I am currently in my 37th year as a licensed pharmacist, and I have never before seen such greed and corruption that has been forced upon the American people by Congress, the insurance industry, and the omnipotent Pharmaceutical Manufacturers Association.
I find it an egregious insult to the intellect of the citizens of this country that Congress has been given the power to create and implement policy by which we must abide... while in the process... exempting themselves! When did we become second class citizens? Who proclaimed that members of Congress are better than you and I and deserve special treatment? Should not members of Congress and the President live with the consequences of congressional action? Whenever it is suggested that Congressmen be held to the same standard, we hear that body consists of fewer than 600 members, and it's only a drop in the bucket. Well, if we are required to fill the bucket, then I...for one...would like to see to it that they contribute that drop.
Certainly we are cognizant that a vast majority of that "Sacred Body" has been bought and paid for by those who lobby on behalf of insurance and pharmaceuticals, and the abomination that was enacted into law as a Medicare Rx Drug Plan is nothing more than a dream come true for those industries that prosper inordinately due to its passage. Without the support of AARP, the bill would have been defeated, but that organization showed its true colors and spent nine million advertising dollars to convince seniors that it was in their best interest. What Mr. Novelli failed to tell Americans was the fact that it would enrich AARP's coffers by nearly six million dollars annually in insurance premiums.
Bill Novelli...CEO of AARP...has embarked upon a campaign to persuade pharmaceutical manufacturers to allow the American people to import more affordable drugs from Canada. Pardon me while I take a break from this writing to regurgitate!! Has not Mr. Novelli and his staff at AARP done enough harm to American pharmacies and pharmacists? Just how far is this man willing to go to try to win back the 60,000 members that AARP lost over the Medicare Rx Drug Legislation? I am proud to say that I am one of the 60,000 people who dropped my membership and was refunded $24.00. Perhaps Mr. Novelli did the math and realized that AARP had lost nearly $1.5 million in annual membership fees alone.
We are also hearing that Congressman Billy Tauzin is resigning his position in the House of Representatives to take on a job as chief pharmaceutical lobbyist with an annual salary of two million dollars. How ironic that he was one of the chosen few who met in secret in Washington to craft the infamous legislation that was forced through the House by the Republican majority in the wee hours of a Saturday morning. The historic lobbying effort took a total of three hours before enough arms could be twisted and votes could be changed and the gavel was finally slammed down in favor of passage. George W. Bush was more than happy to sign the bill into law even though 70% of Americans still don't realize that the law was even passed.
No one has addressed the real problem, i.e., price gouging by drug companies. These companies have elected to hide behind the pretense that research and development would dry up and innovation would be lost if they are not allowed to charge these ridiculous prices. Please spare us all from the threat, because that is not going to happen!
Thirty years ago, pharmacists and physicians were presented with the awesome responsibility of deciding whether or not to substitute more cost effective generic drugs for the brand name drugs that we all trusted to be safe and effective. I can recall facing the dilemma with mixed emotions, because I certainly didn't want to take part in a process that resulted in killing the goose that laid the golden egg. Time proved me to be completely wrong as the goose began laying eggs faster than ever before, and the price of gold soared to unprecedented heights.
Today, generic drugs are not much cheaper than their patented counterparts. There are far too numerous examples to mention in this context, but it was shocking indeed, when Meprobamate jumped from $30.00 per thousand to nearly $1,500.00 in a single price hike! The price of Quinine is another example of a drug industry gone awry. Up until two or three years ago pharmacies were allowed to sell Quinine over the counter primarily for nocturnal leg cramps. It was quite a surprise when the FDA... in its infinite wisdom... came out with the news that Quinine was ineffective for leg cramps, and it was only indicated for Malaria. At that point in time the drug was placed on Rx only status, but a doctor could write a prescription for anything he deemed appropriate such as Malaria or leg cramps. Pharmacies, however, could no longer sell 30 capsules for $1.80, and the wholesale cost to the pharmacy escalated to $1.00 per 5 grain dosage unit. I am forced to ask the question; was it research and development that caused these steep escalations? Both of the drugs I have used as examples here are more than fifty years old!
What all of this means is that the pharmaceutical industry needs to come forth with prices that make sense, and if this was done, insurance companies and plan benefit managers (PBM's) would extricate themselves from the business as the incentive would automatically be removed. Many cities and several states are in a desperate struggle to import affordable drugs from Canada for state employees, retirees, and for use in state penitentiaries. What this suggests to me is that it's not the drugs that need to be imported but the Canadian system that needs to be implemented in the US. Call it socialized medicine or national health insurance or whatever you please, but give us a system that ordinary Americans...other than the very wealthy...can afford.
Could it be that pharmaceuticals would again be within reach if manufacturers stuck to manufacturing and left the dispensing to pharmacies? Would drug prices come down if television advertising was eliminated and pharmaceutical sales reps focused on educating physicians and pharmacists about their company's products? How many more families will be forced to file for bankruptcy as a result of out of control medical expenses? Recently, NBC Nightly News told of eight million families filing for protection last year alone. Do we really believe that ANY political party will step up to meet this challenge? I'm afraid that all we can hope to get from the political arena is more of the same rhetoric that is flooding the airwaves every waking hour of this election year.
When I became a pharmacist in 1967 I was proud to be a part of an honorable profession. Things were so much simpler then, and the roles played by each sector of the industry were clearly defined. Every facet of the pharmaceutical industry worked hard to be the very best it could at performing its function. Today, manufacturers are trying so hard to control the distribution process from their plants right into the homes of the patients who consume their product. Wholesales and pharmacies are only utilized whenever there is not enough time to set up a patient to receive their product from a mail order company in which they have a proprietary interest.
It has long been my contention that for a drug to be considered a valuable component in the total healthcare picture, it must only possess three important characteristics. The first thing that a drug must prove is that it lives up to the claim that is made regarding its efficacy. In other words, if a drug is designed to lower blood pressure, it must do just that. The second characteristic that a drug must exhibit is a side effect profile that a patient can live with. If a drug makes a person miserable, that patient is not likely to continue to take it. The third and final characteristic that must be possessed by a drug is affordability. It does not matter how many wonderful things can be said about a drug...if a patient cannot gain access to it... it need not exist!
If the citizens of this country, young and old, rich and poor, would band together and demand that changes be made, perhaps corporate America and those who purport to run our government would sit up and take notice that we are not going to stand for such treatment anymore
Guy Stirling
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