# Ha!! That's what I've been saying (about the pharmaceutical companies)! **URL:** \ **Category:** The BBQ Pit\ **Created:** [March 15, 2004, 6:05pm UTC](https://boards.straightdope.com/t/ha-thats-what-ive-been-saying-about-the-pharmaceutical-companies/234475 "2004-03-15T18:05:37Z")\ **Posts on this page:** 11\ **Page:** 4
**Author:** ![curly\_chick](https://avatars.discourse-cdn.com/v4/letter/c/7ba0ec/32.png) [@curly\_chick](https://boards.straightdope.com/u/curly_chick)\ **Post date:** [March 18, 2004, 3:00pm UTC](https://boards.straightdope.com/t/ha-thats-what-ive-been-saying-about-the-pharmaceutical-companies/234475/61 "2004-03-18T15:00:12Z")
> [@Mr. Moto](#): > > If drug companies had to deal with price controls here, like they do elsewhere, they’d simply stop innovating. Well, that can’t be true, what about countries where there are indigenous pharma giants \*\*and \*\* price controls? No innovation? Does anyone really believe that 100% of the innovation in the pharma world is American? Sure, many of the big pharma companies are American. Many of the American pharma companies do set up manufacturing bases outside the US to manufacture products. But there are plenty of other countries in the world which have indigenous pharma companies of their own and unless I miss my guess - they are innovating too. And if America is the only place where there is no control on pharma prices, surely it is down to the government of that country to implement controls, it aint the pharma companies fault that they are allowed to make big profits on the backs of the consumer. ---
**Author:** ![Mr.Moto](https://avatars.discourse-cdn.com/v4/letter/m/9de0a6/32.png) [@Mr.Moto](https://boards.straightdope.com/u/Mr.Moto)\ **Post date:** [March 18, 2004, 4:14pm UTC](https://boards.straightdope.com/t/ha-thats-what-ive-been-saying-about-the-pharmaceutical-companies/234475/62 "2004-03-18T16:14:42Z")
> [@curly chick](#): > > Well, that can’t be true, what about countries where there are indigenous pharma giants \*\*and \*\* price controls? No innovation? > Does anyone really believe that 100% of the innovation in the pharma world is American? > > Sure, many of the big pharma companies are American. Many of the American pharma companies do set up manufacturing bases outside the US to manufacture products. But there are plenty of other countries in the world which have indigenous pharma companies of their own and unless I miss my guess - they are innovating too. > > And if America is the only place where there is no control on pharma prices, surely it is down to the government of that country to implement controls, it aint the pharma companies fault that they are allowed to make big profits on the backs of the consumer. American drug companies currently provide well over half of the world’s new drugs. I get this from my uncle, who is a hospital pharmacist and an official with a state board of pharmacy in the Northeast. This is borne out, too, by the Economist link below. Canadian drug companies, universities, and government researchers make a comparatively insignificant contribution to global pharmacopoeia. I believe the Canadian drug manufacturers concentrate on generic drugs, not R&D. European officials are currently debating raising drug prices to help spur domestic drug innovation. This is being resisted by some who feel the safety net will be forever torn asunder. Familiar arguments, all around. > **[The San Diego Union-Tribune - San Diego, California & National News](https://www.sandiegouniontribune.com/)** > **[The trouble with cheap drugs](https://www.economist.com/business/2004/01/29/the-trouble-with-cheap-drugs)** > > Europe pays a lot less for its drugs than America. But do hidden costs mean that Europeans are actually worse off? ---
