Author: Fran Quigley

  • Three reasons why a faith-based movement can help fix our broken medicines system

    Three reasons why a faith-based movement can help fix our broken medicines system

    When it comes to our medicines system, it is hard to overstate how profoundly broken it is.

    Here in the U.S., many of our neighbors, especially seniors, are forced to choose between paying for medicine or food.  Hundreds of cancer physicians recently wrote an angry public letter protesting the fact that one in five of their patients can’t afford to fill their prescriptions—not surprising, with the cost of cancer medicines now averaging over $100,000.

    Hepatitis C and prostate cancer drugs are so expensive that even insured patients go without the drugs they need. Insurance companies and government programs balk at paying pharmaceutical corporation mark-ups that can make a pill manufactured for $1 carry a $1,000 price tag.

    Meanwhile, the corporations that own the rights to those medicines are rolling in money. Some enjoy breathtaking corporate profits as high as 42 percent annually, with the industry’s average return on assets more than double that of the rest of the Fortune 500. Pharma CEO pay exceeds even the swollen average of other big corporations.

    No wonder, given the gold-plated business model of the pharmaceutical industry. These corporations grab government-granted monopolies on government-developed medicines, then sell the medicines—often back to governments, their biggest customers—at prices set at hundreds of times over manufacturing costs. When you hold a monopoly on a life-saving product, you can force the desperately ill to pay any price you name.

    As bad as we have it in the U.S., the crisis is even worse in many other parts of the world. I recently spoke with a South African mother who faces an early and unnecessary death. Neither she nor her government’s healthcare program can come close to affording the monopoly-protected breast cancer medicine that may save her. United Nations health officials estimate that 10 million people die each year because they don’t receive medicines that exist, but are unaffordable.

    Ten million people is more people dying each year than the entire population of New York City. Many of those who die are children whose families and communities couldn’t afford basic vaccine protection.  Many more suffer in unrelenting pain and misery, all because medicines cost too much.

    We can fix this system, and we can fix it soon.  Here are three reasons why a faith-based movement can help:

    1. The Time is Ripe. The medicines problem is no secret. People across the U.S. are well aware that the cost of prescription drugs is bankrupting families in their own communities, and putting a huge strain on state and federal budgets. Outrageous EpiPen price hikes and the greed of “Pharma Bro” Martin Shkreli are the high-profile symptoms of a diseased medicines system that features routine double-digit annual price increases on many necessary drugs.

    And people are angry. With huge majorities demanding a change in our medicines system. An ambitious California ballot initiative is aimed directly at lowering medicine prices. Patients and media are seeing through the corporate damage-control smokescreen of promised discounts and limited donations.

    The inability of the pharmaceutical industry to curb its own gluttony suggests that the corporate monopoly on life-saving goods carries within itself the seeds of its own destruction. Social movement history tells us that profound and widespread frustration with the status quo is a prerequisite for systemic change. With medicines reform, that first ingredient is already in place.

    2. The Solution is at Hand.  There are many social justice problems that can and must be fixed, but will take significant reallocation of resources to do so. Think of the refugee crisis, climate change, affordable housing. Comparatively, the medicines crisis offers an easy solution. There are already more than enough taxpayer dollars flowing into the system now to make essential medicines available to all, and still fund more and better research for new medicines.

    The U.S. government alone puts tens of billions of dollars annually into medicine research, and then pays billions more in monopoly markups on medicines—many of which were actually developed by that same government funding. For now, suffice it to say that current law allows the U.S. government to bypass the huge corporate markups, and save more than enough money in medicine prices to exceed pharma corporations’ claimed research investments.

    And that research can be far better targeted to discovering medicines we need. When we stop funding pharma’s eternal quest for the 7th copy-cat version of an erectile dysfunction drug destined for a billion-dollar marketing campaign, we will find the resources are available to do better—much better.

    3. Faith-Based Advocacy Can Put the Movement Over the Top.   There are already many wonderful access to medicines advocates and organizations, including the inspiring people behind Knowledge Ecology International, Médecins Sans Frontières’ Access Campaign, Public Citizen, Universities Allied for Essential Medicines, HealthGAP,  Treatment Action Campaign, and others.

    But all involved agree that a successful medicines reform movement needs to be strong within the U.S., since our government is the chief sponsor of toxic medicines policies both domestically and internationally. And all agree that the movement is not yet strong at the grassroots level in the U.S.

    That is where the faith community comes in. In the U.S. and beyond, our communities and politics are still significantly influenced by faith-based organizations and activists. History’s iconic social movements, including the U.S. civil rights movement, the labor movement, the anti-apartheid movement, et al., relied on faith-based organizations for grassroots organizing, outreach to new allies, and morally-resonant messaging.

    For our current faith-based organizations, access to medicines should be a natural priority issue. Virtually every congregation and creed embraces two principles that are at core of the access to medicines challenge: basic equity among all people rich and poor, and access to health care. Roman Catholic institutions alone provide one-quarter of the world’s healthcare services.

    So, at PFAM, our mission is to push access to medicines up to a priority spot on the faith-based agenda. Join us!

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    To urge Congress to put an end to allowing drug companies to set prices for medically necessary drugs and to put people at risk of going without needed medications, sign here.

    Click here for six tips for keep your drug costs down.

  • Your tax dollars are making big Pharma rich–twice

    Your tax dollars are making big Pharma rich–twice

    Have you heard the old saying that, if you look around a poker table and can’t figure out who is the sucker, then the sucker is you?

    When it comes to the current medicines system, it is time for us taxpayers to take a good look: we are the suckers in this game. Taxpayers pay for the research to discover medicines we need, which is great. What is not great is that we then hand over monopoly rights to those medicines to corporations, which turn around and charge us taxpayers and our governments sky-high prices for the very same medicines we paid to discover.

