Thursday, March 26, 2009

Why People Passionately Hate Drug Companies

Andrew Sullivan professes to be both wounded and puzzled at public perceptions of pharmaceutical companies:

I find the knee-jerk hostility to private companies that take enormous risks and make products that save and improve lives to be baffling. It's a form of bigotry on the left - a loathing of the private sector and an inane notion that somehow public dollars are more virtuous than private ones.
The hostility is neither knee-jerk nor baffling, but reasonably condign and readily explained. Here are a few stabs at explaining this "bigotry," presented in no particular order:
  • Constant advertising: Pharmaceutical ads are frequent and uniquely irritating not only for the catalog-of-ships enumeration of terrifying side-effects. It's also because there is something inherently suspect about treating substances that will make the difference between sickness and health, if not life and death, as though they're a laundry detergent we've not yet had the good fortune of hearing about. "Talk to your doctor about [drug]" is a come-on that doesn't sit right. Shouldn't the doctor be coming to me with this information if indeed this drug holds promise for my health? Isn't that what he's paid so well to do? Isn't that the kind of knowledge he spent so much time and effort mastering? But no -- sick people -- or people who, by virtue of the ad, who are led to believe they may be sick -- should be self-diagnosing and suggesting treatments to doctors based on advertisements, the bulk of which are enumerations of terrifying side-effects? This is the manner in which important information about human health should flow? Really?
  • SSRI Anti-depressants (e.g., Prozac, Paxil, Zoloft, etc.): These drugs (a) don't work for a great many people and yet (b) have reached a point where they're passed out with all the gravity of breath mints. It's difficult not to suspect that behind this odd conjunction of fecklessness and ubiquity lies nothing more than aggressive lobbying, marketing, and P.R.
  • Boner pills: Pooh pooh this if you like, but we are fucking sick and tired of hearing about pills designed to induce erections. It's a matter of no small delicacy, at best; and the frequency with which it is thrown before us seems far out of proportion to its seriousness in the grand scheme of public health. In turn this suggests a skewed sense of priority among the companies that hawk the boner pills.
  • Special pleading: How is it, many of us wonder, that this particular line is drawn between legal and illegal drugs? Again, it's difficult to look into this matter and find any better, more convincing explanation than the successful rent-seeking behavior of well-heeled lobbies.
  • Pricing schemes: All those billions spent on advertising, lobbying, and P.R., and yet there still has never been a decent explanation of why drugs are often dramatically more expensive in the USA than in Canada or Europe. The obvious explanation: the pharmaceutical companies are charging whatever the market will bear, and the market will bear quite a lot when it comes to questions of health/sickness or life/death. So fuck them, and fuck anyone who pretends not to understand why that would generate resentment.
  • The so-called 'Donut Hole': This is another instance in which rent-seeking by pharmaceutical companies has prevailed over the public good. An industry that wants to be given the benefit of the doubt will not do this sort of thing.
  • Gaming patents: Industries that want not to be seen as self-seeking assholes will, now and then, pass over an opportunity to game the intellectual property laws in their favor.
  • Spending priorities: Pharmaceutical companies love to flack their devotion to research, but they spend more money warping the political process, marketing, and public relations. This is a good gig so long as it is not widely known. When the word gets out, as it has done by now, it looks very bad. And it should!
For all this, there's a kernel of truth to Sullivan's plaint, namely, we need effective drugs and the research that will produce them, and we need it from all available sources. We give a damn about how and how well this particular industry functions, and we should. That's what gives rise to passion and intensity when it comes to pharmaceutical companies, and that's why their shortcomings irk more than those of the makers of soaps or soups.


twoblueday said...

In addition to your cogent comments about drug companies, I'll add my two cents.

I seem to be seeing more and more drug ads which tout prescription medications I should take as an additional nostrum for a particular malady IN ADDITION TO THE ONE I'M ALREADY TAKING AND PAYING FOR.

The implication, to me, is that the market for the first layer of medicine for, say, Tsutsugamuchi Fever, has become "mature," meaning either sales are "flat" or it has become eligible to be a generic, or both.

Drug companies suffer from the same failing as all the other recently-failed corporations: they are for-profit corporations and, as a matter of law, must maximize profit above any other goal.

I'm not saying I don't believe in profit, but, in the long run, the profit-motive as superior to all other motives has its limits, or should.

I think I've known for a while that drug companies spend more on marketing than research. Not a penny of those marketing dollars are intended to improve anyone's health, but only intended to improve the bottom line.

Dale said...

two, thanks for extending the list. It could have been even longer. To wit: in my case, I am taking a prescription for narcolepsy (no big secret - I've blogged about it several times) and the game they're playing there is a plan to release essentially the same drug that's altered chemically just slightly enough to win a new patent. In the lab this "new" drug works no better than the one I'm already using (as it happens, not very well) but the fact that they can put essentially the same wine in a new bottle means they extend the patent for another few decades AND get to charge a higher price because it's NEW. Naturally, they'll need to devote some effort to exaggerating the crap out of the "benefits" of this new drug, and that effort is already getting started.

Now, all of this hocus pocus took some "research" to happen, but obviously, the goal was never to put a better treatment on the market, but to game the pricing and the intellectual property laws to their financial benefit.

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