**Author:** ![KarmaComa](https://avatars.discourse-cdn.com/v4/letter/k/e36b37/32.png) [@KarmaComa](https://boards.straightdope.com/u/KarmaComa)\ **Post date:** [March 18, 2004, 4:52pm UTC](https://boards.straightdope.com/t/ha-thats-what-ive-been-saying-about-the-pharmaceutical-companies/234475/63 "2004-03-18T16:52:44Z")
> [@Mr. Moto](#): > > American drug companies currently provide well over half of the world’s new drugs. I get this from my uncle, who is a hospital pharmacist and an official with a state board of pharmacy in the Northeast. This is borne out, too, by the Economist link below. > > Canadian drug companies, universities, and government researchers make a comparatively insignificant contribution to global pharmacopoeia. I believe the Canadian drug manufacturers concentrate on generic drugs, not R&D. > > European officials are currently debating raising drug prices to help spur domestic drug innovation. This is being resisted by some who feel the safety net will be forever torn asunder. Familiar arguments, all around. > > [http://www.signonsandiego.com/news/business/20040316-0558-eu-drugprices.html](http://www.signonsandiego.com/news/business/20040316-0558-eu-drugprices.html) > > [The trouble with cheap drugs | The Economist](http://www.economist.com/displayStory.cfm?Story_ID=2388708) A couple of little points about Canada, and I’ll try not to be too defensive. 😉 Saying that Canada has a comparatively insignificant contribution to the pharmacopoeia is pretty vague. We’re one tenth the size of the States, too, but I don’t know what you mean by “comparatively”… The education/academic model in Canada is way different from the US. The States’ system is more financially elitist, and therefore more financially elite. The universities have a lot more research money, but I can tell you that there is a lot of microbi/biochem research coming from Canada. I’m doing a little myself, actually. But that’s not the point. Further, the Economist article has a tone of “price control is hurting Europe because jobs and profits are going to the States”. Well, duh. Of course it’s going to hurt the industry when it’s lopsided like that, but it doesn’t make much of a comment on what the effect is on the global market, or what the effect of global price controls would be. Seems to be from a more Economic standpoint, naturally. My opinion is that a reduction in profiteering by pharma’s would not hurt the industry as much as it would benefit the patients. And by “hurt the industry”, I’m talking about innovation and product quality. YMMV ---
**Author:** ![Carol\_the\_Impaler](https://avatars.discourse-cdn.com/v4/letter/c/6a8cbe/32.png) [@Carol\_the\_Impaler](https://boards.straightdope.com/u/Carol_the_Impaler)\ **Post date:** [March 18, 2004, 5:32pm UTC](https://boards.straightdope.com/t/ha-thats-what-ive-been-saying-about-the-pharmaceutical-companies/234475/64 "2004-03-18T17:32:02Z")
> [@Nametag](#): > > You assume incorrectly, as you’d know if you read the fucking thread. Hmm. I did read the thread, you twit. I’m not talking about the FCC regulations as to what they can say. I’m speaking of why they have tv ads in the first place. Which is of course to market their drug. The ultimate goal of which is to get people to spend money on it, no? ie - creating a need, no? ie - creating a drive to have the product? There’s no need for vulgarity, fucktard. > [@](#): > > Wrong again. There is no “old Nexium”; the active ingredient in Nexium is a new chemical entity, formed by chiral separation of the racemic mixture used in Prilosec. Allllright… I concede that it was not a coating change (read that long ago. Will find link if I can.) Nice use of big words, though. So, let me restate my point with quotes from [here](http://www.post-gazette.com/healthscience/20020423hclarinex0423p2.asp) **From the article:** > [@](#): > > Nexium is based on the same principle as Clarinex – it’s a spinoff. > > Most drugs are composed of two molecules, mirror images of each other called stereoisomers. AstraZeneca isolated Prilosec’s biologically active isomer and repackaged it as a new drug. **From you: (Who are you again?)** > [@](#): > > It’s true that Nexium was introduced because Prilosec was going off patent, but the difference was real and beneficial, and nothing so trivial as a coating change. Real and beneficial, huh? Nope. Only a way for the maker to gain a patent on what is effectively the same drug, and again recoup excessive profit. > [@](#): > > Mueller and Wilson-Norton are skeptical of Nexium because they have read the drug’s label. In two FDA-reviewed studies, Nexium worked consistently better than Prilosec only when it was used in a higher dose. In a third study, however, a higher dose of Nexium did not work any better than a lower dose of Prilosec. > > \ > > One FDA reviewer concluded that although AstraZeneca proved Nexium worked, it failed