December
7, 2004
Drug Industry Must Change Its Ways To Improve Its Image
By Mort
Kondracke
Instead of spending hundreds of millions of dollars on ads showing
men grinning and leaping for joy as a side effect of Viagra, or
telling people to ask their doctors about little pills without
any hint of what disease they’re intended for, the U.S.
pharmaceutical industry needs to start selling itself.
It needs to remind Americans that, unlike the tobacco and gun
industries, it is producing life-saving products, not lethal ones.
Beyond PR, though, drugmakers need to take action to lower costs
— and to convince the public and Congress that they are
not putting profits ahead of the nation’s health.
Polls show that public attitudes toward drug companies have cratered
and, despite the fact that Republicans gained strength in the
last election, chances are greater than ever that Congress will
pass a law permitting mass importation of U.S. drugs from abroad.
One indication of trouble: USA Today reported last week that
Republican Billy Tauzin III, a candidate for his father’s
Congressional seat in Louisiana, favored importation.
Tauzin’s father, Rep. Billy Tauzin (R), former chairman
of the House Energy and Commerce Committee, is widely expected
to be the new president of the Pharmaceutical Research and Manufacturers
Association.
In other words, political pressures are such that the top-lobbyist-in-waiting
for the brand-name drug industry can’t convince his own
son to oppose the industry’s top threat.
President Bush indicated in a presidential debate with Sen. John
Kerry (D-Mass.) that he might support importation if it can be
done safely. USA Today quoted Senate Finance Chairman Chuck Grassley
(R-Iowa) as flatly predicting that importation would pass.
The administration is conducting a new study, due out this week,
on whether importation can be done safely. The report’s
conclusions are said to depend as much on political judgments
as medical ones.
In reality, despite overwhelming support in polls, importation
is a terrible idea. Drug costs are lower in other countries because
they impose price controls, so importation amounts to imposing
price controls in the United States.
Foreign countries contribute little or nothing to the huge costs
of researching new drugs — estimated to be $800 million
per product — and they produce few medical breakthroughs.
Price controls would slow down medical progress here, too.
And Canada, the first country of choice for importation, can’t
handle a major upsurge in demand from the United States. Its drug
market is only 10 percent the size of ours, so prices there would
skyrocket if millions of Americans started buying. Canada’s
health minister has said Canada doesn’t want to be America’s
drugstore.
So, if mass imports are to be permitted, they would have to cover
Europe and Latin America as sources. The U.S. Food and Drug Administration
conceivably could monitor warehouses in a few nations, but the
cost of doing so all over the world would be prohibitive.
Adulterated and fake products — or poisons planted by terrorists
— would inevitably find their way into the United States.
Regardless of logic or danger, however, there’s a tidal
wave of popular support for drug importation, driven partly by
high U.S. drug prices and falling respect for the drug industry.
A Harris poll last year showed that only 13 percent of respondents
said that drug companies were “generally honest and trustworthy.”
The poll showed that 57 percent considered drug prices “unreasonably
high” — a view bolstered when The New York Times quoted
the one-time chairman of Merck, Roy Vagelos, as saying that prices
were “exorbitant.”
The industry’s reputation is taking a new hit from the
current Vioxx scandal, in which Merck and the FDA are accused
of ignoring evidence that the arthritis pain pill caused heart
attacks, allegedly resulting in 55,000 deaths.
The revelations about Vioxx have led to other articles indicating
that the FDA and academic researchers are unduly influenced by
the drug industry. Indeed, it’s hard to remember the industry’s
last favorable story.
What to do? Part of the answer is for the industry to tell its
own story better, with ads modeled on those that feature champion
cyclist Lance Armstrong affirming that he would not be alive were
it not for cancer drugs.
Millions of Americans have been saved from chronic heart disease,
diabetes and depression by the products of drug companies. Most
Americans take that for granted and have no idea what it costs
to produce a new drug.
Various drug companies have mounted deep-discount programs to
make their products available more cheaply to low-income patients,
but the public doesn’t know about it. An industry-wide program
is supposed to be launched next year. It can’t come too
soon.
Moreover, journalist Alan Murray, writing in The Wall Street
Journal last week, advised the industry to stop saying “No”
to new ideas — such as a 12-state registry that compares
the effectiveness of various drugs. The industry should be helping
patients compare products, not thwarting the process.
The industry also needs to be more open about how it makes its
money. Are marketing costs hidden in its claimed investments in
research? If so, that practice ought to stop.
Tauzin, if he takes the reins of PhRMA next year, has a big job
ahead of him:He’s got to convince industry CEOs to settle
for somewhat lower profit margins, in exchange for making what
Murray rightly called “a national treasure” a respected
industry once again.
Mort
Kondracke is the Executive Editor of Roll Call.
