Thursday, August 20, 1998

News from that other war on drugs

By Molly Ivins

AUSTIN - Fresh news from the front line of the Drug War! No, not that drug war - the other drug war, the drug war between the brand-name pharmaceutical companies and the generic-drug manufacturers. And then, there's additional news about the war both are waging against the American consumer. Billions of dollars at stake, political influence, chicanery, lobbying, special-interest legislation, fun, games, rip-offs galore. Don't miss this special report.

Of course, what it comes down to is the slow, sad voice of a proud old man dying of cancer, a man fiercely independent and self-sufficient, finally admitting to his child he cannot afford the $1,000-a-month drug bill and asking for financial help. But hey, that's just the human reality; we're talking big bucks here.

The brands, as they are known in the trade, get a 17-year patent on any new drug they develop through their own research labs, after which the generics can replicate the drug and sell it, usually for half the price. Now, no one argues the brands are not making obscene profits; do not waste even a tiny tear on their much-vaunted claims of the dreadful, awful research expenses they bear - paying the scientists, lighting the labs, buying all those beakers and retorts. Over 17 years of charging an arm and leg for every improvement on Tums they come up with, they do just fine, as witness their high standing among connoisseurs of the stock market.

According to a study done at the University of Quebec, the brand-drug industry is the most profitable in the world, and "the financial resources allotted to research and development of new drugs in no way follows increased sales." But every now and then, they come up with some dandy new wonder drug that saves a lot of lives, and they use this as an excuse for ripping off the public the rest of time.

But now, the brands have gotten even greedier. Using an impressive variety of tactics, mostly involving the political system, they are working madly to keep their patents past the 17-year limit. You can understand why; keeping a patent on a major, widely prescribed drug is worth as much as $1 million a day to these companies.

Hence their very large contributions to the politicians of our nation. Hence some very odd legislative ploys.

Last year, the generics were on full red alert for months over an anonymous proposal that would have prevented the generics from making up to 150 medicines. Bristol-Myers Squibb, Schering-Plough and others would have been able to hold onto their patents for another five years, according to Legal Times, and the challenge to the generics was to keep that little tiny amendment from being added to some bill no one was paying any attention to.

At the state level, the brands managed to get Texas, Virginia and North Carolina to pass laws saying that even if a doctor specifically authorizes the substitution of a generic drug for a brand name, a pharmacist refilling certain prescriptions cannot make the switch without again asking the doctor if the substitution is allowed. Like the doc didn't know what she was doing in the first place. According to some pharmacists, what with their being busy and the docs being busy, this produces a 24- to 48-hour delay, often inducing the patient to just give up and pay the higher price for the brand name.

Another fun wrinkle in the drug biz is getting your medicine on "formularies," the lists of meds any given health insurance company will pay for. Naturally, you assume, the insurance companies favor the generics. Ah, but the drug companies now own several of the firms that make the formulary lists, according to a Knight Ridder article published in July. Like it? And they offer financial incentives to health plans - and some doctors' groups and pharmacists - for using specific drugs. Can you spell "conflict of interest," boys and girls? If you get a prescription for a drug not on the list, your doctor either has to justify it to the insurance company or agree to change you to another drug, so imagine how interested the drug companies are in being on those formularies.

Now, we would like to report that the generics are our friends, the David against the brands' Goliath, and they like to play that role themselves. However, some little Davids have been very naughty lately.

Mylan Laboratories Inc., one of the giants among the Davids, is now being investigated by the Federal Trade Commission on allegations of unbelievable price-gouging. Since August of last year, Mylan has raised the price on seven of its generic drugs by as much as 1,000 percent; the increases were so steep in June that they actually caused an increase in the Consumer Price Index, according to the Washington Post. The suspicion is that Mylan pushed up the prices after cornering the market on ingredients through an Italian supplier.

According to Common Cause, the brands have given $18.6 million in political contributions since 1991, including $8.4 million in soft money to both political parties. But what an investment for them. According to Common Cause, restricting access to generic drugs costs consumers as much as $550 million a year.

Hey, half a billion here, half a billion there - pretty soon we're talking about real money. Our elected representatives will get back to us on this as soon as they're able to stop worrying about Monica Lewinsky.

Creators Syndicate, Inc.