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PharmaEconomics: Are We Duped Or Accomplices?

Posted on the 17 November 2012 by Fadi Bejjani @DrFadiBejjani
Most americans probably own some big Pharma stock in their portfolio and/or retirement account. If sales increase, the stock value increases and the investors do well. Thus, since many of us profit from big Pharma profits, we are their de facto accomplices: when they charge exorbitant amounts of money for their medications we should not complain...or should we?
The truth hit me like a ton of bricks in 1991 when I was invited as a speaker to an International Conference in Shanghai then Visiting Professor in Beijing, My back was hurting from all the driving and flying and I asked if I could have some Feldene (it was the fashionable  nsaid at the time and Pfizer was really taunting it with ballerina posters all over). The driver went into a pharmacy and got me an entire box. I thought to myself that I really did not need all that since it must cost a lot of money. The fact was that I bought 20 pills for the equivalent of $10! In the US those 20 pills would have cost close to $250.  So how do we explain this?
The simple explanation is that the American taxpayer single-handedly pays the high price for medications, thus supporting all the research and development and the FDA process, and bolstering the stock value. Be that as it may, America represents only 5% of humanity, so after that new pill is discovered and is out on the market, it also becomes just as available all over the globe at drastically lower prices. So 95% of humanity benefits from this new medication at very low cost while 5% foot the tab. This is when the accomplice becomes duped! This price disparity is staggering and one can only wonder if the costs were shared by 50% of the world population for example instead of 5%, how much cheaper it will be for us.
Big Pharma does make sure we pay the high price by sponsoring laws and regulations forbidding us from filling a prescription or obtaining medications from abroad. However bus loads of US citizens cross the borders to Mexico or Canada to get their meds. The movie "Love and other Drugs" shows a group of seniors traveling regularly to Canada for this very purpose. The advent of the internet is allowing some to circumvent these laws. I saw Viagra advertised at less than $2 a pill recently (US price $15). Can you believe that? I do not know if it is 100% legal but the pills look legit and seem to be coming from Germany. I am sure Pfizer would not condone this but think for a second: an american company invents the pill in America and sells it here at a very high price but quite cheap elsewhere, so that pill reenters the American market through the back door at a price that is a fraction of what it started with! That is PHARMAECONOMICS for you!
Another example is Victoza, an excellent medication for type II diabetes, which literally saved my life. The 180 mg pen is worth $180 in the US, often despite insurance. My sister bought me the exact same pens, in the exact same packaging, from Lebanon for $80 each. For me it is a saving of about $300 a month. Food for thought!
Big Pharma justifies the big costs by blaming the huge R&D expenses and the tedious and lengthy FDA process. I do not know about you but I am not very impressed by the latter. How many FDA-approved drugs have you seen being blamed for unknown complications and pulled off the market in recent years? Bextra, Vioxx, Avandia, Actos, Ephedra, to name a few. The 1-800-BADDRUG lawyers are beaming and one can wonder if they are in cahoots with the FDA. Despite all the money it receives from big Pharma and others, the FDA has been lackadaisical lately: salmonella epidemics in food, fungus-tainted steroids that  caused meningitis in 440 people in 12 states and killed 32, etc. Many they should streamline their processes and save resources and man power to do more of them.
Another thing that protects big Pharma is their patents. These last 17 years but they are really only valid in the US and maybe western Europe. For sure India and China (3 billion people) couldn't give a hoot. When the patent is about to run out, they modify the medication a little call it Extended-Release and off they go for another 17 years, instead of supporting and producing the impending generic form which is much cheaper.
The issue of patents is so dear to big Pharma that they are willing to sell their soul to the devil for it. Some of you may remember the Women's Health Initiative (1991) which addressed 161,808 postmenopausal women who were taking Prremarin and Provera (synthetic Estrogen) and concluded that estrogen supplementation was not recommended in this population because it increased the rate of breast cancer and cardiovascular disease among others. So for years thereafter, endocrinologists and gynecologists were scared to prescribe these drugs and millions of menopausal women preferred to suffer for years with hot flashes and all kinds of misery because they were afraid too. The raw truth is that BIOIDENTICAL Estrogen (as in Yam and Soy) is perfectly harmless and has only positive effects on the body. The only problem is big Pharma CANNOT PATENT a bioidentical hormone. They had to modify a bit the natural molecule to synthetize Provera, just enough to be able to patent it, but sadly also just enough to cause all sorts of complications. Besides, the treatment with bioidentical hormones costs less than $50 per month whereas Provera was close to $10 a pill.
Something else you should know about big Pharma, they love to develop and produce new narcotics. For every new cancer drug that comes out, there is at least two or three new narcotics as if we needed yet another one of those. The latter are easier to produce (most are byproducts of morphine, codeine or oxycodone) and SO lucrative. Not only people cannot get enough of them (once hooked, you want more and more) but they are also sold at a high premium on the street, unlike cancer pills or any other life-saving medication. It is PharmaEconomics 101: Do the Math!
Accomplices or duped? I let you decide

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