Following is a summary of a 2,600-word reply/critique of “Bitter Medicine,” the one-hour documentary broadcast by ABC last week. The complete essay is available on Heartland’s Web site at www.heartland.org or contact Greg Lackner at 312/377-4000, email firstname.lastname@example.org, for a copy or to schedule an interview.
“Bitter Medicine: Pills, Profit and the Public Health,” an hour-long attack on the nation’s pharmaceutical industry narrated by Peter Jennings, accused the industry of earning “huge profits,” marketing “me too” drugs instead of finding new cures, and suppressing research exposing the ineffectiveness or dangerous side-effects of its products. In fact, “Bitter Medicine” is filled with bitter mistakes. Specifically:
Most of the drug companies are profitable, but no more so than many other companies in other fields.
- Drug companies and their profits appearing in the latest Fortune 500 listing include Amgen (28%), Pharmacia (7%), Abbott (7%), and Gemzyne (-9%).
- Compare this to Coca-Cola (20%); Bank of New York (19%); Mellon Financial (33%); Microsoft (29%); Oracle (24%); Gannett (publisher of USA Today) (13%); Knight-Ridder (15%); AT&T (13%); and SBC Communications (16%).
“Bitter Medicine” suggested the drug industry profits by relying on spending by the National Institutes for Health and patent protection of existing drugs rather than discovering new breakthrough products. The actual record contradicts this:
- The pharmaceutical industry invests about 17 percent of sales in research and development, more than nearly any other industry and well above the average for all industries at 3.9 percent.
- The pharmaceutical industry outspent NIH $26 billion to $18 billion in 2000, and according to NIH itself, only four out of the 47 best-selling drugs were developed in part with NIH funding.
New and improved?
According to a study cited by Jennings, 80 percent of “new” drugs are not “significantly different” or “proven to be more effective” than drugs already on the market. But consider:
- It is impossible even for experts, much less television commentators, to characterize most or even some changes to prescription drugs as being medically “insignificant.”
- If he had wanted to present balanced coverage, Jennings easily could have found very respected doctors who believe some of the new drugs are better than others.
Jennings implied that patents provide drug companies with a monopoly so they can charge higher prices. However:
- Patents protect inventions for 20 years. In the case of pharmaceutical drugs, approximately nine of those years are taken up with testing, trials, and Food and Drug Administration approval delays, leaving 11 years, on average, for drug companies to recover their R&D expenses and earn a profit.
- Generic drugs have increased their market share rapidly in recent years, to where they now account for nearly 50 percent by volume of the prescription drug market.
Failing to protect consumers?
Jennings’ interviewees complained that new drugs are tested against placebo rather than existing drugs, and sometimes doctors overseeing clinical trials had received funding from drug manufacturers. But:
- The FDA’s drug approval process requires new drugs to be safe and more effective than placebo, not more effective than existing drugs. Achieving this level of quality assurance involves tests and approvals that require an average of nine years and cost more than $800 million.
- Trials may involve 30 academic medical centers, 50 or 100 doctors, and perhaps hundreds of nurses and support staff. To imply that all of these scientists, administrators, doctors, and nurses are in the pockets of drug companies, and that their Institutional Review Boards are all asleep at the wheel, is both insulting and ludicrous.
Whether one drug is better than another is, and ought to be, decided by patients in consultation with their physicians. Only they can decide whether the trade-offs of benefits, costs, and risk are worthwhile. “Bitter Medicine” was full of people attempting to second-guess patients and their doctors. We should not go down that road.
For more information contact Heartland Public Affairs Director Greg Lackner at 312/377-4000, email email@example.com.