 |
 | Home | Contact Us | FAQ | Search & Site Map | Link to Us |
 | Sign In | Join | Other 45 Sites in Network |
Medical Forum / General / General / January 2005A drug-company executive speaks out
Houston Chronicle Dec. 29, 2004 What big drug companies don't want you to find out Those least able pay the most for prescriptions By PETER ROST The U.S. health-care system is the best in the world. Or so we are often told. But is it really true? It is certainly the best system for drug companies, which can charge the highest prices in the world to some U.S. consumers. The Congressional Budget Office has estimated that average prices for patented drugs in 25 other top industrialized nations are 35 percent to 55 percent lower than in the United States. And it is a pretty good system for hospitals, insurance companies and others that deliver health-care services. Americans spend about twice as much per person for health care as do Canadians, Japanese or Europeans, according to the World Health Organization. But it's not a good system for American citizens. The United States has shorter life expectancies and higher infant and child mortality rates than Canada, Japan and all of Western Europe except Portugal, according to the WHO. I'm a drug-company executive who has spent 20 years marketing pharmaceuticals. And I'm troubled. I'm most troubled by the fact that we stick it to the people who can afford it the least. For instance, elderly people who use a Medicare discount card and have to pay $1,299 annually for a drug that the Department of Veterans Affairs purchases for $322, according to a comparison by Families USA. Or middle-class families that lose health insurance and have to pay $29,500 for an overnight hospital stay, when Medicaid would have paid only $6,000, according to The Wall Street Journal. It just doesn't make any sense. And, not surprisingly, the companies with the biggest profits - those in the drug industry - have been fighting hardest to maintain the status quo. Our dirty little secret is that the drug industry already sells its products, right here in the United States, at the same low prices charged in Canada and Europe. It's done through rebates. These are given to those with enough power to negotiate drug prices, such as the VA. A 2001 study by the consumer advocacy group Public Citizen found that drug companies' favorite customers paid just a little over half the retail price. This leaves the 67 million Americans without insurance to pay cash, with no rebates, at double the prices paid by the most-favored customers. The fight against reimportation of drugs is a fight to continue to charge our uninsureds full price while giving everyone else a rebate. But what about all those programs drug companies provide to help the indigent pay for drugs? If they really worked, the Kaiser Family Foundation wouldn't have reported that 15 percent of uninsured children and 28 percent of uninsured adults had gone without prescription medication in 2000 because of cost, and 87 percent of uninsured individuals with serious health problems reported trouble obtaining medication. People today have to choose between drugs and food. The journal Diabetes Care recently reported on a study of older adults with diabetes. One in three said they went without food to pay for drugs. As a drug-company executive, I care about profits. When I was responsible for a region in Northern Europe, I doubled sales in two years by lowering drug prices, and in the process increased my company's sales ranking in Sweden from No. 19 to No. 7 in less than two years. I proved that it is possible to do good business with lower prices. It's encouraging to see that the American Medical Association recently came out in favor of a system that would allow U.S. pharmacies and wholesalers to reimport drugs safely from other countries. This is exactly what Europe has had for more than 20 years. It is outrageous to claim, as politicians and drug companies have done, that the United States wouldn't be able to safely and cost-effectively handle reimportation. A key trade association for European pharmaceutical companies claims there has never been a confirmed case in Europe of a counterfeit medication reaching a patient as a result of reimportation. In Germany, this was verified last year by the Federal Ministry of Health. In the next five years, branded drugs with annual sales of $72.9 billion are expected to lose patent protection. So we in the drug industry are fighting reimportation because we're worried about the bottom line. But when we have to choose between that and the lives of those who can't afford drugs, we have to choose life. I joined this industry to save lives, not to take them. And that's the reason I've chosen to speak out. .... Rost is a vice president of marketing at Pfizer; the views expressed here are his own, not those of his employer. >The U.S. health-care system is the best in the world. Or so we are >often told. But is it really true? [quoted text clipped - 14 lines] >than Canada, Japan and all of Western Europe except Portugal, according >to the WHO. Although I agree with this, I would not blame mostly the USA's robber baron club of a healthcare system for the health of Americans being worse than that of those in other industrialized nations. I give most of the blame to the especially unhealthy lifestyles of all too many Americans. Americans eat too much of everything except not enough vegetables and fiber, too much fat in general, too much saturated fat, too much trans fat (mostly in partially hydrogenated oils), too much salt and are much too sedentary. I also suspect that enough Americans consume enough recreational drugs to have some measurable impact on overall national health statistics. Americans also have HIV/AIDS more than people in other "first world" nations, and I suspect also other sexually transmissible diseases. - Don Klipstein (don@misty.com) > Houston Chronicle > Dec. 29, 2004 [quoted text clipped - 97 lines] > Rost is a vice president of