about the global prices charged for revolutionary, life-saving medicines around the world -- see the last six or so posts, below.]


Anonymous said...

Don't we really have to look at the cap on Rx costs in other countries as to why our costs are so high?

And, aren't the costs for development and research really being paid for by the payments here in the US?

Can you speculate on how well a bill would succeed in the House of Reps, if one was proposed, that capped the recoverable $ allowed to be charged?

Finally, won't the people who subsidize the costs in e.g., Canadians, eventually restrict shipments of their Rx to other countries?

Just looking for the debate~

Anonymous said...

meanwhile, on a different topic~you did see this, yes?


Condor said...

Thank you both!

Last one first -- I cannot bring myself to believe that Merck will get $12 billion for it. And until the deal is announced, Sanofi being in or out -- is just a Merck-side banker's stealth move to try to jack up the price.

[I'd note in passing that Sanofi's affiliate was aprt of the failed attempt to spin off the Animal Health assets in 2009 to 2011.]

Now, to answer the first one. . . I'll use a second comment box.


Condor said...

I think we need to ask differing questions -- on global pricing, Anon. No. 1. . .

It is certainly true that pharma manufacturers will need to make handsome profits to take the risks they do.

But I am not convinced that those prices in the US need to be where they are.

Forever (since at least the middle 1980s), other EU and western government payors have capped payments.

But even so, I think pharma charges Americans whatever they think the market will bear, not just cost plus a reasonable profit. The proof of this is what Lipitor still cost, ten years on, clocking $12 billion a year in the US.

No way did it cost $120 billion to develop atorvostatin. And in no way did Pfizer lower the price.

Until the patent expired.

So -- on legistlation -- no need for the House to do so. (Republicans will kill it in committee, anyway.)

No need, because HHS and the VA and Medicare/Medicaid do have the rule-making authority to set prices for all government programs they cover. And if they did so, insurers would follow suit. No need for new laws. Watch -- because that is what is likely to happen, in 2015, and beyond -- as Obamacare rolls on.

The government payors will lock arms and get better pricing. Just my guess.

Finally, Canadians are likely only paying a fair price, with a profit in it, for pharma. And the drgs are from US companies, moved north, then reimported to the US. I suppose there could be shortages -- but that's a long way off, from here.

I think most people expect pharma to get lower prices, 2015 to 2020, than the same companies got, 2008 to 2012.

We shall see.

Great questions -- but I guarantee you pharma is in no danger of going broke. Not even in a million bad years.

Thanks again -- do stop back -- and Namaste!