Watching “Last week tonight with John Oliver” on HBO got me to thinking anew about the raw deal that Americans get for prescription drugs. In a half hour program, he took up about 17 minutes demonstrating Pharma’s power trip ploys to sell drugs, including its insidious, but often ludicrous, commercials, its endless gifting to doctors and its overpowering sway over us and our culture.
Pharma spends $4 billion per year to market us, their hopeful consumers, but over $24 billion to market doctors. According to the BBC, 9 of 10 big Pharma companies spend more on marketing than they do on research and development. The latter is the reason Pharma gives for obscenely large drugs prices – their need to spend for research and development. It is difficult to not only research how Pharma’s money is spent, but also to browse price comparisons between countries.
Both are hampered on internet browsing by few argument returns or by Pharma marketing site returns. Try the comparative search argument, “comparative global drug prices,” for example. Any studies found are usually not recent and cover limited comparisons of drug prices. The one linked highlights some, including a 2010 comparison of Plavix prices before it went generic. For example, the UK average price was around $60 while the US was about $150. Overall, the report said that US drug prices are three to six times greater than other countries.
We do excel at marketing, though.
Marketing is ubiquitous, something our drug spending massively supports. It permeates our culture: billboards, television, magazines, internet and doctor’s offices. On television, a bombardment of commercials has each saying “Ask your doctor,” for they need someone’s permission to buy their drugs. Next they hurriedly unload the possible scourge of side effects their drugs might induce, saving death as the last, perhaps coinciding with the numbing of your mind and senses.
“If your bladder is calling the shots” (a cute little red bladder is being led by the hand by a plagued woman, purportedly on an interrupted shopping trip) is the message. “That woman needs a pill to stop hallucinating,” says John Oliver. We all know what to do about “erections lasting more than four hours,” attesting to the potency of Viagra, as well as the funny ED commercials of the past. We pay for these commercials, baby, and pay and pay.
Meanwhile doctors get free lunches and sample pills, are courted by young, attractive Pharma reps whose sole goal is to sell drugs, even to children. Doctors are subtly encouraged to “go off label,” using drugs for purposes other than what the drug label specifies. Some doctors are made “thought leaders” and participate in physician speaker programs where they pitch the Pharma company with scripted speeches. Oliver also provides a list of companies fined billions of dollars in fraud lawsuits, including Johnson and Johnson, Eli Lilly, NOVARTIS, and GSK.
The only specifics that were missing in the Oliver piece was how Congress has been totally bought off by Pharma, actually forbidding Medicare to bargain with Pharmaceutical companies for affordable prices among American consumers. One of the most blatant rip-offs came with the Bush administration and Congress’s 2003 Medicare Part D deal with Pharma, which not only ruled out Medicare bargaining for fair drug prices but also made it a crime to buy drugs outside the country, where prescription drugs are often cheaper than our price, even with our co-pays. To this day, there have been feeble efforts to change that, but Pharma’s lobbying is still working.
Probably the biggest disgrace of Pharma’s hold over (through Congress) American consumers are the millions of Americans, especially seniors, who can’t afford the price of drugs – even co-pays — and either do without or cut back on their prescriptions, all in order to pay for food and lodging.
Our best defense is knowledge of what other countries are paying and how our government is only representing the interests of the health care industry. This information is sorely lacking, either due to subtle network tampering or the lack of investigative reporting by the American media – maybe both.
Either way, most Americans are ignorant about how Pharma is taking them for a ride – and even the ride is on our dime.
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