84% Americans Blame Big Pharma for Healthcare mess

A Harris Poll held in August found that 84% of Americans have wised up to the pharmaceutical industry’s contribution to the current U.S. healthcare crisis through price gouging: Big Pharma overcharges Americans for prescription drugs they sell at half the price in the rest of the world.
 
Big Pharma’s defense for its inequitable U.S. pricing is grounded on a Big Lie: PhRMA, the American Pharmaceutical trade organization, has made the unsupportable claim that medical advances were driven by U.S.-based medical research and innovation.

PhRMA touts reports by the Tufts Center for the Study of Drug Development, such as a recent study claiming that a staggering 75% of all new drugs approved worldwide from 2005 to 2007 were first introduced in the U.S.

That claim is shown to be unsupportable:
Europe leads in the development of drugs that offer clinical improvements–first-in-its class of new drugs! 
Large studies show that most new drugs added few if any clinical benefits over previously discovered drugs.

The U.S. market is the profit-center of Big Pharma’s hastily approved, "me too" drugs: these drugs offer NO clinically significant benefit, but often pose considerable risks. 

For example, three classes of drugs that became blockbuster sellers through aggressive marketing, put consumers at life-threatening risks of harm:
SSRI antidepressants, antipsychotics, and COX-2 painkillers–none of which offer clinical improvement over older, far less expensive drugs–induce debilitating adverse effects. Yet, through aggressive, mostly fraudulent marketing campaigns, these three classes of drugs have exponentially inflated Pharma’s profit-margins.

Furthermore, the credibility of studies by the Tufts drug development center has been criticized as industry-sponsored propaganda masquerading as independent analyses.

Indeed, the Tufts Center for Study for Drug Development receives at least 65% of its funding from drug companies.
See, Public Citizen, Tufts Drug Study Sample Is Skewed ; True Figure of R&D Costs Likely Is 75 Percent Lower, Dec. 4, 2001

Most recently, Dr, Donald Light conducted an independent analysis of the comprehensive data set of all new chemical entities approved between 1982 and 2003. He found that the United States never overtook Europe in research productivity, and that Europe in fact is pulling ahead of U.S. productivity.

His analysis, "Global Drug Discovery: Europe Is Ahead" (abstract below) was published in Health Affairs, Aug. 2009, found that "dollar-for-dollar, European research productivity has increased to surpass the U.S. in global and first-in-class new drugs. In biotech and orphan drug innovation, the U.S. still leads."

Indeed, recently unsealed, internal company documents make clear that industry’s aggressive marketing tactics rely on fraud and deception, not on evidence of improved clinical outcomes. Companies have succeeded in marketing lethal drugs, such as Vioxx, by polluting the scientific journal literature with ghostwritten reports which laid claim to unsubstantiated benefits while concealing negative data about their products from physicians and the public alike.

Big Pharma’s biggest fear is that American consumers’ healthcare decisions will be informed by the facts rather than industry’s propaganda.  Companies willingly pay hundreds of millions, indeed–billions of dollars in settlement fees to keep the evidence of their worst crimes under seal.

Once consumers learn the facts about the drug industry’s corrupt practices–its fraudulent efficacy claims; concealment of life-threatening risks; and price gouging of American taxpayers–consumers will no longer be fooled by industry’s false claims.

As President Lincoln wisely observed:
"You can fool all of the people some of the time; you can fool some of the people all of the time, but you cannot fool all of the people all of the time…"

Posted by Vera Sharav

PHARMA GOSSIP
Pharma partly to blame for healthcare woes
10 September 2009

As many as 84% of Americans blame the pharmaceutical industry for the country’s healthcare woes, a new survey has found.

Results of The Harris Poll, held in August, show Americans blame many different parties for the problems of the current healthcare system in the USA, with pharma coming second in the blame game with 84% of adults pointing the finger at pharma. Even more than 50% believed the industry deserves a “great deal” of blame.

Industry was piped to the post by the health insurance industry where 90% of adults believed it was the main cause of issues and 60% believed it deserves a “great deal” of blame.

But there were other parties also considered to have played a role: Republicans in Congress (74%), business (72%), hospitals (70%), Democrats in Congress (69%), President George W. Bush (66%), and doctors (61%). However, less than 30% believed any of these deserve a “great deal” of blame.

The poll comes at a time when President Barack Obama is moving to reform the US health system. The Harris Poll also questioned public perceptions of these proposals.

A 58% to 19% majority believes that President Obama’s plans would create a “government-run health care system” but a 49% to 40% plurality of adults support President Obama’s proposals.

A slender 54% to 46% majority rates Obama’s proposals as “good” but only 19% believe they are “very good”. However, a 54% majority rates the proposals by the Democrats in Congress as “bad” and a larger 69% majority rates the proposals of the Republicans in Congress as “bad”.

