This Is MS Multiple Sclerosis Community: Knowledge & Support

This article appeared in http:www.medicalnewstoday.com. It is not about MS, but pertinent to many discussions we have about drug companies.

I am glad to see that the soon to be doctors are taking a stand against such practices.

gwa


US Medical Students Stand In Solidarity With Thais In Response To Abbott Laboratories' Withholding Essential Medications
27 Mar 2007

The American Medical Student Association (AMSA) stands in solidarity with Thai colleagues in their national day of action protesting Abbott's alarming decision. AMSA encourages future and current US healthcare professionals to boycott visits and telephone calls from representatives of Abbott until the company supplies all withdrawn medicines to Thai markets. AMSA calls on its physician colleagues to shut the door on Abbott as Abbott has shut the door on patients in Thailand.

"Abbott's actions threaten patient lives and to our knowledge, no pharmaceutical company has withdrawn AIDS medicines in retaliation to a movement toward universal access to healthcare," said Laura Frye, AMSA Global AIDS Fellow. "AMSA strongly supports the legal rights of the Thai government to protect their citizens and their access to affordable medicines, and we condemn Abbott for refusing to provide life-saving medications." Medical students across the nation are uniting in support of the Thai government. Representing over 68,000 physicians-in-training, AMSA sends the message to Abbott that patients' welfare is the priority of healthcare professionals. "We must send a clear message to Abbott and other pharmaceutical companies that access to affordable medications is a human right and that patients deserve the opportunity to receive the same treatment available in developed countries," said Frye.

Last year, in an effort to offset the prohibitive costs of AIDS medicines, Thailand issued a compulsory license in an attempt to manufacture an inexpensive generic version of Abbott's Kaletra. In response, Abbott prevented access in Thailand to the heat-stable version of Kaletra that is available to US patients as well as to other life-saving medication, including antibiotics. AMSA strongly affirms the Thai government's right to issue compulsory licenses within international trade agreements.

"Abbot is putting the profits before the people," said AMSA National President Jay Bhatt. "It's time the bottom line doesn't come before the health of our patients and their access to essential medicines."

About the American Medical Student Association

The American Medical Student Association (AMSA), with more than a half-century history of medical student activism, is the oldest and largest independent association of physicians-in-training in the United States. Founded in 1950, AMSA is a student-governed, non-profit organization committed to representing the concerns of physicians-in-training. With more than 68,000 members, including medical and premedical students, residents and practicing physicians, AMSA is committed to improving medical training as well as advancing the profession of medicine. AMSA focuses on four strategic priorities, including universal healthcare, disparities in medicine, diversity in medicine and transforming the culture of medical education.

To learn more about AMSA, our strategic priorities, or joining the organization, please visit us online at http://www.amsa.org.

Article URL: http://www.medicalnewstoday.com/medical ... wsid=66284

Yep, it is very emotional indeed. "Che" - style declarations (he was a pediatrician, by the way )

I think this idea is totally wrong.
Let me use this analogy. You personally have a spare 2000 every months. Then you decide to donate 100 bucks to charity, sometimes more, sometimes less. But one day the charity organization starts a nasty action against you claiming that you a bad person because you don't donate all 2K for charity. What kind of feelings you'll have?

Drugs making is a business, private business. People use their own money to build up a company, do research, do drugs and sell them for profit.
What's wrong with that?

Amount of money spent by the government so far in the last war (Iraq) could make financially secure all MS research for few HUNDRED years ahead, and lab mice could have golden cages. Of u can find other use of this money.

Why some people try to get into the pocket of other people? You will never go to Ford and ask - give me a free car, you have plenty, will you?

Abbott as well as many other major pharma companies donates every year a huge amount of money for people with low income, research, and so on. Let's them decide to whom and when and how much.

The solution for problems, like this Thai case, always could be find using appropriate ways.

Kind regards,
Tony

Note. I have no business with Abbott.

_________________
"All truth passes through three stages.
First it is ridiculed.
Second it is violently opposed.
Third it is accepted as being self-evident."
Schopenhauer

This is a very emotional issue, understandably so.

I agree Tony that you would not go to Ford demanding or expecting a free car but there is surely a distinction to be made here for a number of reasons.

The first being that your analogy is comparing a consumer product that you may want but do not need to life saving medical drugs that you may not want but you do need.

It is an inquitable system at play, I don't think anyone believes that a company is not entitled to make a profit but surely no one believes that profit should be at the expense of life?

