Ill-Gotten Gains: Big Pharma’s Sick Hold On Doctors And The Health Care Economy

Patients' needs compete with the dancing dollar signs in their physicians' heads.
By @drRhymes |
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    (Photo/Chris Potter/ Flickr)

    (Photo/Chris Potter/ Flickr)

    Pharmaceutical companies’ grip on the practice of medicine and healthcare is near absolute. From its influence over medical students to the bribing of their generic drug-making competition, Big Pharma has shown that making more money is preferable to making more people well.


    Educate to disseminate

    A study published in the Journal of General Internal Medicine found that while students and residents felt confident they could accept gifts from the pharmaceutical industry and remain neutral, they couldn’t say the same of their fellow medical students. Natural News reports:

    In the first survey of its kind, more than 2,000 medical students and residents representing every U.S. medical school were asked how often they interacted with pharmaceutical representatives, what kinds of gifts they received, and what influence they thought these gifts had on their education.

    The researchers found that one-third of all first-year students had received industry-sponsored gifts; among fourth-year students and residents the figure was higher than 50 percent. Gifts included food, beverages and meals, pens and note pads, clothing, drug samples, and educational materials.

    The study also revealed that the farther in their medical education they were, the more trusting they were of drug companies and the more likely they were to say the information they received from the industry was useful.

    How does this not create a possible conflict of interest between the best interests of the patient and the demands of the drug companies? Yes, drugs are a big part of medicine and healthcare and there is absolutely no problem with pharmaceutical companies helping physicians to be better informed. Nevertheless, patients need the assurance that their doctors have not been bought and paid for by Big Pharma and that their needs are not an afterthought.


    Ain’t no sunshine when they’re done

    During the 2008 Presidential campaign, Barack Obama chastised Hillary Clinton for the backroom negotiations that went on during the healthcare fight in the 90s. As president, however, he apparently has gotten over his aversion to secrecy. According to a article from 2009, “after being reported in the Los Angeles Times, the White House confirmed it has promised Big Pharma that any healthcare legislation will bar the government from using its huge purchasing power to negotiate lower drug prices. That’s basically the same deal George W. Bush struck in getting the Medicare drug benefit.”

    This, by the way, has made Big Pharma’s already-considerable profits even more sizeable. The irony of how and under what preconditions Obamacare was crafted is portrayed in the Sunshine Act portion of Obama’s healthcare law. As a report explains:

    Originally adopted as part of the Patient Protection and Affordable Care Act in March 2010, the Sunshine Act requires pharmaceutical companies and medical device manufacturers to report annually to CMS [the Centers for Medicare and Medicaid Services] about transfers of value that they make to physicians and teaching hospitals. The information reported in these disclosures will then be compiled by CMS and posted in a publicly accessible database.

    This law goes into effect, by the way, September, 2013, for drug companies. It specifies that the information about payments to doctors and medical institutions needs to be posted on a federal website easily available to the public and that it must be searchable, clear and understandable, and able to be easily collected and downloaded.

    Additionally, the biggest concern about the Sunshine Act is the giant, built-in loophole — not unlike the Super Pac loophole built into campaign contribution limits. Big Pharma and medical supplies companies can simply divert their spending to areas that they don’t have to disclose. Instead of trying to influence practicing physicians directly, they may redirect their contributions to the providers of continuing medical education (CME) for physicians and let them do the influencing for them.


    Everything is not fine

    Yes, the law technically strives to keep drug companies in check by fining them up to $10,000 per instance if they fail to report any payment worth more than $10. The fine goes up to $100,000 if they knowingly fail to report an incident – the cumulative fines can go up to $1 million a year.

    But pharmaceutical companies – Big Business in general, actually – have consistently looked at fines as a necessary cost of doing business (they spend approximately $188 million a year lobbying Congress and about $14 million annually on political candidates).

    Let’s not forget that over the past four years, drug companies have shelled out astronomical amounts of money in fines and settlements without even flinching:

    — In 2009 Pfizer was fined $2.3 billion, then the largest health care fraud settlement and the largest criminal fine ever imposed in the United States.

    — Also in 2009, Eli Lilly was fined $1.42 billion to resolve a government investigation into the off-label promotion of the antipsychotic Zyprexa.

    — November of 2011 brings us to Merck, who agreed to pay a fine of $950 million related to the illegal promotion of the painkiller Vioxx, which was withdrawn from the market in 2004 after studies found the drug increased the risk of heart attacks.

    — GlaxoSmithKline, in July 2012, agreed to pay a fine of $3 billion to resolve civil and criminal liabilities regarding its promotion of drugs, as well as its failure to report safety data.

    This is only a partial list of the infractions and crimes committed by drug companies.


    TRIPPIN about generic drugs

    The compelling documentary, Fire in the Blood, tells the story of how the World Trade Organization’s TRIPS – Trade-Related Aspects of Intellectual Property Rights – Agreement of 1994 has prevented lifesaving generic drugs for diseases such as AIDS, malaria, tuberculosis from reaching African nations.

    It is estimated that as a result of this blockade, millions have died across Africa. Cecilia Oh wrote that “the minimum term of 20-year patent protection required by the TRIPS Agreement effectively allows a pharmaceutical company a monopoly over its patented drug. Free from competition, the company will be able to keep the price of the drug high during the protection period.  By virtue of TRIPS protection, no generic equivalent can come into the market until expiry of the 20 years, denying patients cheaper alternatives.”

    The loss of human life appears to weigh less heavily on the consciences of drug companies than the loss of profits. It’s hard not to believe that if those were American lives and of a lighter hue, this would be considered the outrage that it is.

    So with one hand, Big Pharma — helped by the WTO — denies access to less expensive and much-needed drugs to suffering Africa. With the other, they are essentially paying generic drug-makers into delaying the manufacture of their cheaper-than-name-brand counterparts.

    As reported by Reuters, in an amicus brief, the Federal Trade Commission said makers of name-brand medications that settle challenges to patents by agreeing not to introduce their own generic alternatives are actually using those promises to delay generic competition. In the amicus brief the FTC said such patent settlements, in which drug manufacturers promise not to introduce their own authorized generic drug versions, are really just a way of paying a generic rival to keep their products off the market longer.

    For example, Solvay had sued generic drug-makers in 2003 to stop the sale of cheaper versions of AndroGel, a gel used to treat men with low testosterone.

    Solvay settled and paid as much as $30 million annually to the generic drug makers to help preserve its profits from AndroGel, estimated at $125 million. Now does anyone believe that a measly $1 million in fines, annually, will be sufficient incentive for pharmaceutical companies to provide full and complete disclosure?



    Large numbers of doctors receive payments of sometimes hundreds of thousands, even millions of dollars from drug and device companies every year in exchange for providing advice and giving lectures.

    There are very few things that make us feel more vulnerable than sitting in a doctor’s office or laying down in the hospital room with those gowns that leave our backs exposed. It isn’t just a physical nakedness; your whole person is out in the open. At that time of extreme vulnerability, a patient shouldn’t have to wonder if their needs are competing with the dancing dollar signs, courtesy of Big Pharma, in their physician’s head. That isn’t too much to ask… is it?

    The views expressed in this article are the author’s own and do not necessarily reflect Mint Press News editorial policy.

    The views expressed in this article are the author’s own and do not necessarily reflect Mint Press News editorial policy.

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