Tuesday, November 14, 2006

Drug Firms Will NOT be Bullied...

... says US Deputy Health Secretary Alex Azar! From the Guardian...

"The White House is lobbying British ministers to allow the world's main drug companies unrestricted access to the NHS as part of a package of free market reforms for the service. The US government is positioning itself behind the giant pharmaceutical firms, predominantly based in America, which have been piling pressure on the body that approves drugs for use in hospitals and for prescription by GPs. The drug companies claim that they are being held back by the National Institute for Clinical Excellence and have separately lobbied for it to be reformed. In a surprising intervention, the US deputy health secretary, Alex Azar, forced the issue in London yesterday, ahead of talks with officials following a trip to the US last week by the health secretary, Patricia Hewitt. He said attempts to use rationing mechanisms such as Nice to cut soaring drugs bills would stifle innovation - an argument that is constantly made by the pharmaceutical industry. Allowing all new drugs to be used in the NHS would result in the companies "fighting it out" on price, Mr Azar said, which would drive the drug bill down.
He made it clear that he was also in favour of the drug companies being allowed to advertise directly to patients. At the moment they may only advertise to doctors.

He also wanted to share the US experience of offering private insurance packages to people on Medicare - the healthcare scheme provided by the government to the poor and elderly. It might be possible for the UK government to consider something similar, he suggested, so that everyone could choose either a basic healthcare deal or top it up themselves if they wanted to pay for more than the state could afford.

--SNIP--

"How are we making sure that we don't take steps on cost containment that are short-sighted and prevent the investment in long-term biomedical research and development and innovation, so that when my kids are senior citizens we have the next generation and next, next, next generation of drugs?"

"The White House arguments will increase the mounting pressure on Nice, which is regularly castigated by patient groups and drug companies when it rejects a new medicine from use in the NHS on cost grounds."

--SNIP--

""In all of our systems it is so easy to make the decision to cut costs today by going after drug prices, and to not focus on what will be the impact on long-term innovation," he [Azar] said.

My View: Yeah, I am sure that the Brits would LOVE a Medicare boondoggle like ours! There is no doubt that seniors across the UK are begging for an Americanized system of health care.

Then Azar has the audacity to say that these "market reforms" will cause price competition? Find me one iota of evidence to support such a baldfaced lie. The American government decided, nah, we don't need to negotiate prices -- we'll pay whatever y'all good folks in the drug industry would like us to pay. Despite all the free market rhetoric, this is the kind of thing that would make Adam Smith turn over in his grave! In a free market, prices are determined through negotiation, not by fiat.

Arguably, my favorite statement from Azar was the time-honored scare tactic of, to paraphrase, "if drug prices drop, how will they ever have enough money to conduct research to develop new products?" I'd buy that if three things were true:
1) If drug company research was devoted to truly discovering new drugs, rather than copycat me-too meds that add no benefit to patients
2) If drug company research was NOT frequently devoted to conducting trials that simply showed an additional indication for an existing drug in an already crowded market. Risperidone for depression is an example of such (more on that later) -- how many drug treatments do we really need for depression? Or, how about Seroquel for anxiety?
3) If drug company cash was not devoted so highly to marketing as opposed to research

Oh, and as for the new drugs save lives argument, please see this excellent post at the incomparable Pharma Marketing Blog.

1 comment:

Daniel Haszard said...

My issue is Zyprexa which is only FDA approved for schizophrenia (.5-1% of pop) and some bipolar (2% pop) and then an even smaller percentage of theses two groups.
So how does Zyprexa get to be the 7th largest drug sale in the world?

Eli Lilly is in deep trouble for using their drug reps to 'encourage' doctors to write zyprexa for non-FDA approved 'off label' uses.

The drug causes increased diabetes risk,and medicare picks up all the expensive fallout.There are now 7 states (and counting) going after Lilly for fraud and restitution.

--
Daniel Haszard