According to the Centers for Disease Control and Prevention (CDC), Fox News reports, overdoses of prescription opiod painkillers have more than tripled in the past 20 years, killing more than 15,500 people in the United States in 2009. In response to the epidemic, two of California’s largest counties have filed a civil suit against five of the world’s largest painkiller manufactures. Attorneys for Santa Clara and Orange counties filed a complaint, naming Actavis, Endo Health Solutions Inc., Johnson & Johnson’s Janssen Pharmaceuticals, Purdue Pharma and Teva Pharmaceutical Industries’ Cephalon Inc. as defendants.
According to a new report prepared by the George Washington School of Public Health and Health Services for the District of Columbia municipal government, 147 pharmaceutical manufacturers and labelers reported marketing expenditures of $97.5 million in 2012, which represents the first year‐on-year increase in such spending since 2007. The reported amount included expenses for local pharmaceutical sales representatives, speaking fees and gifts to physicians, and free samples.
BMJ reports that the UK based pharmaceutical giant GSK has said that it plans to employ doctors to educate their peers, rather than pay key opinion leaders to speak about its products at medical conferences and other events.
A manufacturer of pharmaceutical products has agreed to pay more than $724,000 to the Massachusetts Medicaid program over allegations of unlawful marketing practices aimed at promoting the drug Lidoderm for conditions not approved by the Food and Drug Administration (FDA), Attorney General Martha Coakley announced. The global settlement with Endo Pharmaceuticals, a wholly-owned subsidiary of Endo Health Solutions, resolves civil allegations that it illegally marketed Lidoderm for use in connection with lower back pain or chronic pain. The FDA approved Lidoderm only for the treatment of pain associated with post-herpetic neuralgia, more commonly known as “shingles.”
The Lancetreports that when employees at the German drug firm Boehringer Ingelheim learnt that the conclusions of a company study clashed with a marketing claim that its new anticoagulant did not need monitoring, they sought to have the paper revised and even questioned whether it should be published at all, internal company documents released by a US court indicate. One employee complained that the paper would harm the company’s marketing efforts and make discussions with regulatory agencies more difficult. “Can’t this be avoided?” the employee asked.
This week, Oxford University Press releases a new book by Corporations and Health Watch founder Nicholas Freudenberg, Distinguished Professor of Public Health at City University of New York School of Public Health and Hunter College. Here’s an excerpt from the Preface:
Never before in human history has the gap between the scientific and economic potential for better health for all and the reality of avoidable premature death been greater. In the past, babies died in infancy, women in childbirth, workers from injuries or occupational diseases, and people of all ages from epidemics of infectious disease exacerbated by inadequate nutrition, contaminated water, and poor sanitation. For the most part, the world lacked the resources and the understanding to eliminate these problems. As societies developed; as science, technology, and medicine advanced; and as people organized to improve their standards of living, more and more of the world’s population attained the living conditions that support better health and longer lives.
Today, the world still confronts the global health challenges of the last century. Epidemics of malaria, HIV infection, tuberculosis, and other communicable diseases still threaten well-being and economic development in many poor countries. More than a billion people live in urban slums where the average lifespan can be 35 years, half of that in better-off places where residents have certain access to adequate nutrition, clean water, and sanitation.
Now new threats have emerged. Deaths from chronic conditions like heart disease, cancer, diabetes, and stroke have surged, today accounting for more than 60 percent of the world’s deaths. Injuries have become the leading cause of death for young people around the world. Everywhere, from the wealthiest nations like the United States to the poorest countries in Africa, Asia, and Latin America, the proportion of deaths from these causes of death are growing. These premature deaths and preventable illnesses and injuries impose new suffering on individuals, families, and communities. They burden economies and taxpayers and jeopardize the improvements in health brought about by the public health advances of the previous two centuries.
Alarmingly, these new epidemics are not the result of the poverty and squalid living conditions that caused illness and death in the past, even though chronic disease and injuries afflict the poor much more than the rich. Nor are they the result of ignorance and inadequate science. For the most part, we understand the causes of these illnesses and injuries enough to prevent them. What we lack is the political will to implement the needed preventive measures. Even worse, in some cases the growing health burden is the result of new science and technology, which have been used to promote profit rather than prevent illness. These new epidemics of chronic diseases and injuries are instead the consequence of what most people thought were the remedies for poverty-related ill health: economic growth, better standards of living, and more comfortable lifestyles.
While many factors contributed to this global health transformation, Lethal but Legal focuses on what I consider to be most important and most easily modifiable cause: the triumph of a political and economic system that promotes consumption at the expense of human health. In this book, I describe how this system has enabled industries like alcohol, automobiles, firearms, food and beverages, pharmaceuticals, and tobacco—pillars of the global consumer economy—to develop products and practices that have become the dominant cause of premature death and preventable illness and injuries. This system was born in the United States and has now spread around the world.
