This is not all-inclusive but gives the sense of the pharmaceutical industry’s prime reason for being–making money.
10. Charging $100/pill for anti nausea medication (Emend). I have had patients tell me they would rather throw up than pay an exorbitant price for this type medication. There is something surreal about this pricing.
9. Aggressively marketing “new” patented drugs that have no additional benefit over previously developed and now generic medications. Prime example of this is Nexium a drug with no additional benefit over omeprazole (generic prilosec). Ironically Nexium is made and marketed by the same manufacturer as the generic. Why pay less when you can get the new “purple pill.”
8. Aggressively marketing drugs based on flimsy evidence: The recent findings that Aranesp and Epogen have serious side-effects and limited benefit (10 billion in sales/year) is the tip of the ice-berg. Other drugs that have been inadequately studied and found later to have marginal benefit and/or serious side-effects include estrogen, Oxycontin, and a number of anti-depressants. If one goes back in time there are many more examples.
7. Pricing to maximize profit–the name of the game: This sounds like good capitalistic policy but doesn’t it seem a bit excessive when people can’t afford a medication and suffer. Today many new drugs cost more each year than the median and average incomes in our country? Most important is the fact that pricing does not reflect the actual cost of development (much of which is from tax supported research). Our patent system actually protects these monopolists and assures that our pharmaceutical prices are significantly higher than anyplace else in the world. We won’t even allow the government to negotiate prices for the Medicare program–PHARMA strongly lobbies against such provisions. .
6. Paying physicians various stipends and fees with the result that they prescribe the company’s products more frequently than those who don’t receive these payments. The payment may be a subsidy for seminars, research projects, or whatever pretext the drug company can devise. The end result is a conflict of interest.
5. Paying researchers. This is particularly pernicious as the researcher (at universities, cancer centers and in private practice) rarely disclose the funding they are receiving from drug companies to enroll patients in research studies. The question is does payment affect results, their interpretation, patient selection or any number of potentially confounding variables.
4. Having FDA consultants on their payroll. The consultant then judges whether the medication is worthy of FDA approval. It’s hard to prove whether there is actual bias in these consultants’ behavior, but the appearance is damning. Disclosure of the relationship is not enough to eliminate the appearance of a conflict of interest.
3. Direct marketing that overemphasizes (or misstates) benefits while deemphasizing risks. You can refer back to the Epogen and Aranesp ads for verification. Direct marketing advertisement also never mention the cost of the drug. In addition, it is a fact that PHARMA spends more on drug marketing than research and guess who gets to pay?
2. The manufacturers of OxyContin (Perdue Pharma) for misrepresenting the addictive potential of their drug Oxycontin. At one point, they also recommended off label dosing of every 8 hours rather than the approved 12 hours. We are talking billions in profits for this drug. It appears with this manufacturer that anything that will maximize profits is fair game.
1. Not adequately cutting the cost of drugs to impoverished AIDS victims and blocking the use of cheaper generics whenever possible in third world locations. Many of these poor countries have health budgets of less than $25/person/year. The drug companies still want to charge in the range of $100-$1000/year for their anti-AIDS drugs and oppose the use of, and marketing of, generics that cost a fraction of the branded drugs.
People are dying while the drug companies are fiddling–not a pretty picture of humanity in the 21st century.