The “Ethical” Drug Business
I Hope you notice that the word ETHICAL is in quotation marks
There is a perception with the public that the Pharmaceutical Manufacturing Industry, PMI, (all companies, trade name and generic), is essentially different from other industries because they are in the health care field and produce medicines. This leads the public to believe that there is a higher standard of ethics and morality in their operations. That perception is false.
The PMI is motivated by the need to earn a good profit for the owner, whether private or public. It is the most profitable industry in the world, showing the highest percentage of
earnings against investment. However it also produces many life-saving drugs and requires a great deal of money to continue research. The problem lies in measuring the relative effectiveness of new drugs against those presently in use.
The international drug companies that bring out these new drugs must, for survival, introduce them, since a drug patent lasts twenty-one years, after which their profit on sales is modest or non-existent.
People will always find drug prices too high because nobody willingly wants to spend money in an area that is not of their choosing.
You take your prescription from a medical doctor to a pharmacist. The doctor has learned what to prescribe at medical school, from past clinical experience, from medical journals and personal visits from drug company representatives. But is the medicine you receive the best available for your illness at a competitive price?
The universities employ many medical researchers. These universities are, in turn, involved with PMI companies who usually pay for all of the research and receive most of the profits. In some cases the university and the investigators form private companies in partnership with the PMI companies. As everyone can see, there is potential for massive conflicts of interest, all of which is to the detriment of the paying public.
The practice of medicine is clearly affected by the outcomes of clinical research sponsored by universities and drug companies. Unfavourable results of this research can be very expensive for the sponsoring companies. An unfavourable result can consist of the drug not being cost-effective compared to the other drugs in the field, or if the drug is less clinically effective or less safe. Because there is so much pressure to show favourable outcomes, there can be biases in the design of the project outcomes and the reporting of the results. To go into detail on how a researcher can “cook” (laboratory expression meaning change) the results of a clinical trial is beyond the scope of this article. Rest assured it is possible.
There is another problem with getting a completely honest result in a clinical trial. The investigators are looking for professional recognition from the drug companies and the universities compete with each other for research funding. A survey of ten research-oriented medical schools shows that only one school prohibited researchers from benefiting beyond their university salary. In the publishing of the clinical trials of the high-impact medical journals it was found that only half of them required disclosure of conflict of interest.
Approximately twenty new patented drugs go on the market each year. Of the twenty only one is of any real significance. The others are produced by slightly changing the formula of recognized treatments or by changing the form of delivery from a tablet to a capsule or visa versa. There are very few of what I would call “blockbuster” drugs brought out each year similar to the original antibiotics (penicillin) and steroids (cortisone). The new drugs are usually introduced in order for the company to maintain its volume in any particular market and to overcome loss of patent exclusivity.
The AIDS crisis has highlighted the significance of the statement that “the drug business is a business”. Because the afflicted people in Africa are unable to pay the going price for the “AIDS cocktail” which can allow them a better life than they presently enjoy, they are allowed to just die miserably. This is a sad commentary on PMI priorities since by giving away or lowering the prices on these AIDS drugs it would not affect their present profit picture. Their excuse for adopting this stance is that the countries cannot insure delivery to the people. A pathetic excuse at best.
Canada is in the process of passing a new law to allow PCI companies to bid on the AIDS drugs for Africa (ignoring the patents), with the proviso that the trade-name companies have the right to sell at the bid price, if they so desire. Why would the generic companies even bother bidding?
Purdue Pharma halts marketing of opioids in Canada. Purdue has acknowledged in the United states that its marketing of Oxycontin was misleading and paid $634.5 million (US) in 2007 to settle criminal and civil charges. Both the Canadian and American companies sold the drugs as non-habit forming pharmaceuticals. A BLATANT LIE!
Today the total price of prescription drugs costs the public more than medical care. How long will the public continue to pay for new drugs at as much as three or four times more than the cost of the present ones, when in fact, they are only marginally better, if at all?