to demonstrate that it worked better than Prilosec. And, finally, to revisit my point about the “fuckload of crap that is Nexium”: > [@](#): > > When top-selling drugs face patent expiration and generic rivals, companies launch blockbuster retreads to hang onto customers, Vermeulen said. “The company tries like crazy to find something to differentiate the new agent from the parent, but the clinical advantage is simply not there. No self-respecting physician will be swayed by the propaganda that these companies are passing off as relevant science.” > > Because of that, companies turn to direct-to-consumer ads to whip up consumer demand, he said. Consumers with no medical background make easy targets and are quite willing to make the switch, at least as a trial. > > Vermeulen says he would like to see the FDA refuse to approve drugs unless drug companies show a clear benefit over products already on the market. He says that could happen if the federal government gets into the drug-buying business. ::checking to make sure this is The Pit:: Oh yeah. Fuck off, please. ---
**Author:** ![Mr.Moto](https://avatars.discourse-cdn.com/v4/letter/m/9de0a6/32.png) [@Mr.Moto](https://boards.straightdope.com/u/Mr.Moto)\ **Post date:** [March 18, 2004, 6:50pm UTC](https://boards.straightdope.com/t/ha-thats-what-ive-been-saying-about-the-pharmaceutical-companies/234475/65 "2004-03-18T18:50:44Z")
So a bureaucrat would get to decide whether the public gets a drug, **a safe, effective drug** just because he decides they won’t benefit enough? And this, presumably, would be a good thing? What if a patient has an allergy to existing medications, or suffers from side effects to them that won’t appear with the new drug? I’m sure I don’t need to point out that all patients are different, and that having choices among different medications is a **good thing**. [From the “What medications have changed your life” thread.](http://boards.straightdope.com/sdmb/showthread.php?t=245238) > [@angelabaca](#): > > Effexor XR - I tried Prozac and Paxil and hated them (Prozac turned me into super-bitch and Paxil gave me a general blah feeling. ---
**Author:** ![KarmaComa](https://avatars.discourse-cdn.com/v4/letter/k/e36b37/32.png) [@KarmaComa](https://boards.straightdope.com/u/KarmaComa)\ **Post date:** [March 18, 2004, 7:01pm UTC](https://boards.straightdope.com/t/ha-thats-what-ive-been-saying-about-the-pharmaceutical-companies/234475/66 "2004-03-18T19:01:21Z")
> [@Mr. Moto](#): > > So a bureaucrat would get to decide whether the public gets a drug, **a safe, effective drug** just because he decides they won’t benefit enough? > > And this, presumably, would be a good thing? > > What if a patient has an allergy to existing medications, or suffers from side effects to them that won’t appear with the new drug? The point seems to be that there **isn’t** any such difference between the drugs. The bureaucrat (um, bureaucrats already decide what drugs can and can’t go on the market, but I see your point) would have the job of deciding whether or not the new drug was just an old drug (with an expired patent) in new molecular clothing. ---
**Author:** ![Carol\_the\_Impaler](https://avatars.discourse-cdn.com/v4/letter/c/6a8cbe/32.png) [@Carol\_the\_Impaler](https://boards.straightdope.com/u/Carol_the_Impaler)\ **Post date:** [March 18, 2004, 7:41pm UTC](https://boards.straightdope.com/t/ha-thats-what-ive-been-saying-about-the-pharmaceutical-companies/234475/67 "2004-03-18T19:41:11Z")
> [@Mr. Moto](#): > > So a bureaucrat would get to decide whether the public gets a drug, **a safe, effective drug** just because he decides they won’t benefit enough? > > And this, presumably, would be a good thing? Yes. When the supposedly new drug is not an improvement or alternative in treatment, but just a drug company trying to manipulate patent law and preserve profit. (Instead of, say, _actually developing a new treatment_!) > [@](#): > > What if a patient has an allergy to existing medications, or suffers from side effects to them that won’t appear with the new drug? Not the case nor the motivation in the example I cited. And I suspect, nay, assume, that this kind of chicanery goes on all the time. > [@](#): > > I’m sure I don’t need to point out that all patients are different, and that having choices among different medications