See, there’s a new sheriff in town.

Just the same — I wish you the best. Sincerely.

Namaste

(a) US Drugs’ actual costs (your 10 percent):

Describing all US pharma costs as a percentage of total health care spending (as PhRMA does) is deceptive. How so? Well, a more relevant measure would be how much is spent on the chronic conditions (the 80-20 rule), and THEN, how much of THAT spend would have been preventible — with better well-care. Diet and exercise. We don’t see the fully-loaded INCREMENTAL cost (to the system) of pharma pushing pills for cholesterol management (for life) — if we don’t compare it to a population that is NOT afflicted as heavily with obesity — and thus the precusors for life long conditions like diabetes and cardio-pulmnonary diseases. [Pharma owes a debt to McDonalds here.] In the rush to sell drugs, big pharma is ENCOURAGING the “crowding out” of the role of diet and exercise, toward life long wellness. [This is a system-wide problem, though -- not just pharma is to blame, here.]

(b) If you are right that drug profits are so small, why did Billy Tauzin so quickly offer up $80 billion over the next ten years — to close the “doughnut hole”?

He did it, on behalf of PhRMA, because it is far CHEAPER than having to directly negotiate prices with the government. DOn’t cry “poor” about pharma to me — it is one big fat lie.

And I can prove it.

(c) We all know that not a single big pharma company lost money last year — despite some of the worst economic conditions, in a generation. We also know that pharma CEOs are paid like rock-stars. Neither of these would occur, if pharma wasn’t a vastly high-margin business in the USA.

(d) As to why big pharma stocks haven’t done so well — you ought to look at the amount of money pharma is siphoning off for things like DTC, CME, CEO and Top Five comp. (usually post-departure of same). . . and yes, being assessed in fines penalties and verdits. Clean up the house, drain the swamp — and stop wrestling the alligators. It will be cheaper, long term.

(e) Finally, that big pharma stocks have been flat this year is actually a victory, compared to financial and real estate returns (losses).

(f) I don’t “attack success” — I attack the mis-use of the priviledges “we, the people. . .” granted big pharma — a dual monopoly, through patents and FDA approvals — when the same are “gamed”, solely to maximize profits, at the expense of good science and long-term medical advances. In my book, that is “failure” — a failure to respect the vast priviledge bestowed upon the industry — not a success. I attack unbridled greed, masquerading as “poor pharma” — we need more corporate welfare programs for big pharma, like we need to hear more from Dick Cheney on foreign terror threats [not at all]. That turns my stomach.

Some 45 million Americans are living in fear that any illness could wipe them out — financially. And yet, at the same time — insurers reimbursed over $4.2 billion worth of Viagra prescriptions last year. [While it does improve quality of life, the balance there -- seems. . . off. Way-off.]

Defend that — to a minimum-wage-earning single mom, with a kid living with asthma, or cancer, or lupus, or diabetes, or renal disease — and no insurance. I dare you.

So — don’t be so quick to paint all of us with one falsely broad brush.

To say the thing (health-care delivery in America) is “broken“, is not to be some wild-eyed wing-nut — it is to be a realist.

Namaste

So, first — the matters upon which we agree in principle (if not all of the finer details):

(1) Shorter patent-lives — measured from first commercial sale date, not patent grant date. I actually think 7 years would be plenty.

(2) More than two-thirds of all hospitals in America are losing money. Some of it is inefficiancies, but a fair amount of it is insufficient reimbursement from insurers — and yes, Medicaid.

(3) On balance, doctors in the USA make 40 percent more than their counterparts in the European Union. Yet, again — on balance — European Union patients are healthier. [A large portion of the difference, there, to be fair, is that on balance, diet and exercise in Europe are the first forms of preventative health care.] So, yes — doctors need to surrender some compensation, and in return, malpractice insurers need to reduce premiums charged (and yes that means some level of tort reform).

(4) By your dodge of mine (in the main), it seems we also agree that generic manufacturers have a place — clearly so, if you favor limited periods of patent protection.

