The performance of Big Pharma

This article”:http://www.americanscientist.org/template/BookReviewTypeDetail/assetid/39097;jsessionid=aaa5f9pT7Kt1Vn in the lat­est issue of Amer­i­can Sci­en­tist reviews some recent well-informed crit­i­cism of the indus­try, includ­ing the find­ings of a 2002 “report by the U.S. lob­by group ‘Fam­i­lies USA’”:http://www.familiesusa.org/site/DocServer/PPreport.pdf?docID=249 that found nine of the largest US-based phar­ma­ceu­ti­cal com­pa­nies spent an aver­age of only 11 per­cent of rev­enues on R&D com­pared to 27% of rev­enues on mar­ket­ing, adver­tis­ing and administration[1]. The Amer­i­can Sci­en­tist review­er argues, how­ev­er, that the great­est pub­lic pol­i­cy prob­lem posed by big Phar­ma is not the venal­i­ty of the firms but the lack of com­pa­ra­ble data on the effi­ca­cy of their prod­ucts and on the qual­i­ty of their research. bq. The FDA and its Euro­pean coun­ter­parts can demand that phar­ma­ceu­ti­cal com­pa­nies pro­vide them with data to show that drugs are effi­ca­cious. But they have no man­date to show that drugs are effective‚Äîthat they will work not only in close­ly mon­i­tored clin­i­cal tri­als but also in the real world under a vari­ety of con­di­tions. Nor is there any sys­tem­at­ic, inde­pen­dent source of evi­dence about the com­par­a­tive val­ue of drugs and med­ical tech­nolo­gies. Head-to-head tri­als com­par­ing a drug with a rival company’s sim­i­lar prod­uct or gener­ic ver­sion are almost nonex­is­tent. There are no data­bas­es that report the results of all tri­als in a stan­dard­ized way, describ­ing adverse events and effi­ca­cy in var­i­ous sub­pop­u­la­tions. In the absence of this data, con­sumers and gov­ern­ment author­i­ties are unable to make rea­son­able deci­sions about the pub­lic resources that should be avail­able to these firms (includ­ing not only tax sub­si­dies but also the patent monop­o­lies they so vig­or­ous­ly pro­tect) or the price that should be paid for their prod­ucts. On the spe­cif­ic issue of Vioxx, the rev­e­la­tions seem to be get­ting “only worse”:http://news.ft.com/cms/s/b9967e4a-5cf0-11d9-bb9c-00000e2511c8.html Australia’s “Phar­ma­ceu­ti­cal Ben­e­fits Scheme”:http://www.health.gov.au/internet/wcms/Publishing.nsf/Content/Pharmaceutical+Benefits+Scheme+(PBS)-1 review of drugs that are sub­si­dized for pub­lic health use is an essen­tial source of infor­ma­tion on effi­ca­cy because it is charged with review­ing the rel­a­tive val­ue of big Pharma’s prod­ucts and allo­cat­ing it’s $5.6 bil­lion bud­get accord­ing­ly. h4. Update Jan­u­ary, 6: Bet­ter late than not at all: bq. From Thurs­day, drug indus­try asso­ci­a­tions in the US, Europe and Japan will co-ordi­nate an indus­try-wide plan to pub­lish on the inter­net detailed infor­ma­tion on com­plet­ed and cur­rent clin­i­cal tri­als of their drugs. Although the scheme is vol­un­tary, drugs com­pa­nies will be under great pres­sure to take part in it. (“ft”:http://news.ft.com/cms/s/35b81458-5f5c-11d9-8cca-00000e2511c8.html) fn1. The Familes USA report (well worth skim­ming) shows that the 11 per­cent num­ber is like­ly an exag­ger­a­tion, since the com­pa­nies do not report the after tax val­ue of R&D expen­di­ture which attracts tax sub­si­si­dies that halve the aver­age income tax paid by these giant cor­po­ra­tions to 17 per­cent.

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