is a **good thing**. > > [From the “What medications have changed your life” thread.](http://boards.straightdope.com/sdmb/showthread.php?t=245238) Agreed. Once again, I am not talking about destroying capitalism or competition or innovation. I’m talking about how the system is set up to take undue advantage of a captive audience, if you will. That it is unfair, unthical, unjust and frankly just pisses me off. And, parenthetically, your reference to anti-depressants is not relevant to my points. New anti-depressants do, in fact, bring with them clear benefits. Especially, as you point out, because everyone reacts differently to them. One will work well for one person, and not for another and no one knows why. Lastly, why is this being presented as a zero-sum game (I’ve used that term twice now today!!). _Again, I don’t have a problem with drug companies making a profit._ And my life is markedly improved because of R&D. I’m just tired - and more than a little broke - because I’m Big Pharma’s patsy. ---
**Author:** ![Mr.Moto](https://avatars.discourse-cdn.com/v4/letter/m/9de0a6/32.png) [@Mr.Moto](https://boards.straightdope.com/u/Mr.Moto)\ **Post date:** [March 18, 2004, 8:21pm UTC](https://boards.straightdope.com/t/ha-thats-what-ive-been-saying-about-the-pharmaceutical-companies/234475/68 "2004-03-18T20:21:54Z")
> [@niblet\_head](#): > > Lastly, why is this being presented as a zero-sum game (I’ve used that term twice now today!!). _Again, I don’t have a problem with drug companies making a profit._ And my life is markedly improved because of R&D. I’m just tired - and more than a little broke - because I’m Big Pharma’s patsy. I, likewise, believe changes need to be made to get drugs to people that truly can’t afford them. I just think we need to be mindful that there can be unintended consequences that could affect the ability of the pharmaceutical industry to be innovative and responsive to the needs of their consumers. Canadian pharmaceutical companies found that out, as did European companies. And its very possible that we’d have even more life-saving and life-improving treatments today if the inventiveness of companies in these countries hadn’t been artificially stifled. It’s not a zero-sum game, indeed. ---
**Author:** ![Nametag](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/nametag/32/406_2.png) [@Nametag](https://boards.straightdope.com/u/Nametag)\ **Post date:** [March 18, 2004, 10:45pm UTC](https://boards.straightdope.com/t/ha-thats-what-ive-been-saying-about-the-pharmaceutical-companies/234475/69 "2004-03-18T22:45:55Z")
> [@](#): > > I did read the thread, you twit. I’m not talking about the FCC regulations as to what they can say. I’m speaking of why they have tv ads in the first place. Which is of course to market their drug. The ultimate goal of which is to get people to spend money on it, no? ie - creating a need, no? ie - creating a drive to have the product? Well, let’s go back and look at that: > [@](#): > > Originally Posted by **niblet\_head** , long, long ago: > > I assume they don’t tell you what it’s for so you have to ask your doctor. And then you can pressure him for a prescription. I also think by not telling you what it does, the med itself will stay in your mind because now you’re curious. Whereas if they told you, you’d just block it out like so much pabulum.I think it’s done that way to set up the atmosphere to buy in the patient’s mind. Uh-huh. Somehow, that’s about why they advertise their products? Nah. The “Infiniti gambit” might be a clever advertising tactic in a few select cases, but for the most part, drug advertising, even under **FDA** regulations, is the same as all other advertising. The vast majority of products are sold by telling the potential buyer what it is and what it’s good for. Most drugs are marketed similarly – the manufacturer bites the bullet and quickly and quietly quotes the required warnings. Patients can pester their doctors more effectively if they know the drug is for allergies and not lupus. In the case of Zoloft, on the other hand, they decided that the four pages of required warnings made the “mystery drug” route the better choice. > [@](#): > > Real and beneficial, huh? Nope. Only a way for the maker to gain a patent on what is effectively the same drug, and again recoup excessive