Saturday, March 14, 2020

The Truth about the Drug Companies By Marcia Angell Essays

The Truth about the Drug Companies By Marcia Angell Essays The Truth about the Drug Companies By Marcia Angell Paper The Truth about the Drug Companies By Marcia Angell Paper Americans every day are subjected to a bombardment of advertising by various pharmaceutical companies. The advertisement is mixed in with different pitches for a drug showing beautiful people who are enjoying in the outdoors is the main message. Coming down to the essential and this is what is said: Prescription drugs are very costly but that shows how precious they are. The Research and Development costs are huge and companies need to cover them in some way. Research based companies tend to turn out a stream of innovative medicines which enhance its quality, averts more expensive medical care and extends life. People are the beneficiaries of the achievement of the American free enterprise system so we should all be grateful, and stop whining and pay for the drug. The industry says that you get what you pay for. Prescription drugs cost are very much high and rising fast. Americans spend around $200 billion a year on prescription drugs and the figure is growing at a rate of 12% a year. The fastest growing parts of a health care bill are Drugs which are also rising at a fast rate. The increase spending on drugs show that people are taking a lot more drugs than they used to. The prices of those drugs are frequently increased sometimes several times a year. Before its copyright ran out, the price of Schering Plough’s allergy pill, Claritin was increase about twelve times in a time span of five years for a total increase of more than fifty percent. Poor people are not the only one having a problem paying for the prescription drugs. Health care is shrinking due to the struggling economy. Employers want workers to pay more for the cost themselves and many organizations are decreasing health benefits. As the costs of prescription drugs are increasing so fast, payers are eager to get out from under them and shifting the cost to the individuals. The end result is that more and more people pay a larger fraction of their drug bills out of their own pocket and that is way too costly. Many people cannot pay so much. They tend to trade of drugs against food or home heating. Some people take them less often than it is prescribed or share them with a family member. Some who are too embarrassed to admit that they cannot afford to pay leave the doctors office with prescription in their hand and not getting it filled. These patients go without the treatment needed and sometimes their doctors wrongly conclude that the drugs they were given haven’t worked prescribed by other which complicates the problem. Elderly people get hurt the most. When Medicare was ratified in 1965, people took less prescription drugs. No one thought it is important to include an out patient prescription drug advantage in the program. Senior citizens could also buy the drugs which they needed. Around two thirds of the elderly people had additional insurance which covered prescription drugs but that percentage is decreasing as insurers and employers decided that they suffer from it. A medical reform bill was passed by Congress at the end of 2003 which included a prescription drug benefit which was to begin in 2006, but its benefits are insufficient to being with and will rapidly be taken over by administrative costs and rising prices. For apparent reason elderly people need more drugs than younger one. In 2001, around one in four elderly people reported that they do not take regular does or do not fill prescription because of the costs. The frailest are least likely to have a supplementary insurance. An average cost of $1500 a year for a drug, a person without an additional insurance who take different prescription drugs would need to spend around $9000 out of his own pocket. Not many people have such deep pockets. In one of the more wicked practices of the pharmaceutical practices, prices are higher for the people who mostly need the drug and can least afford them. The pharmaceutical industry charges the Medicare recipients more than its favored customers such as Veterans affairs system or HMO’s as the latter buy the drugs in a bulk quantity and they can bargain for rebates or discounts. People who do not have insurance have any bargaining power and therefore pay the high prices. In the last two years, people have started resisting to the increasing prices and other practices of the industry. Because of this resistance, drug companies are now covering us with different public relations messages which include the magic words like innovation, research and American. While the expression is inspiring, it has little to do with reality. Research and Development is a small part of a company’s budget. Year after year for over twenty years this industry has been the most profitable in the United States. The price drug companies’ charges have a minute relationship to the cost of making drugs and can cut them with coming close to threatening Research and Development. Secondly pharmaceutical industry is not innovative. It is hard to believe only a few important drugs have been brought into the market in the past years and they were mostly based on tax payer funded research at small biotechnology companies, National institute of Health or at academic institutions. Majority of the new drugs are not new but variations of older drugs. These are known as me too drugs. The main idea is to have a share of the lucrative market by manufacturing something similar to a top selling drug. For example there are six drugs in the market, Mevacor, Zecor, Pravachol, Lipitor, Crestor and Lescol which controls cholesterol and copies of the first. Finally the industry is hardly a model of the American free enterprise. It is free to decide which drugs to produce and it is totally free to price them as high as the public can bear and are totally dependent on the government granted monopoly in the form of Food and Drug administration’s approved marketing rights. It is not particularly innovative in making new drugs but it is aggressive and highly innovative. As America is a main profit center, it is good public relations for the companies to show themselves as American they are or not. It is true that some European companies are starting their R D operation in America. They say that the main reason behind it is that United States does not regulate prices as much of the world does. Drugs which are less profitable and which fight against tuberculosis and malaria tend to receive less attention. George Bush who is friendly to the big pharmaceutical industries refused to allow the promised $15 billion in funds allotted for HIV treatment in the Third world to be spent on common drugs. Among the many tricks exposed are the huge pharmaceuticals use of contract research organizations to apply excessive influence on clinical research and its sinister seduction of doctors. Drug companies in 2001 gave doctors nearly $11 billion worth of free samples. Along with that they gave other incentives to the doctors. In the final chapter of the book, there are seven important reforms, chief of which is for the Food and Drug Administration to compare new drugs with old drugs to see if there are additional benefits. The main goal of Angell is that people can get good drugs at a reasonable price and this require pressure from the public so that the government may take necessary action against the pharmaceutical companies. She performs an important public service in focusing on the drug companies and their dishonesty. The improvement of Pharmaceutical companies start with the outcry of the public against the abuses she showed in the book. She says that doctors should stand by their patients and not their pockets. Personal Opinion There is a significant problem in the United States about the financial conflict of interest in the clinical drug trials. It tends to affect millions of people those who are subjects in drug trials and those who use the drugs. The drug companies frequently control the date which is collected in the drug trials. The university scientists even are not provided with the whole data. Big companies tend to publish data which is favorable to their product which holding back the unfavorable data. In the case of Dr James O Kahn who published a journal article in which he concluded that a vaccine for AIDS did not help the patients. Dr Kahn was not given the data he required. But still he managed to publish the study. The company started a legal action against Dr Kahn and its employer, the University of California worth $ 7 Million. If such things happen very few researchers will have the courage to stand up to the companies. Pharmaceutical companies design their own studies to make their drug look more effective than they really are. Patients tend to suffer from the studies that offer incomplete or false information including the information about the doctors financial relations to the company. There is a need for improvement with the clinical drug trial process where there must be some other party testing the drugs. Scientists outside the company should have the final say on the drug trials. All the data should be available to the project investigators and to the public, press and who ever needs it. All financial relations to the companies should be made public. People need more information and more safety. The time is right for the nation’s medical centers, medical journals, FDA (food and drug administration), universities, medical journals and National institute of Health to come together and tell lawmakers to take back the rules under which the medical products are approved and tested. Bibliography The Truth about the Drug Companies` by Marcia Angell Publisher Random House; 1 edition (August 24, 2004)