By Katrina Megget
~~~~~~~~~~~~~

Health Affairs
Published online August 25, 2009
Global Drug Discovery: Europe Is Ahead
Donald W. Light

  Abstract

It is widely believed that the United States has eclipsed Europe in pharmaceutical research productivity. Some leading analysts claim that although fewer drugs have been discovered worldwide over the past decade, most are therapeutically important. Yet a comprehensive data set of all new chemical entities approved between 1982 and 2003 shows that the United States never overtook Europe in research productivity, and that Europe in fact is pulling ahead of U.S. productivity. Other large studies show that most new drugs add few if any clinical benefits over previously discovered drugs. I discuss ways in which Congress, employers, and insurers can increase the value of drugs and revitalize the U.S. pharmaceutical industry. [Health Affairs 28, no. 5 (2009):w969-w977 (published online 25 August 2009; 10.1377/hlthaff.28.5.w969)]

Donald Light is the Lorry Lokey Visiting Professor at Stanford University, in Stanford, California, and a professor of social medicine in the Department of Psychiatry at the University of Medicine and Dentistry of New Jersey.
~~~

PhRMA’s Statement blasting Dr. Light’s article: 

Dr. Lights Response to PhRMA
August 27, 2009

PhRMA, the American pharmaceutical trade association, issued a strong rebuttal to an article in the August 25th issue of Health Affairs-web exclusive that documented the superior research productivity of Europeans to Americans in developing global drugs since 1982.  (See article at http://content.healthaffairs.org/cgi/content/abstract/hlthaff.28.5.w969v1 ). 

“Global Drug Discovery: Europe in Ahead” apparently touched a raw nerve at PhRMA because the article took a prominent study that is used to show American superiority and demonstrated it was due to companies investing much more money in the United States than Europe, especially in recent years.

By correcting for this bias and comparing innovativeness on a level playing field, however, Europe came out ahead. Written by Donald Light, the Lokey visiting professor at Stanford University and a professor at the University of Medicine and Dentistry of New Jersey, the article otherwise used the same data and methods as the original study proclaiming U.S. research dominance.

Light also cited evidence over the past 25 years that most new drugs offer few or no benefits over existing drugs.

PhRMA charges that Light “paints a distorted picture that gives short shrift to the medical advances made possible by America’s pharmaceutical research and biotechnology companies…” In fact, all the new chemical entities credited to the United States in the original study claiming American superiority were included.

The PhRMA statement also charges that the article “ignores the chilling effect of government price controls on such innovation.” In fact, Light notes that European research productivity has increased despite countries negotiating lower prices on many drugs that reflect their added value. He cites evidence that UK prices on patented drugs are high enough to pay for all research and related costs and make a reasonable profit. Several other countries and Canada have comparable prices. But companies can make more profit faster in the United States, where they can charge about twice as much; so they usually launch new drugs first in the U.S.  Companies also frequently raise prices on older drugs, which most countries do not allow.

The industry trade association claims that cancer patients are living on average three years longer due to new treatments, and heart attacks fell by nearly half from 1999 to 2005. Evidence for such claims needs careful assessment, especially studies supported by industry. For example, earlier diagnosis of cancer results in higher 5-year survival rates regardless of treatment effects, just because the cancers have not advanced as far. Heart attacks have declined for a number of reasons, including the benefit of drugs.

As proof of clinical benefit, PhRMA points to the high percent of new drugs that receive a priority rating from the FDA while being tested. Many of these drugs, however, do not prove to have much clinical advantage. Only 1 in 7 new drugs offers significant clinical benefits over good drugs discovered before. The FDA used to rate even fewer as notable until the industry pressured it to abandon its rating system and replace it with the looser one used now. The FDA is under constant pressure from the companies that now pay for its review of new drugs to give them a priority rating.

PhRMA claims that Light used “misguided” ways of attributing new drugs to Europe and the U.S. Those methods, however, were developed in order to demonstrate how completely the U.S. has dominated Europe in drug research productivity by Henry Grabowski, a distinguished economist whose studies the industry widely cites to claim that research costs are staggering and profits are modest. By correcting for investment size, Light found that dollar-for-dollar, European research productivity has increased to surpass the U.S. in global and first-in-class new drugs. In biotech and orphan drug innovation, the U.S. still leads.

For all four kinds of drugs, the data from IMS and Grabowski show that U.S. research productivity has been declining. Other methods for attributing new drugs might come to different conclusions. More helpful than giving the impression that nearly all new drugs are developed in the United States when the data show this is not the case would be to seriously consider reasons why US research productivity has been declining on a level playing field.

Contact: Donald W. Light  dlight@princeton.edu or dwlight@stanford.edu

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