Thursday, June 02, 2005

Column 34 - Big Pharma

The Nevada Legislature has stepped into the issue of access by Nevadans to non-US sources of prescription medication. In March, Assembly Majority Leader Barbara Buckley (D-Las Vegas) introduced Assembly Bill 195 which would allow Nevada’s Pharmacy Board to license Canadian pharmacies and to set up a website to provide information and access for Nevadans. The bill passed the Assembly in April, but last week Senator Randolph Townsend (R-Reno), usually one of the legislature’s more rational Republicans, attached a provision that would require the federal government’s approval before this program could be launched, a move that would effectively kill the initiative. The bill will now go to a conference committee, where hopefully a compromise will be worked out. (It never ceases to amaze me how quickly Republicans abandon their “no federal interference” stance when it serves their ends),
I have worked as a consultant to big pharmaceutical companies including some of the biggest, in the US and abroad, and while the individuals I have worked with there are, by overwhelming numbers, dedicated, committed people, the industry as a whole is one of the most venal, self-serving, and cynical I have encountered this side of the tobacco and firearms industries. In the US, big pharma pushes its margins higher and higher and does its best to block admission of less expensive generic drugs to the market, all at the expense of those who need prescription medications for life and health, and nowhere has this venality and cynicism shown so clearly as in the industry’s fight against importing drugs from outside the US.
If you believe pharma advertising, importation of drugs that are FDA-approved in the US from reputable pharmacies in Canada exposes the hapless American consumer to impure, mislabeled, and otherwise dangerous drugs made in Fiji, China, Cambodia, and who knows where.
I have no doubt that there are unscrupulous and unethical people and companies out there in the dark recesses of the world beyond America’s borders – why wouldn’t there be, when we have plenty of them here – US “ethical” drug companies have, in the recent past, been shown to have withheld data on possible drug dangers and drug interactions, failed to remove drugs such as Vioxx from the market until long after dangers were reported, and failed to fully test “hot” drugs such a Viagra, resulting in recent findings that it may cause blindness. In other words, US drug companies and their partners at the FDA are very quick to point out the faults of foreign suppliers while ignoring their own.
In point of fact, many “US” drugs are manufactured abroad. If you take generic prescription drugs, the chances are very good that they were manufactured by Teva Pharmaceuticals of Israel, the world’s largest manufacturer of generics, and manufactured in Israel or in Europe. Many of the world’s largest drug companies are non-US companies. Yes, these companies are subject to FDA review and approval, but do you really think that, when a company produces, say, a heart drug, they produce one, pure, version to sell in the US and a second, impure version for the rest of the world?
The Federal Government’s resistance to importing drugs that can be obtained more cheaply from non-US sources comes from big pharma’s lobbying and donations, not from any concern about US consumers’ health. It is established fact that, because of this unholy alliance between big pharma and the FDA, many in the US, particularly seniors and the indigent, cannot afford medication that they need or take less than the prescribed dosages to stretch their medication dollars. Assemblywoman Buckley is looking out for the welfare of Nevadans in her attempt to make medication available more cheaply, and her inserting the Nevada Pharmacy Board into the process shows that this is not an irresponsible or wild approach. Senator Townsend’s blocking move may be well-intended, in which case he needs to educate himself about the realities of the industry, or it is further evidence of the Republicans’ cynical alliance with big business at the expense of the citizen on the street.