Sunday, September 26, 2004

my only "liberal" issue?

So, not to blaze off into completely unrelated territory, but the whole "runaway drug pricing" thing is really bothering me. I have (until this point) resisted the urge to say anything because my knee-jerk conservative tendencies whisper sweet nothings in my ear and tell me that everything must be okay in Pfizer-land, otherwise the U.S. wouldn't have the amazing range of healthcare options that it does.

But a series of damning revelations about drug companies has finally tipped me over the edge, and I'm furious with the way these companies manipulate public opinion, especially those of people like me who want to believe them, and generally give them the benefit of the doubt.

Unfortunately for me, I'm now in quasi-independent land, which is a terrible place to be, because I realize that all of the prescriptions (pun certainly intended) to fix the drug industry will only make things worse...but I'm getting ahead of myself.

The biggest lie that drug companies want you to believe is that drug pricing is directly related to a research motive rather than a profit motive. But drug companies are consistently among the most profitable companies in the US (Fortune 500). Now, me being me, I don't see a problem with this as long as these companies are producing world-class research and innovative treatment methods from their high profit margins. No reason to punish the companies just because they're successful, right? If we did that, no one would want to create innovative treatment methods, and the U.S. is certainly cutting edge. That's the beauty of a market economy.

But what really pisses me off is that most of the cutting edge research for new drugs and treatment methods is publicly funded at universities or research labs! This stuff is funded by taxpayers and then co-opted by drug companies to be marketed at exorbitant prices to the very people who funded the research in the first place! If this is not perverse, I don't know what is.

Most of the "research" done by drug companies is for "me-too" drugs (not my term). Me-too drugs are company specific versions of drugs already on the market (for example, Lipitor is 1 of 6 drugs of the same kind that have been on the market since 1988). When Viagra came out and was wildly successful, every drug company decided that it needs its own version...that is where the high profits are going (that and large yachts in the Caymans). Drug companies also spend millions upon millions of dollars convincing people that they "need" new me-too drugs that weren't even on the market until recently! (anti-depressants or erectile dysfunction medication) Granted, depression is a serious illness and warrants research (I won't comment on erectile dysfunction), but what did the world do for thousands of years without these medications?! We found alternate ways of coping rather than medicating ourselves at the drop of a hat, and we certainly managed to reproduce alright (to the current level of 6 billion people on the planet)...Okay, I know I'm opening myself up for some legitimate criticism here, but somebody's got to say it!

The worst part of it is that the solutions are even worse than the problem. You can't price-regulate without companies simply moving their operations elsewhere. If the government negotiates lower prices, it is not a fair negotiation. The US government is so huge that it can simply impose its will on the drug companies. And let's be honest...we could buy cheap drugs at Canadian prices if the US government were willing to subsidize health care to the degree that Canada does! It's not that Canada magically has lower drug costs...they're subsidized! This book recommends regulating drug companies like a "public utility." But let's think about the public utilities around the country. Would that really be a step up? I mean, really??

The only solution I can see is for the US government to limit access to publicly funded research conclusions to those companies who agree to limit their profit margins on drugs developed from that research. This way, companies can decide to keep their profit margins high (opting out of the government research results), and develop drugs themselves by whatever methods they choose. But if they want to benefit from the money of US taxpayers, they have to re-examine their fiduciary responsibility to their shareholders and decide that profit can't be their only motive. I imagine that faced with such a dilemma (given the currently weak research going on at drug companies) most of them could "see their way clear" to reducing their profit margins on those drugs developed from taxpayer driven research. However, if drug companies are willing to do this, I think the US government should support these companies and protect their patents around the world. Oftentimes, these companies are robbed of their intellectual property by nations who simply steal the rights to drugs and manufacture them generically for their own populations with no compensation to either the US or to the drug makers. This only makes the problem worse. In other words...let's just be fair, to the companies and to US citizens.
Grace & Peace