The original ethos of the majority of drug companies was not about profit at the expense of people and I doubt very many researchers involved in the industry believe this to be the case. But they don't make the decisions and somewhere along the line the ethics gets lost.

Yes, Big Pharma is a business and the rising cost of bringing drugs to market is making small in- roads in to their profits, so to satisfy the shareholders cuts in charitable giving will always be the first to go.

Fair enough you might say, but not so simple. While the drug companies do supply low cost drugs and treatments in developing countries they are also responsible for blocking trade in generics such as the recent case of Novartis attempting to obtain patent rights in India on for Glivec.

If Novartis suceed the implications for generics across the world look very grim. Generic drugs are responsible for MOST medicine provided in Africa, UNICEF uses 40% generic drugs for its Africa programmes and over half of all AIDS medication in the under-developed world comes from India!

In 2001 the Doha Declaration pledged to put health before profits. It was to enable developing countries to access generic versions of patented drugs,yet this has failed miserably.

Profit margins are not exactly suffering, most still well above30% and with patients living longer the market is not diminishing. The arguments that R&D takes up the biggest cost are red herrings.

How much money is spent on promotion of lifestyle type drugs that represent big profits compared to how much money goes in to innovative research? A higher percentage is down to the marketing than R&d.

The solution, does not lie in donations and philanthropy, this will never make a dent in the problem. The judgement of whether some 40 millon people in the developing world suffering from preventable disease deserve to live or die can not be left to the whim of a drug company.


Manchester

Tony,

I don't think anyone here is denying the right of Abbott or any drug company the right to make money. After all, that's why they are in business and if they don't make enough money, they soon are out of the business world.

It's also not a good idea to compare Ford refusing to give you a free car simply because they have thousands of them and wouldn't miss one. If Ford decides not to give you a car, a lot of people certainly won't die. And this is the BIG difference between drug company actions and other company actions.

In situations like Abbott and the Thai government, there is always a way to negotiate some kind of settlement that benefits everyone.....perhaps not making everyone happy but at least not having many people die because of unilateral action. Obviously we don't know what has gone on behind closed doors in this situation but the perception of Abbott's actions certainly isn't gaining them any popularity these days.

Harry

I don't know the entire background of this situation but I do know that for many years the "rich" developed countries have subsidized the cost of these drugs by paying much higher prices so that poorer countries had affordable access.

It's a nice thought that everyone should always have access to these life saving drugs but it's just not a sustainable reality.

I personally don't blame Abbott for not selling Thailand these drugs at a cost they can afford because that practice will eventually insure that none of us can afford them.
Bob

- Manchester

Thank you for the post. I would like to add some comments.

In common, I hold a neutral position on drug industry; we need them anyway to have old and new drugs for treatment.
But it doesn’t mean that I accept everything they did, do or will do.

The “weakest link” in really big Pharma companies is that all crucial decisions on perspective drug manufacture and therefore research based on medico-financial forecast from several serious financial institutions, like BNP for ex.
Directors of Board, who represents the shareholders, make these decisions. This informational forecast is tailored for every company and cost much. Of course it is for inside use only and strictly confidential.
Researchers are hired professional workforce and they do what they told to do, like they or not, all decisions come from above, no way – from below.
The problem lies in guys (‘grey cardinals’ of the medical world if you like) who write these forecast, they are definitely not “top” scientist, they have some necessary background but their primary goal is a financial forecast.
That’s why many companies came up with new drugs which development was based on wrong (ok, say, not perfect) ideas.
The average cost of new drug development I think is still around 300 mil now, maybe even more, and it takes around 6-8 years to put it on sell.
Then, it is CEO job to make sells of this product and get the profit on top. They are usually very aggressive, business wise of course, they are very highly paid, and they always squeeze everything out for profit, that’s why bad things happen. (Vioxx, for ex.)
If we speak about moral climate of the company, I truly believe that majority of shareholders are proud in developing new “miracle” drugs to help the humankind, just sometimes it didn’t work that way.

So, as you can see, this a complex issue with Big Pharma.

Generic companies are not as innocent as they appear. Sometimes they make more money on generic drugs than company of the original drug. How? They use low grade equipment, buy cheaper compounds from less trustful suppliers, they pay less to workers, no medical insurance, no pension, etc, and they eliminate the cost of drug development. Consider them as mini Wal-Marts or even Toyota (comparing to GM), and you will realize that they are not a “nice” guys who want to provide people with ‘affordable” product. And we are not talking about intellectual property rights even.
There is more, generic companies always support international funds which take care of developing countries seeking to achieve earlier entrance into the market.

