Against What Grain?
First, start with this article from CBS News writer Dick Meyer, published in February.
The article was sent to us from a well-meaning colleague at work, who was excited to read something positive about pharmas. We almost blew a gasket reading this. No, we DID blow a gasket, and replied to our colleague with the following verbatim text, copying the four others in our department who also received the initial email:
My impressions of the article, blog-style.
"We expect drug companies to be altruistic, not to be motivated by profits...I don't think they are more or less greedy or corrupt than companies in any other sector of the economy."
Why would we expect drug companies to be altruistic, a cut above other types of corporations? Because that's the image they are giving us, through their company branding adverts. They are actively selling themselves as the deliverers of a better life, with mission statements that sound like something written for the WHO. In fact, they have a fiduciary duty to maximize return to shareholders above all else, a point that is painfully clear to AstraZeneca, considering the wave of class-action suits being filed against us: see http://www.lerachlaw.com/cases/astrazeneca/complaint.pdf
"I don't think they are more or less greedy or corrupt than companies in any other sector of the economy...And just because they make medicine, their malfeasances are not quantitively more evil than those of other corporate evildoers."
Is this guy kidding? Pharma malfeasance kills people. How many people died as a result of Enron, Global Crossing, MCI/Worldcom, Arthur Andersen, etc?
"Personally, I am incredibly thankful for drug companies. People I care about deeply are alive and full-strength because of drug companies."
How about some recognition for the NIH or NCI? Others have spent many electrons and killed many trees discussing Pharma perfidy in claiming medical advances; I shall not attempt to duplicate them here. One example only: http://lists.essential.org/pipermail/pharm-policy/2000-June/000215.html
"When more people use more effective drugs, overall health spending costs are lessened and national productivity goes up enormously, but in incalculable ways." Correct. But what is being prescribed? The ALLHAT trial http://allhat.sph.uth.tmc.edu/ clearly demonstrated the wastefulness of current prescribing habits for hypertension, to give one example. I have personal experience with this - when my wife was initially diagnosed with postpartum hypertension, our family doc reached for his prescription pad, and gave her a script for a (under patent) calcium channel blocker. We "fired" that pharma bimbo asap. For something closer to home, see: http://www.prescriptionaccesslitigation.org/resource.php?doc_id=662
"Critics don't want drug companies to advertise like other companies. They say the money should be spent to make drugs cheaper, which is a bogus point."
Classic strawman argument. How the heck does this guy know what critics are thinking? Basic economics shows that (successful) DTC doesn't raise the price of individual drugs - it pays for itself through higher sales volume. But at what price? Are the most effective treatments being advertised, or just the newest and most expensive? Are physicians prepared to discuss with their patients why they prefer to prescribe X instead of Y, when the patient insists on Y because she saw a lady with arthritis dancing around on TV? See: http://www.jabfp.org/cgi/content/full/16/6/513. - from study article: "Physicians filled 69% of requests they deemed clinically inappropriate"
"When a patient uses an expensive prescription drug for heartburn when a cheap over-the-counter might work just as well, we blame the drug company. But isn't the doctor more or equally responsible?"
Absolutely the physician is partly responsible, but they work within an irrational system. They continue to prescribe Nexium when Prilosec OTC is just as good, because they know that the insurance won't pay for the OTC.
"But the decisions about how medical care is distributed in this country are our decisions, collectively, through elections, laws and government...It is only by a spectacular feat of cynicism that our political system's moral negligence has become the fault of the pharmaceutical industry," Gladwell wrote in 'The New Yorker.'"
Again, is this guy for real? An investigative journalist? Has he read the Medicare Modernization Act, and seen the provisions that were inserted DIRECTLY FOR PHARMA that prohibit price competition, like the VHA enjoys (again, only one example)? Does any other industry have the benefits bestowed upon pharma by Congress? Has he checked to see what industry is the largest political contributor in the US?
Damn, we loved that reply! We wrote it all in a fury, with the links, in about 15 minutes. After we sent it, we panicked, and followed-up with another email begging the recipients to PLEASE not forward the message to anyone else. Brilliant analysis, perhaps, but lousy judgment. We also sent a copy to Dick Meyer, who replied with a polite Thank You. We had every intention of blogging this article at the time, but events intervened.
Save those links. Impress your friends and relations. Ciao.