Corporatocracy Gone Wild

The Trans-Pacific Partnership (TPP) is a trade deal that's supposed to be good for all US citizens, but as I've blogged before, it is totally controlled and written by mega corporations to secure their grip on international trade and laws, and if it is enacted it will further the degradation of our people while the mega rich will gain control over everybody and everything.  It is blessed by President Obama, but no members of Congress will be allowed to see it or debate it, it's being written in total secrecy by the corporate elite.  Public Citizen obtained a leaked chapter of the draft language from WikiLeaks and had this to say.

“The Obama administration’s proposals are the worst – the most damaging for health – we have seen in a U.S. trade agreement to date. The Obama administration has backtracked from even the modest health considerations adopted under the Bush administration,” said Peter Maybarduk, director of Public Citizen’s global access to medicines program. “The Obama administration’s shameful bullying on behalf of the giant drug companies would lead to preventable suffering and death in Asia-Pacific countries. And soon the administration is expected to propose additional TPP terms that would lock Americans into high prices for cancer drugs for years to come.”   Last week, the AARP and major consumer groups wrote to the Obama administration to express their “deep concern” that U.S. proposals for the TPP would “limit the ability of states and the federal government to moderate escalating prescription drug, biologic drug and medical device costs in public programs,” and contradict cost-cutting plans for biotech medicines in the White House budget.

Other U.S.-demanded measures for the TPP would empower the tobacco giants to sue governments before foreign tribunals to demand taxpayer compensation for their health regulations and have been widely criticized. “This supposed trade negotiation has devolved into a secretive rulemaking against public health, on behalf of Big Pharma and Big Tobacco,” said Maybarduk.

Predatory Drug Pricing

I don't know what it would take to get government action on predatory drug pricing, but take a look at this article on two drugs to treat fatal illnesses, Cystic Fibrosis and cancer.  It makes me so angry that we tolerate this abuse of very vulnerable sick people.

In January 2012, the U.S. Food and Drug Administration approved Kalydeco, the first drug to treat the underlying cause of cystic fibrosis, after just three months of review. It was one of the fastest approvals of a new medicine in the agency’s history. Vertex Pharmaceuticals, which discovered and developed the drug, priced Kalydeco at $294,000 a year, which made it one of the world’s most expensive medicines. The company also pledged to provide it free to any patient in the United States who is uninsured or whose insurance won’t cover it. Doctors and patients enthusiastically welcomed the drug because it offers life-saving health benefits and there is no other treatment. Insurers and governments readily paid the cost.  Several months later, Zaltrap was approved to treat colorectal cancer. The drug was discovered by Regeneron, an emerging biopharmaceutical company like Vertex, but sold by the French drug maker Sanofi. Though it worked no better in clinical trials than Roche’s cancer drug Avastin, which itself adds only 1.4 months to life expectancy for patients with advanced colorectal cancer, Sanofi priced Zaltrap at $11,000 a month, or twice Avastin’s price. Unexpectedly, there was resistance. Doctors at Memorial Sloan-Kettering in New York, one of the world’s leading cancer centers, decided Zaltrap wasn’t worth prescribing. They announced their decision—the first time prominent physicians anywhere had said “Enough” to the introduction of a high-priced cancer drug—on the op-ed page of the New York Times. Three weeks later Sanofi effectively dropped its price by half through rebates to doctors and hospitals. Even so, British health authorities said they would not pay for the treatment.

Pharmaceutical Marketing as Organized Crime

One of the Links on my blog is to Howard Brody's blog, Hooked.  He blogs about medical ethics in the Pharmaceutical industry, or, more often, the lack of it.  He recently did a book review on a book by a European Researcher, Peter C. Gøtzsche, Deadly Medicines and Organized Crime: How Big Pharma Has Corrupted Healthcare (New York: Radcliffe Publishing, 2013).  Here are some of the zingers in the book.

Throughout the book, Gøtzsche uses the organized crime motif to characterize the drug industry. This is quite deliberate and measured. He argues that something counts as organized crime when:

• They kill people
• They lie about what they do
• They routinely break the law as a part of their business practices
• They use their ill-gotten gains to corrupt the government regulatory apparatus so as to be allowed to continue to operate

Gøtzsche is a physician, epidemiologist and research methodologist, and has achieved prominence as head of the Nordic Cochrane Center, a part of the Cochrane Collaboration which is generally recognized as the most reliable and independent assessor of medical data—a sort of gold standard if you want to know: how good is the evidence that any treatment works for any disease? So this guy is not one to fly off the handle and make charges that he cannot document with solid evidence.

• “In the United States and Europe, drugs are the third leading cause of death after heart disease and cancer.”(1)
• “The main reason we take so many drugs is that drug companies don’t sell drugs, they sell lies about drugs. Blatant lies that—in all the cases I have studied—have continued after the statements were proven wrong.”(2)
• “The book addresses a general system failure caused by widespread crime, corruption and impotent drug regulation in need of radical reforms. Some readers will find my book one-sided and polemic, but there is little point in describing what goes well in a system that is out of control. If a criminologist undertakes a study of muggers, no one expects a ‘balanced’ account mentioning that many muggers are good family men.”(2)

Medical Industrial Complex Tramples US

I continually run across stories on health care costs in the US that make me gasp in disbelief at how we are being legally robbed (sometimes robbed to death) by the Medical Industrial Complex and their partners in crime, the FDA.  The latest is an article published in the NY Times about Asthma treatments.  It includes many of the infuriating facts driving drug costs in the US.

Pulmicort, a steroid inhaler, generally retails for over $175 in the United States, while pharmacists in Britain buy the identical product for about $20 and dispense it free of charge to asthma patients. Albuterol, one of the oldest asthma medicines, typically costs $50 to $100 per inhaler in the United States, but it was less than $15 a decade ago, before it was repatented. 

Rhinocort Aqua, a prescription drug that was selling for more than $250 a month in Oakland pharmacies last year but costs under $7 in Europe, where it is available over the counter.

Unlike other countries, where the government directly or indirectly sets an allowed national wholesale price for each drug, the United States leaves prices to market competition among pharmaceutical companies, including generic drug makers. But competition is often a mirage in today’s health care arena — a surprising number of lifesaving drugs are made by only one manufacturer — and businesses often successfully blunt market forces. 

Thanks in part to the $250 million last year spent on lobbying for pharmaceutical and health products — more than even the defense industry — the government allows such practices. Lawmakers in Washington have forbidden Medicare, the largest government purchaser of health care, to negotiate drug prices. Unlike its counterparts in other countries, the United States Patient-Centered Outcomes Research Institute, which evaluates treatments for coverage by federal programs, is not allowed to consider cost comparisons or cost-effectiveness in its recommendations. And importation of prescription medicines from abroad is illegal, even personal purchases from mail-order pharmacies.

“Our regulatory and approval system seems constructed to achieve high-priced outcomes,” said Dr. Peter Bach, the director of the Center for Health Policy and Outcomes at Memorial Sloan-Kettering Cancer Center. “We don’t give any reason for drug makers to charge less.”

And taxpayers and patients bear the consequences.

See also this story on the FDA,  this story on high health care costs, and this story on Novartis in particular, as well as this one.