profit. > > > [@](#): > > > > Mueller and Wilson-Norton are skeptical of Nexium because they have read the drug’s label. In two FDA-reviewed studies, Nexium worked consistently better than Prilosec only when it was used in a higher dose. In a third study, however, a higher dose of Nexium did not work any better than a lower dose of Prilosec. > > > > \ > > > > One FDA reviewer concluded that although AstraZeneca proved Nexium worked, it failed to demonstrate that it worked better than Prilosec. I didn’t say it worked better – that’s almost never the benefit of chiral separations. If you think critically about the above excerpt, you’ll realize that fully half of the drug dispensed as Prilosec was NOT effective in treating anything, but may well have had undetected side effects. In a chronic-use drug like Prilosec, that’s something to worry about. Nexium eliminates this risk. It’s not a big difference, and I’m not a fan of such tactics, but it’s not **only** a way to get a patent extension – just mostly. ---
**Author:** ![Nametag](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/nametag/32/406_2.png) [@Nametag](https://boards.straightdope.com/u/Nametag)\ **Post date:** [March 18, 2004, 11:07pm UTC](https://boards.straightdope.com/t/ha-thats-what-ive-been-saying-about-the-pharmaceutical-companies/234475/70 "2004-03-18T23:07:54Z")
> [@chula](#): > > The 90% figure sounds inflated to me, but I’d like to see a cite on exactly how much government money goes into Big Pharma’s R&D costs. Preferably a figure that excludes marketing costs. My intellectual property law professor brought up **furlibusea** ’s point to debunk the argument that there would be no development of new drugs without strict patent laws. Well, the entire American drug industry spent $32 billion on R&D in 2002; the entire NIH budget for 2004 was only $28 billion, and only a fraction of it could be called drug research. I’d like to see a cite showing that ANY federal money went to drug companies. ---
**Author:** ![Carol\_the\_Impaler](https://avatars.discourse-cdn.com/v4/letter/c/6a8cbe/32.png) [@Carol\_the\_Impaler](https://boards.straightdope.com/u/Carol_the_Impaler)\ **Post date:** [March 19, 2004, 1:25pm UTC](https://boards.straightdope.com/t/ha-thats-what-ive-been-saying-about-the-pharmaceutical-companies/234475/71 "2004-03-19T13:25:09Z")
> [@Nametag](#): > > Somehow, that’s about why they advertise their products? Nametag, my response wasn’t talking about _why_ they advertise their product, just\* how\*. > [@](#): > > In the case of Zoloft, on the other hand, they decided that the four pages of required warnings made the “mystery drug” route the better choice. Yes, duh. And why would they have made that particular choice (considering the production and placement of a nationwide ad isn’t cheap)? It’s a tactic, right? And what are it’s strategic marketing aims, considering they can’t tell you what it is? Myself, I believe it’s to create top-of-the-mind awareness and curiousity, and my theory was that - considering all advertising has as its aim action on behalf of the consumer - the action they wanted was for you to ask your doctor. Um, like I said. Your thoughts? > [@](#): > > I didn’t say it worked better – that’s almost never the benefit of chiral separations. If you think critically about the above excerpt, you’ll realize that fully half of the drug dispensed as Prilosec was NOT effective in treating anything, but may well have had undetected side effects. In a chronic-use drug like Prilosec, that’s something to worry about. Nexium eliminates this risk. It’s not a big difference, and I’m not a fan of such tactics, but it’s not **only** a way to get a patent extension – just mostly. Okay, so we mostly agree. But I haven’t read anywhere that the undetected side effects it may have had were the motivation. If you can find me some examples, I would be happy to read them. And why would a drug company spend all those precious R&D dollars, plus marketing dollars on top of it, to pre-empt “undetected” side effects its drug “may have”? Oh, and I figured out on my own from thinking critically about the article that half of Prilosec wasn’t effective in treating anything, thankyouverymuch. [Previous page](https://boards.straightdope.com/t/ha-thats-what-ive-been-saying-about-the-pharmaceutical-companies/234475.md?page=3)