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What’s Big Pharma’s Position On Healthcare Reform?

Mar 25, 2009 - 7 comments
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Today I participated in a conference call with Billy Tauzin, CEO of PhRMA (the Pharmaceutical Research and Manufacturers of America - http://www.phrma.org/about_phrma/). The goal of the call was to let bloggers know about PhRMA’s position on healthcare reform. I counted at least 12 bloggers on the call, and I was the only physician. It pains me to see how few physicians participate in reform discussions and I’d like to get more of us involved.

The salient points, as I understood them, were:

1.    PhRMA would like all Americans to have health insurance. They believe that Medicare Part D is a model health insurance program. They do not support a single payer system because it would likely attempt to cut costs by rationing care and denying options to patients. They don’t believe that insurance coverage mandates are a good idea unless the insurance is subsidized to the point of being affordable for all. They favor the current public (Medicare and Medicaid for the elderly, poor, or disabled) private blend of insurance, with roughly 50% of the population in each category.
2.    PhRMA would like to support “precision medicine” where treatments are tailored more effectively to the individual. Mr. Tauzin suggested that some FDA-approved drugs are only effective for 30% of the patients in a given disease class. He’d like to see more research devoted to figuring out why that is, and supports comparative clinical effectiveness research insofar as it furthers this agenda.
3.    PhRMA wants to preserve the unique features of the American healthcare system – to maintain our leadership in biomedical research and new drug development, and to protect the sacred shared decision-making between physicians and patients (to shield it from government intervention).
4.    PhRMA wants to support IT infrastructure that would track patient medication compliance and let physicians know when/if they fill their prescriptions.

Now, the business case for all four of these positions is clear – the pharmaceutical industry benefits from having everyone able to afford medications (i.e. universal coverage), personalized medicine would reward the development of new and innovative drugs and establish a consumer base for many different treatments, protecting the doctor-patient relationship allows for off-label use of medications and a broader array of similar drugs, and IT infrastructure would help to increase drug purchase and compliance with treatment regimens, thus increasing overall sales.

However, the truth is that PhRMA’s positions on healthcare reform – beneficial as they are to themselves – also happen to be beneficial to patients. Increasing the number of insured improves access to medical care, personalized medicine could create more effective treatments with fewer failure rates and side effects, shared-decision making empowers patients to make the right decisions for their circumstances (with their physician’s guidance), and IT solutions that facilitate medication adherence, tracking, and reminder systems could improve patient health outcomes and keep them out of the hospital.

So, in a way pharmaceutical companies, advocacy groups, and physicians are fairly well aligned on many aspects of healthcare reform. Now if certain members of Big Pharma would please give up on those “me-too” drugs, stop creating more expensive medicines by simply combining two perfectly good ones into a new pill, stop hiding negative research studies, and refrain from aggressive direct-to-consumer marketing tactics, we might all really be on the same page.

***

Interesting factoids from call:

    * Medicines only account for 10% of total healthcare costs (unchanged from the 1960s), but they “feel” like a larger cost driver because health insurance doesn’t cover their cost as completely as they do hospital fees.
    * There are about 750 new cancer drugs in the research pipeline.
    * Half of all prescriptions remain unfilled.
    * Physicians provide 30 billion dollars a year in free care.
    * The United States conducts 70% of the world’s research in biomedicines.


Comments
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572651 tn?1530999357
by Lulu54, Mar 25, 2009
Thanks for the fairly objective reporting on this conference call. I'm sure Big Pharma is having sleepless nights thinking of ways to mobilize the troops against drastic reforms.

The factoids are interesting and I assume are substantiated somewhere with objective research numbers.  Thanks too for pointing out the craziness of the "me-too" drugs that do nothing beneficial for us patients by keeping them out of the generic market.  

My hope is from the changes to health coverage, everyone will get the treatment they need while private industry will still have the financial incentive to research and develop new drugs.  We have to find an equitable balance.

My best,
Lulu
MS Forum


585414 tn?1288941302
by ILADVOCATE, Mar 26, 2009
That is positive news and I'm glad that much of what they think is what will cogently benefit the American public as regards health insurance. And I do agree what you said about researching "me too" drugs. In being in study for a new class of antipsychotics in development (glutamate antagonists, google "Dr. Javitt, glycine" and "psychmeds123") that will promote a fuller recovery and have a far more favorable side effect profile I have recieved nothing but support from provider agencies that all research on new antipsychotics should be in new treatment modalities. And I'm sure there are other examples for other disabilities and diseases that should prioritize research into new forms of treatment. As for Medicare Part D and Medicaid (through the Medicaid Buy in for Working People with Disabilities) I have that combination and if every American had it, it would benefit people but they need to stop the continuous denials for medications that are not on their formulary, especially since with me its a matter of treating dysphagic choking spasms and respiratory convulsions from advanced tardive dyskinesia. I've corresponded with many fine researchers (can't post their names for confidentiality reasons) and I have nothing but respect for them. I do tend to get a bit cynical (at least weary) about the insurance industry and wish they would take away their exemptions for "pre-existing conditions" which in reality are disabilities. Health care reform will not be an easy win no matter who supports it.

389974 tn?1331015242
by swampcritter, Mar 26, 2009
The complaint about "me too" drugs is a common one. The trouble is that certain kinds of medical conditions -- most notably those that have to do with either sexual health or fertility -- will always command a higher price. Its not possible to tell a company that they shouldn't develop and market something that will make them $10, 20, 30 billion.

Especially given that the development price of a new drug is around $600 million.


One thing that would be helpful is if health care providers competed on price and service, like other industries do.

809379 tn?1308659610
by Val Jones, MDBlank, Mar 29, 2009
Thanks for the comments, all. I look forward to interacting with you over future blog posts. :)

Avatar universal
by LevelynL, Aug 13, 2009
Betsy McCaughey has gone on a real tear.  Betsy McCaughey, a journalist of distinction and former Lieutenant Governor of New York state, has taken aim at Obamacare and especially Dr. Ezekiel Emanuel, MD, brother to White House Chief of Staff Rahm Emanuel, and in her op-ed piece that's being billed as New York Post Deadly Doctors, she claims that the public health care plan will deny care to the mentally disabled and elderly.  However, nothing in the bill has come to light that would indicate she's correct, and the oversight agency for the program would be only be staffed by physicians.  Regardless of criticism by Betsy McCaughey and others, most still need payday loans for the most basic of care.

Avatar universal
by LevelynL, Aug 13, 2009
Betsy McCaughey has gone on a real tear.  Betsy McCaughey, a journalist of distinction and former Lieutenant Governor of New York state, has taken aim at Obamacare and especially Dr. Ezekiel Emanuel, MD, brother to White House Chief of Staff Rahm Emanuel, and in her op-ed piece that's being billed as New York Post Deadly Doctors, she claims that the public health care plan will deny care to the mentally disabled and elderly.  However, nothing in the bill has come to light that would indicate she's correct, and the oversight agency for the program would be only be staffed by physicians.  Regardless of criticism by Betsy McCaughey and others, most still need payday loans for the most basic of care. Visit this site to read more: http://personalmoneystore.com/moneyblog/2009/08/10/deadly-doctors-part-2/

Avatar universal
by GrettaG, Apr 07, 2011
When it comes to industries like the pharmaceutical industry supporting or not supporting the health care reform, I do tend to take their opinions with a grain of salt. What I want to know is how the health care reform or their positions will affect patients. I think everyone should have access to affordable health insurance and affordable medicines and treatment. But I also understand that these things come at a cost and that's where things get complicated.

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