Healthy Skepticism Library item: 1307

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: news

Cassles A.
Don't gamble with our drug prices
2003 Jun 23

Full text:

In the poker game surrounding prescription drug costs, the stakes just got a whole lot higher.

Last week, the United States’s big drug companies gave us a peek at the cards they hold when it was learned that they intend to spend $1million “to change Canada’s health care system.” Thanks to confidential documents by the Pharmaceutical Research and Manufacturers of America (known as PhRMA) leakedto the New York Times, we learned of industry plans to massively increase lobbying budgets so that any tinkering with drug coverage in the United States is going to bear their interests in mind.

A million dollars is a pittance to big drug companies but, as Mark Grayson, PhRMA’s senior director of public affairs said, “it is money to . . . help patients in Canada realize they need a different system.” Huh? Those words should send chills down the spines of everyone on this side of the 49th parallel: patients, taxpayers, health care workers, provincial health ministers, the federal health minister and the Prime Minister himself.

We’re already spending unprecedented amounts of money on drugs — $12 billion last year. That’s more than we spend on anything else in health care except hospital services. And, as all gamblers know, when you blow your whole wad at the craps tables, you don’t have any on hand for other things.

For instance, with just the increase in prescription drug expenditures between 2001 and 2002 — $1.2 billion — Canadians could have hired about 5,300 new doctors or 24,000 new nurses. That’s enough to hire 65 new nurses today, tomorrow and every day forever.

But what we’re risking in this case is more than money — it’s the viability and integrity of Canada’s health care system. Any “changes to the system” of the kind desired by the multinational drug cartel would mean even more of our public dollars going to drugs and less to what some would argue are far more worthy priorities.

PhRMA also aims to eliminate what it says is Canada’s “subsidized” prescription drug prices. In other words, they want Canada’s drug prices to be as high as those in the United States. Then Americans who’ve been buying drugs through Canada’s multi-million dollar Internet pharmacy industry would pay premium prices no matter where they shop.

But that’s not all Big Pharma wants. Their lobbyists have also been trying to dissuade members of Canada’s Parliament — such as the House of Commons’ Industry, Science and Technology Committee — from listening too closely to the generic drug industry’s claims about unfair patent regulations. Generous patent protection was a gift to the pharmaceutical industry enshrined in law by the Conservative government of Brian Mulroney. It has forced generic drugs to wait a whole lot longer before becoming available. Generics typically cost 45 per cent less than brand name drugs.

And there’s more on the drug industry’s hit list, such as weakening the newly minted “Common Drug Review” — a national process aimed at reviewing new drugs and recommending some of them for health care coverage. Imagine if those drug reviews concluded that many of the new drugs make so little difference in a person’s health, they aren’t worth public money? No wonder Murray J. Elston, president of Rx&D, Canada’s equivalent of PhRMA, warned that such a system better not “create an unnecessary layer of red tape” and keep new medicines from Canadians.

Of course, according to the drug industry, all this lobbying is not about their bottom line but about improving Canadians’ health. In a twist of logic that would make a pretzel blush, they say Canadians would actually benefit from more drug spending, because it would motivate drug companies to create more drugs which would in turn further improve Canadians’ health. Yet there is no evidence that Canadians suffer from a lack of necessary drugs.

To the contrary, Canada leads the world in the rate at which we are spending more of our money on drugs. Last year Canadians filled almost 350 million prescriptions, which works out to almost 12 prescription drugs for every man, woman and child. All this is happening at a time when public health experts increasingly identify adverse drug reactions and medication misuse as a serious problem.

Many drugs are inappropriately used and others do more harm than good. The World Health Organization, for instance, reports that there are 326 essential drugs. Health Canada licenses more than 5,200 for human use. Does that mean that nearly 95% of the drugs on the market in Canada are non-essential? It’s a $12 billion dollar question. One thing for sure though, Canada needs a serious public debate on the value of the drugs it pays for.

Roy Romanow realized the pressures government are under to pay ever more for prescription drugs. That’s why he recommended the formation of a national drug agency that would ensure we fund only cost-effective drugs, monitor their outcomes and educate doctors and patients about the effects of those drugs.

He recognized that the stakes around prescription drug costs are higher than ever, and that, at a bare minimum, Canadians should be able to decide for themselves how much to ante up.