Published CommPro.biz 2014.02.10

Legally But Not Medically Necessary

Depending on whose numbers you look at, somewhere between 5% and 40% of the cost of healthcare in America is spent on “Defensive Medicine.”  In 1994 the Congressional Office of Technology Assessment defined it: “Defensive medicine occurs when doctors order tests, procedures, or visits, or avoid high-risk patients or procedures, primarily (but not necessarily or solely) to reduce their exposure to malpractice liability.”

The body formally known as the Trial Lawyers Association, the barracuda bar that strikes fear into the hearts of all in the medical world, says that defensive medicine does not exist. They see it as a big scam that the medical types use as an excuse to ratchet up their income. And while we don’t buy that, there is a certain amount of truth in what they say. Testing facilities owned by doctors, hospitals and others in the game certainly benefit. As do those who consult to affirm the decisions made by their colleagues.

The leading solution is Tort Reform, restrictions on the legal profession. And/or limitations on the amount those harmed by the medical system can collect. Some of those reforms have been set up by state governments, however, and they don’t seem to help. That either means the lawyers are right, that unnecessary medical stuff reflects greed among medical providers, or that the practice is so ingrained that fear makes it near impossible for them to stop.

A totally different approach is now under consideration in Florida and Georgia, a concept that eliminates the possibility that any medical player could be sued. The Patients’ Compensation system would take medical errors out of our legal system entirely. Panels of experts would be tasked with evaluating claims and awarding the injured party funds to cover their losses. It would be quick and fair.

We spend more per-capita than other countries on healthcare but our outcomes rank below third world nations. We fail to make it into the top twenty-five in most cases. On the other hand our VA Health Care system provides excellent care at 40% less per patient than the national average. That’s an impressive number made even more impressive when you look at their patients. Mostly a bunch of beat up old folks, with some really beat up younger folks from our recent wars. Compare that to the national patient base; it includes all those folks under forty who are in relatively good health.

Oh yes, the VA enjoys a few other advantages. Their people don’t have to worry about lawsuits. And they don’t have to spend a lot of time filling out paperwork for insurers. They were among the first to go digital; any Vet can go into any VA facility in the world and they can pull up their records in seconds. All this allows them to focus on prevention. And the VA can negotiate to hold down drug costs, unlike Medicare that is prohibited by Big Pharma who has our Congress bought and paid for.

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Published in CommPRO.biz 2014.01.24

 

Big Pharma Has Congress 

by the Jugular

Andrew Witty, Glaxo Smith Kline CEO, announced last month (December 16) that Glaxo will stop paying doctors to promote their products and stop paying their sales representatives based on the number of prescriptions doctors write. It would be nice to think that this action results from an epiphany on Glaxo’s part. It’s more likely a duck-and-cover move triggered by a nasty bribery mess in China and an upcoming Affordable Care Act disclosure requirement.

It is, however, welcome. This, we hope, will trigger moves (don’t hold your breath) by other Pharma Monsters to fall in line. Pay-to-prescribe -along with Pharma advertising- make up two of the more egregious practices Pharma uses that drive healthcare costs sky high in the United States. The biggie by far is the hold they have on our Congress. Their “K” Street lobbyists lay bucks by the bushel on members of the Congress. In return, those sworn to work in our interest instead work for the drug companies.

By manipulating patent laws and exempting Pharma from anti-trust laws, drug companies have driven costs for their products beyond belief. A drug that costs a few hundred dollars to make, costs a desperate cancer patient close to a hundred grand for each dose. The patient goes bankrupt and the taxpayers pick up the tab. There is no other drug. The doctor says take it or die.

Pharma would have us believe that these drugs cost over a billion dollars to bring to market. A cruel and blatant lie; a study published in the British Medical Journal shows that the average $1.3 billion dollars the drug companies claim it costs, is actually about $90 thousand dollars. The rest is part BS and mostly marketing expenditures. Worse, most of their research funds go to tweaking existing drugs in an effort to stretch out patents on their best sellers.