    There are three important points to be made about this process: One, taxpayers pay for the most important stage of medicines research; two, for the most valuable medicines, taxpayers play a particularly crucial role; and three, there is a silver lining in this otherwise dark cloud.

     1.Taxpayers are the most important supporters of medicines research.

    Low-end estimates are that about 40% of medicine research and development costs are shouldered by governments and private philanthropy, not private corporations.  That number is way higher than pharmaceutical industry rhetoric would have us believe, but even that 40% figure understates the key role played by taxpayers. Taxpayer-funded government investments in medicine research are heavily weighted at the front end of the process, the basic research that is essential to identifying how a disease may be vulnerable to attack by medicines. The results of that basic research provide the building blocks for many drug discoveries down the line.

    That early-stage research is also time-consuming, expensive, and often quite frustrating. It is ground-level work that is several steps removed from a finished product that is ready for sale. All of these factors make basic research an unappealing investment for a for-profit drug corporation.

    So these corporations turn to governments, especially the U.S. National Institutes of Health (NIH), to fund this most risky part of medicines research. The NIH annual budget for medical research is now over $32 billion per year, most of it spent supporting university-based research.  In a future post, we will discuss how Big Pharma successfully pushed for a change in U.S. law that allowed corporations to grab the fruits of taxpayer-funded research, complete with monopoly patent rights.

    To be fair, Big Pharma companies often do spend dollars on end-stage development of drugs—or, often, in buying up smaller companies that did the hard work. But that stage of the process is a far less risky endeavor than the earlier research, and often just a comparatively quick stop on the way to selling the product at monopoly prices. As economist Marianna Mazzucato says, the U.S. “invests in the most uncertain stage of the business cycle and lets businesses hop on for the easier ride down the way.”

    So, we pay for the medicines twice—first for the research and then for the monopoly-inflated product price charged back to us as patients or to our government programs like Medicare and Medicaid. In fact, it is often more accurate to say that taxpayers are paying for some medicines three times. For some drugs, taxpayers support pharmaceutical industry research by way of tax credits that can reach as high as 50%. And those incessant drug ads we see on TV or pop up online? The huge cost of that marketing—Big Pharma spends far more on ads and marketing than it does on research —is all tax deductible.

    Once direct government support and generous tax breaks are added to the equation, some analysts calculate that private industry only pays for a third of U.S. biomedical research.  And  much of that industry contribution is focused on drugs whose chief value is profit, not better health.  Which leads to point #2:

    2. For the most valuable medicines, taxpayers play a particularly crucial role.

    While profit-seeking pharmaceutical corporations are searching for the next big-selling drug, which is far too often a copycat version of another best-seller , the NIH and other government funders are leading the way in discovering the medicines that are innovative and impactful. A study of drugs receiving the U.S. FDA’s priority review status showed that two-thirds of them traced their roots back to government-funded research.

    There are many examples of lifesaving medicines we rely on now that exist because of government research, including prostate cancer drugs,  HIV/AIDS drugs, leukemia drugs,  major mental health medicines, and many vaccines.

    Unfortunately, that means there are also far too many outrageous examples of taxpayers and patients getting played for suckers in the medicines system. Here is a quick sampling of taxpayers paying twice, and at sky-high prices, too:

    • The corporation Genzyme charges as much as $350,000 a year, 10 times its manufacturing cost, for a drug to treat the rare Gaucher disease. That price is often charged to government programs like Medicaid, even though the medicine was developed by the National Institutes of Health.

    • The corporation Amgen has billed Medicare for billions in charges for the kidney disease drug Epogen, developed with taxpayer-supported research.

    • The chemotherapy drug pacilataxel was developed with government research and sold back to government programs at monopoly prices by patent-holding BristolMyersSquibb, who has branded the drug Taxol.

    • National Institutes of Health and Department of Defense funding helped develop the prostate cancer drug Xtandi, sold back to the federal government at over $100,000 per patient per year, a price that is two to four times that paid by patients in other countries—despite the fact that U.S. taxpayer dollars developed the drug.

    The systemic rip-off of taxpayers and patients may be news to many of us, but physicians, economists, and health activists have been raising the alarm for awhile now. They point out that the medicines system socializes risks and privatizes rewards. As intellectual property attorney Alfred Engelberg wrote in the publication Health Affairs in 2015, “For decades, Congress has simply been transferring wealth from ordinary citizens to the pharmaceutical industry. While claiming to believe in free market capitalism, it has created a web of monopolies which cause the United States to pay the world’s highest prices for drugs.”

    3.) The Silver Lining.

    As promised, there is some good news about this outrageous system: we taxpayers already pay so much into the current broken medicines model that we can easily shift our investments over to a system that is more effective and just.

    A decade ago, economist Dean Baker crunched the numbers and estimated the money that could be saved if U.S. health systems provided medicines without the artificial mark-up imposed by monopoly patents. It turns out that the resulting savings could fund the replacement of all private industry research and development several times over, while still leaving billions of dollars in remaining public benefit.

    The rip-off of U.S. taxpayers has not gone unnoticed by U.S. politicians. In August, Democratic presidential candidate Hillary Clinton accurately diagnosed the problem. “Your tax dollars helped support the research that is used to create those drugs in the first place,” Clinton told a crowd in Cleveland. “Your tax dollars support the Food and Drug Administration that tests those drugs to determine whether or not they are safe and effective to be able to go to market.  And then we end up in America paying the highest price for those drugs that we have helped to create.  We have got to take this on.”

    The dollars are already in place to build a better medicines system. Perhaps the political will to do so is growing, too. If we the people demand it, there will be a day when taxpayers and patients will only pay once for our medicines!

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    If you support government drug price negotiation, please sign this petition, here

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