(5) Health insurance reform is overdue.

Next post, I’ll list where we disagree — and why.

– Namaste [It is a salutaion, not a handle -- the handle is Condor, just fyi. Namaste means "I bow to the Infinite in you."]

Regarding patent protection it is 17 years from discovery of the molecule. Since it now takes 10 to 15 years to bring a drug to market (40 years ago it only took 2 to 3 years), you are luck to have 3 - 5 years to recover the hundreds of millions of dollars invested in R&D over the 10 to 15 year drug development and qualification period. THat is why pharmaceuticals are so “expensive”. I advocate that the patent protection period not begin to run until the drug is approved by the FDA or equivalent in that country. Perhaps the new protection period could be shortened to 10 yeras. THis wopuld allow more time to recover the invested money. It would also encourage other to do more research to discover new drugs to compete with each other and drive down the cost. And the what is the cost. Do you know that pharmaceuticals represent only 8% to 10% of the total health care cost .in the U.S.. If you took away all of the profits from the pharmaceutical companies the best you could do is reduce the cost of health care by 1% to 2%. THe problem is that pharmaceuticals are not well covered by health insurance and medicare. Thus we ’see’ it because it comes right out of our pocket. What everyone wants to ignore is the high cost of hospital and doctor care, which represents over 70% of the health care cost. Here is where the biggest waste is. Why do doctors need to make such high salaries and why do hospital need to resemble palaces? For some reason or other they get a free pass. If the health insurance companies (and don’t get me started on them) covered doctors fee and hospital costs at the same rate as they cover pharmaceuticals if public would be up in arms against all of them.

You also forget to consider how much pharmaceuticals save you. For example you have an upper respiratory infection that would keep you in bed for a week, but instead you take that new antibiotic and you are back on the job in a day or two. Another example with which I am familiar was that of my childshood friend’s father. He had a chronic stomach ulcer condition, He had several operations. He was always in pain, grouchy and lost a lot of time and pay at work. Eventually my friend’s father died. We aere only about 12. My friend’s mother could not afford to keep the house so they moved to stay with a relative in another city. I never saw Eddy again. Today Eddy’s father woulod have been treated with an anti-ulcer drug and would very likely be alive today.

Pharmaceutical save more than they cost. THe big pharma’s are niot making 200% ROI. If they were their stock prices wouldn’t be in the dumper and they wouldn’t be merging with each other to cut costs.

Why do you alwqays attack success? Is it because you are jealous? If you are so smart and can do better then go out there and start your own pharma company, put out all of the R&D money from your own pocket for 10 years with no return and give away any profit you eventually make. Then I would have respect for you and could not argue with you because you stod up and acted on what you believe.

The way you have framed your question (above) leads me to wonder whether you really understand the issues, here.

No one is saying that branded pharma should not be allowed to profit from its R&D.

Some of us (wild-eyed nut-jobs that we are, at least in your eyes!) are just asking whether (for example) 32 years of patented exclusivity (when the patent statute mandates a “mere” 17 years), is “enough, already“. [The 32-year example is "New" Merck's cancer drug, Temodar®.]

Actually, let me take my first sentence back –I know you understand these issues — and I know you know that simply demonizing generic companies (because they do not generally “invent” new drugs) is easy, and a fun way to distract the audience.

But it absolutely does distract us from the real debate: Generic manufacturers are there to help the public receive a “fair shake” on drug pricing, once the branded pharma company has received all of its monopoly profits — the ones, by statute and rule (USPTO and FDA) — we grant them. We, as in “We, the people. . .”

Namaste

Pharmaceutical companies don’t give a RATS ASS about patients, nor do many of the doctors….

It’s a job, it’s all about the money….

They package and sell their health care like the snake oil charlatans of old, making the vulnerable think they are really there to help them - Kaching!!

No they are not and once patients figure that out and walk away from doctors and drug dependency then we will all start to be a bit healthier…