In a global economy that focuses relentlessly on profit, enhancing the bottom line of a few hundred corporations and the income of their investors has become more important than realizing the potential for good health that the world’s growing wealth and the advances in science, technology, and medicine have enabled. This tension between private accumulation and public well-being is not new. But in the twenty-first century, it has come to shape our economy and politics in ways that profoundly threaten democracy, human well-being, and the environment that supports life. Paradoxically, the increasing concentration of power in the small number of the world’s multinational corporations also presents new opportunities to create another healthier and more just future.
The Legal Intelligencer reports that drug companies may face product liability claims in Pennsylvania for defectively designed drugs, the state Supreme Court has ruled. The 4-2 ruling stems from a case involving the fatal use of a diet drug made by a Pfizer subsidiary that was later taken off the market. The majority rejected the argument that manufacturing defects and inadequate warnings are the only viable product liability claims against pharmaceutical companies, and the court allowed claims to go forward alleging the drug company negligently designed and marketed the diet pill.
Need another reminder of how much drugmakers spend to discover what doctors are prescribing? asks Charles Ornstein on Pro Publica. Look no further than new documents from the leading keeper of such data. IMS Health Holdings Inc. says it pulled in nearly $2 billion in the first nine months of 2013, much of it from sweeping up data from pharmacies and selling it to pharmaceutical and biotech companies. The firm’s revenues in 2012 reached $2.4 billion, about 60 percent of it from selling such information.
A simply-worded headline in Monday’s New York Times crystallizes the often ignored tension between the proliferation of disease among the global poor and the interests of the for-profit pharmaceutical industry by declaring: “India’s Efforts to Aid Poor Worry Drug Makers.”
As the Times reports—much to the chagrin of the “business groups, legislators and drug makers in the United States”— India has increasingly challenged patent protections in order to care for their impoverished population by allowing the production of less costly, generic versions of numerous drugs.
Citing just once example, in a country where roughly half those diagnosed with breast cancer die from it, in part due to the soaring cost ($18,000 per treatment) of one of the most effective drugs, India’s pioneering stance against the world’s largest pharmaceutical corporations has the business “world watching” as the country strives to bring more affordable medicines to its people, especially the poor.
The New York Times reports:
India, which is one of the world’s leading producers of generic pharmaceuticals, has long viewed patent rights on medicines skeptically. It has already ruled invalid patents protecting exclusive sales of Novartis’s Gleevec, Pfizer’s Sutent and Roche’s Tarceva, all cancer medicines. In a landmark decision last year, the government agreed that the patent protecting Bayer’s Nexavar, also a cancer drug, was valid but overrode it anyway because a generic company promised to lower the price from $4,500 to about $140 per month of treatment.
Most recently, Roche Holdings of Switzerland has surrendered the patent rights to the drug Herceptin, one of the most effective treatments for an aggressive form of breast cancer, after deeming they would lose a legal battle in Indian courts.
And, in a move expected to “create ripples around the world,” according to one Indian public health official, an Indian government committee is soon expected to announce the start of a formal process to set aside patents on 15 more medicines.
The Times continues:
For drug companies, the most worrisome aspect of India’s efforts to lower drug prices is that other countries are beginning to follow its lead. Both Indonesia and the Philippines recently adopted patent laws modeled on India’s, and legislators in Brazil and Colombia have proposed following suit.
“One of the concerns of the industry is not just what India is doing in India, but we realize that the whole world is watching India,” Amy Hariani of the U.S. Chamber of Commerce affiliate, the U.S.-India Business Council, which is fighting India’s patent policies, told the Times.
Critiquing the position represented by Hariani and the Times‘ presentation of the conflict being between the accessibility of generic drugs versus drug innovation, economist Dean Baker, co-director of the Center for Economic and Policy Research, proposed an alternative headline for the Times article: “U.S. Tries to Force India to Accept Medieval Patent Rules.”
One problem with the Times‘ framing of the patent issue, he notes, is the assumption that a government-imposed patent monopoly is the only effective structure for the development of life-saving drugs.
“The patent system for financing drug research both leads to bad health outcomes and is a substantial drag on growth and job creation,” Baker writes on the CEPR blog Beat the Press.
There are other more modern mechanisms for financing research than this relic from the feudal guild system. For example, Nobel laureate Joe Stiglitz has advocated a prize system whereby innovators are compensated for breakthroughs from a public prize fund and then the patent is placed in the public domain so that the drug can be freely produced as a generic. It is also possible to simply fund the research up front, as is already done to a substantial extent with the $30 billion a year provided to the National Institutes of Health.
If we eliminated monopolies it would both reduce the cost of drugs and also likely lead to better medicine.
The New York Times reports that the number of children on medication for attention deficit disorder has soared to 3.5 million from 600,000 in 1990. The rise of AHDH diagnoses and prescriptions for stimulants has coincided with a remarkably successful two-decade campaign by pharmaceutical companies to publicize the syndrome and promote the pills to doctors, educators and parents.
Corporations and Health Watch 