marketing at Pfizer; the views expressed > here are his own, not those of his employer. Is Rost looking for a new job? Hurray to Mr. Ross for speaking out, endangering his job in the process. He makes some excellent points. I learned a lot from his statement. I hope his words are taken to heart by Americans. However, a couple of his concepts I find a bit misleading. > The > Congressional Budget Office has estimated that average prices for > patented drugs in 25 other top industrialized nations are 35 percent to > 55 percent lower than in the United States. The U.S. health care system is geared toward those who have insurance. The insured do not pay high costs for drugs. They pay a copay for each prescription. Also, the insurance companies do not pay full price for the drugs. > I'm a drug-company executive who has spent 20 years marketing > pharmaceuticals. And I'm troubled. I'm most troubled by the fact that > we stick it to the people who can afford it the least. In other words, those who don't have insurance. In this country, those who don't have insurance are largely people who are unemployed. Many are those who qualify for medical assistance but haven't taken the time to apply for it. (Of course, many are uninsured who are employed but worked for small companies or for themselves. And the elderly, though insured, are not adequately covered.) I also agree with the follow-up post about unhealthful American lifestyles. Europeans visiting the U.S. are amazed at how much Americans eat at each meal, and at how fat Americans are. > Hurray to Mr. Ross for speaking out, endangering his job in the > process. He makes some excellent points. I learned a lot from his [quoted text clipped - 27 lines] > lifestyles. Europeans visiting the U.S. are amazed at how much > Americans eat at each meal, and at how fat Americans are. Life expectany is still going UP, not down, and lifestyle, not medical care, is the reason. Of the 35 years of increased life expectancy since 1900, only 5 is attributed the medical care and the rest to social changes like, you guessed it, better food. > Life expectany is still going UP, not down, and lifestyle, not medical >care, is the reason. Of the 35 years of increased life expectancy since >1900, only 5 is attributed the medical care and the rest to social changes >like, you guessed it, better food. I wonder where that attribution came from. I would think that most of the 35 years came from reduced infant and childhood mortality, mainly due to vaccination and public health measures like better sanitation. The introduction of the sulfa drugs and later the antibiotics probably accounts for most of the rest. I suppose you could count it as a lifestyle change to expect sewage-free drinking water, pasteurized milk and to vaccinate your children, but it would be a stretch to call availability of effective drugs to fight infections a lifestyle change. I'd put vaccinations down to "medical care" myself, unless you don't include preventive measures (including screening for disease at an early, treatable stage) as "medical care". 100 years ago, 1 child in 10 died of diphtheria alone. Other childhood diseases killed many, both directly and from secondary infections that can now be controlled by antibiotics. Newborns died of umbilical tetanus, their mothers died of childbed fever, infants and young children died of gastrointestinal disorders due to contaminated water and unpasteurized milk. One young adult in four died of tuberculosis. Pneumonia killed people of all ages, and even minor wounds caused death from tetanus or septicemia. Note that if half the population dies by the age of one, the rest can live to 100, and life expectancy will still be 50, so saving the lives of many infants and children will have a far more dramatic effect on life expectancy than adding a few years to lives of the elderly. As for the rest, life expectancy in developed countries has gone up only slightly if at all in the past few decades. Some is due to lifestyle factors like the reduced number of smokers and the recognition of the role of diet and exercise in postponing the diseases of aging, but I would think more is due to earlier detection and better treatments for such diseases. Cervical cancer used to be the major cancer killer of women of relatively young age. The Pap test probably added enough decades of life for enough women to cause a minor increase in the life expectancy figures. If you ever get a chance to look at 19th century cause-of-death records, you'll see that most people died in childhood of "fevers" and "fluxes", or named diseases, like smallpox and lockjaw. Those who survived to adulthood died of consumption and blood poisoning and "fevers". An appalling number of women in their twenties died in childbirth and of childbed fever, and their infants with them. Those who made it to middle age seem to have done pretty well, but once they reached sixty, their deaths are usually recorded as "old age". Another educational exercise is to examine the tombstones in an old rural cemetery, perhaps one that served only a few families. You'll see how half a dozen or a dozen children of various ages died in a period of a few weeks as some epidemic came through. Often several siblings or cousins share a marker. You'll see the graves of young women who successively married the same man, often buried with their infant of a few days. Off in a corner, you'll see many closely spaced markers of infants and young children. Calculate the average age at death, and you'll see that it's very low, mostly due to deaths of the young. Most such deaths no longer occur, largely due to vaccination, sanitation and antibiotics. |
Reply to this Message |
 Sign In
 Join
 My Latest Posts My Monitored Threads My Blog My Photo Gallery My Profile My Homepage Start New Thread Enable EMail Alerts Rate this Thread
|
©2008 Advenet LLC Privacy Policy - Terms of Use
This website includes both content owned or controlled by Advenet as well as content owned or controlled by third parties.