We keep hearing about how much cheaper it is to buy drugs in places like Canada. Why is that? Because they have a single payer healthcare system that negotiates lower prices. In America, our Congress has forbidden Medicare to do anything like that. So a nation with fewer people than live in California can muscle the drug companies and we can’t. To make it worse the Congress has so limited fraud investigative funds that Medicare catches only a fraction of the bad guys. Like one doc in California who games the system by prescribing name-brand drugs to thousands of low income patients. Drugs’ costing as much as 30 times equally effective generic versions. There are thousands of these docs milking Medicare for Big Pharma and costing the taxpayers billions.

Big Pharma’s pill bill is killing us. Government controlled healthcare serves over half of Americans. With that kind of clout we can negotiate lower costs. Lower costs in drugs, lower costs in every aspect of our out-of-control healthcare sector. We spend more per-capita than any other nation on earth and yet our outcomes don’t even rank in the top 25%. We need to clean out the Congressional medicine chest.

"Am I wrong?"--"Am I Nuts?"--"What do you think?"--"Do you agree?"

Published in CommPro.biz 2013.04.30

Whose $$$$s Anyway?

Two decades ago, John O’Shea, a National Institutes of Health (NIH) scientist at the taxpayer supported entity, was pursuing JAK3, a protein that attaches itself to immune cells. Dr. O’Shea and his team at the NIH thought JAK3 might be used to fight autoimmune disease, specifically arthritis. In 1993 the NIH contacted Pfizer to see if the Pharma giant might have an interest in partnering with Dr. O’Shea in this research. Pfizer said “no thanks” because under the rules in place back then they would have had to share any resulting revenue from the collaboration with the taxpayers who fund the NIH.

Big Pharma’s “K” Street lobbyists had that requirement removed in 1995 and so Pfizer signed on in 1996. Fast forward twenty years and the FDA (Food and Drug Administration) approves Pfizer’s new arthritis medication Xeljanz® (tofacitinib citrate). Three cheers all around says the NIH for the teamwork made possible by Dr. O’Shea’s discovery of JAK3, and his team’s collaboration over twenty years with the folks at Pfizer that led to Xeljanz®.

Big surprise, Pfizer doesn’t see it that way. They say that the good doctor’s work moved into the public domain when it was published in 1994, that anybody could have used it. So far as the cooperative research with Dr. O’Shea goes, Pfizer didn’t end up with anything they could patent, so it was of no value. It was all the work and the more than a billion bucks Pfizer invested that resulted in a new arthritis drug, Xeljanz®. Pfizer is charging Medicare over $2,000 a month for each and every patient on Xeljanz®, a mind-numbing $25,000.00 taxpayer bucks a year.

This whole scenario is so outrageous you wouldn’t believe it if you didn’t know it’s true. A private entity takes the work of a government researcher; brushing a deal aside they made to work with the NIH. They take all the credit for developing this drug, adding the standard boilerplate claim that they sunk a billion bucks into the effort, yada, yada, yada.

A figure debunked last year in a British Medical Journal study. All these billion plus drug development claims start with a half billion they might have earned had they invested in some once-upon-a-time index fund over the same twenty-year period. Then there is $300-$400 million they get in tax credits. At the end of the day Pfizer has maybe a couple hundred million in Xeljanz®, no small amount but nothing close to a billion. Talk about corporate welfare or voodoo economics. It’s time for this nonsense to stop. Without Dr. O’Shea’s team at the NIH there would be no Xeljanz®.  We want our share of the bucks.

The stranglehold Big Pharma has over the Congress is shameful. From endorsing the theft of taxpayer funded science to an outrageous ban that prevents Medicare and Medicaid from negotiating what they pay for drugs, the corrosive impact of corporate spending in our democratic process is overwhelming. It has to stop.