PhRMa’s Free Ride in Health Care Reform

Dan Munro

Posted 3/05/12 on Forbes

You may recall that last year the DOJ agreed to a settlement with Google for $500 million. Basically Larry Page needed to avoid criminal prosecution for actively helping Canadian Pharmacies advertise to American consumers more effectively with Google AdWords.  That alone probably wouldn’t have raised any eyebrows except that the profits were being siphoned away from American pharmaceutical companies (at scale) and of course that simply can’t be allowed to happen.  Pure speculation on my part to say that pharma lobbying helped, but in either case, the DOJ filed criminal charges which forced the settlement. Open and shut case – now closed.  But here’s the thing – it’s a story that keeps repeating itself – in not so nuanced ways.  This time the thread starts with a fairly safe and upbeat report from our Nations largest e-prescribing network – Surescripts. Aptly titled: E-Prescribing Shown to Improve Outcomes and Save Healthcare System Billions of Dollars. Fabulous news. Let’s dive in.

So it turns out that the first bit of news isn’t that good.  According to the World Health Organization “as many as 50% of patients do not adhere fully to their medication treatment, leading to 125,000 premature deaths and $290B annually in the form of increased hospitalizations and costly complications (U.S. only).” Ok – so that’s not good at all.  It’s easy to dismiss the data (it’s from 2003) but still – 50%? According to Kaiser Permanente there were about 3.7B prescriptions filled in the U.S. in 2010 for a total in retail sales of about $221B.  So, in effect, the healthcare costs of poor drug adherence exceeds the total retail sales of all drugs in this country ($290B vs. $221B). While those two numbers aren’t related – it’s safe to say that the cost of poor drug adherence trumps any incremental value we’re able to get through e-prescribing by a very wide margin. In effect, non-adherence accounts for almost 10% of our $3 trillion National Healthcare Expenditure (NHE).

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Ending Pay-For-Delay Deals Could Raise over $5 Billion

Merrill Goozner

Posted 11/08/11 on Gooz News

The deficit reduction “super committee” charged with coming up with $1.2 trillion in budget reductions over the next decade shouldn’t let this one pass. The Congressional Budget Office today estimated that ending drug industry “pay for delay” deals with generic manufacturers will save the federal government over $5 billion over the next decade.

The “Preserve Access to Affordable Generics Act,” sponsored Sen. Herb Kohl, D-Wis., with eight co-sponsors, including two Republicans, requires that any deal between two companies that delays production of a generic drug after a patent has expired must show that the deal is “pro competitive,” which would effectively ban the practice. The Federal Trade Commission issued a report a year ago that found 66 of these deals reached over the past half decade were costing consumers about $3.5 billion a year.

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Should Pharma have Unrestricted Access to Doctors’ Prescribing Profiles?

Kenneth Lin

First published 4/25/11 on the American Family Physician Community Blog

For many years, it has been a common practice for pharmaceutical companies to use individual physicians’ prescribing profiles to tailor their marketing and sales strategies. For example, if a drug rep had access to data showing that a particular family doctor was prescribing more of a competitor’s anti-hypertensive drug, he or she might make a point of dropping off a batch of samples to change that doctor’s prescribing practices. As explained in a previous AFP Journal Club, this strategy is often very effective for the drug company, but ends up increasing patients’ out-of-pocket expenses in the long run.

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Same Old Stories for the Drug Industry

Merrill Goozner

First published 3/7/11 on Gooz News

Two stories in the New York Times over the weekend told readers nothing new about the drug industry. The first, on Sunday, revisited the two-decade-old, reimbursement-driven trend among psychiatrists to prescribe drugs instead of engaging in talk therapy. The second, this morning, reminds readers that expiring patents on blockbuster drugs like Pfizer’s Lipitor will cost the industry about $50 billion or around 16 percent of its revenue next year. There goes research and development, the story suggests.

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Health Innovation In The US Is Ours To Lose


Originally published 1/17/11 on Health Populi.

The U.S. has few bright spots when accounting for global trade: we import much more than we export. Entertainment is America’s #1 export. After that, medical innovation shines.

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Doctors Without Borders

A Special Weekend Article!

Why you can’t trust medical journals anymore.


Brian’s Note: This article was published nearly 7 years ago, in 2004, in the Washington Journal. While transparency and disclosure rules have arguably improved since then, the larger problems associated with financial conflict still pervade all medicine and health care. A spate of recent stories has detailed device manufacturers paying off surgeons. Community oncologists and adolescent psychiatrists are still permitted to profit on the drugs they prescribe. And on and on.

So Ms. Brownlee’s article remains relevant, shocking and very engaging. Enjoy.

With financial ties to nearly two dozen drug and biotech companies, Dr. Charles B. Nemeroff may hold some sort of record among academic clinicians for the most conflicts of interest. A psychiatrist, a prominent researcher, and chairman of the department of psychiatry and behavioral science at Emory University in Atlanta, Nemeroff receives funding for his academic research from Eli Lilly, AstraZeneca, Pfizer, Wyeth-Ayerst–indeed from virtually every pharmaceutical house that manufactures a drug to treat mental illness. He also serves as a consultant to drug and biotech companies, owns their stocks, and is a member of several speakers’ bureaus, delivering talks–for a fee–to other physicians on behalf of the companies’ products.

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Listening in on patient-physician conversations – consumers don’t talk so much about branded drugs


Originally published here on 12/8/10 on Health Populi.

What happens when a company becomes a proverbial fly on the wall in the physician’s exam room as she’s meeting with patients? Real-life insights into what health consumers ask for, and how they converse with doctors – neither of which match up to a pharma marketer’s dream (or business objective) of motivating consumers to ask their physicians to describe specific brands of drugs.

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