It is a complex issue with generic drug producers also, my point is - there are of the same breed.

Nobody likes to be accused in not providing medical help for “poor dying people”, and I think it is unethical to accuse Big Pharma in doing that.
Make you research – how many international funds and charity organizations ‘hang’ on developing countries, you will be shocked to know how much money they have.
My point is, let’s them assist in buying necessary drugs from companies at a reasonable price. I believe that this noise about Abbott and Thai lies in disagreement on that, and it seems that Thai side was pushed the price far below acceptable level.

What I really do not like that medical community dragged to be involved, in what? Hidden underground financial deal?
It is unethical to cover this, without full explanation, with appellation to highly moral things, like: “some 40 million people in the developing world suffering from preventable disease deserve to live or die”

Kind regards,
Tony

_________________
"All truth passes through three stages.
First it is ridiculed.
Second it is violently opposed.
Third it is accepted as being self-evident."
Schopenhauer

Bob,


Do you have any examples of this?



Don't know about that....so far it looks like the drug companies are doing very well these days and for the most part, the very poor countries still have access to the drugs.



It would be interesting to see just what the main stumbling block in this situation may be. I've never heard of a drug company going out of business by supplying their products to less fortunate countries at a negotiated price.

Harry

Gosh Harry, I'm sure there are a ton of fine examples that I don't have at hand but it's common sense that if you and I agree, as we seem to, that the pharmas are not going to allow anything to get in the way of their making a ton of money, and the "rich" countries are being charged at what the market will bare....yet as you say the poor countries are able to access the majority of these drugs.......who do you think is paying more for these drugs and who is paying less for the very same drugs?

What part are you and I disagreeing on, the definition of "subsidize"?

Since you're from Canada and I'm from the US an interesting example is the fact that I can find the same drugs in Canada for less than half of what we pay in the US.

Now you can say the lower cost is due to Canada's national healthcare system negotiating with the pharmas directly, but since the pharmas have a set profit margin they are going to maintain....in reality who is paying for...subsidizing.... the lower costs in Canada?

Bob

Tony said

With respect Tony you no more no my background than I know yours. I have made my research and know a reasonable amount about pharmaceuticals (from many sides) and the NGOs you speak of.

After I first qualified in Clinical Psychology, I worked for one of these 'international funds' that 'hang' on developing countries and the money they have is a drop in the ocean compared to pharmaceutical companies. I am also aware of how complex the issue is and I don't believe I made any aspersions to medical researchers quite the opposite if you re-read my post.



Unethical? Really?I could say the same about your comparison to drugs and cars.And yes for me it is a moral issue-whether the inaccessibilty of these drugs is in the developed or developing world. Your quite right though, it's probably not 40 million any more (this was from a Who report a few years back, as I remember) but a damn site higher.

What I stated was that with these preventable diseases who gets the drugs and who does not should not be down to the charity of drug companies. I can't see why this is such a provocative statement.

Bob

I don't believe it works quite like that. I don't think the pricing differentials have anything to do with western consumers subsidising developing countries. But please elucidate as I would be interest in learning more.

Manchester

Bob,

I don't think what these poor countries can afford to pay has anything to do with what the developed countries' population is charged for these drugs. Like you said...it's what the market will bare. If these poor countries didn't buy any drugs from "big pharma", we would still be charged what the "market can bare". I would certainly like to see the sales sheets of some of these companies and find out who pays what and how much.



And like you stated, the Canadian Health Care system negotiates with the drug companies and buys in volume amounts, thus using the market to reduce costs. Also, I read that if a drug company wants to raise the price of a drug in this country, it has to show just cause or else it won't get approved. So the drug company either keeps the price the same and continues to make millions instead of hundreds of millions or they refuse and don't sell anything. I don't think the US consumer is subsidizing anything in this case but that's only my opinion. I would sure like to hear from someone who is part of this system and find out what really goes on "in the trenches" of pharmaceutical sales.

Harry

-Manchester

Thanks for response, touchy matter indeed.

People differ, they have different background, different level of education and different access to information different life experience, etc., therefore everyone’s opinion must be different by default.
I share my personal opinion here, that’s all. I appreciate everyone’s opinion said, you can count on that.

Canadian drugs are cheaper. Yes, there is a price tag difference for every country where the drug/or product goes for sell. It based on this particular country economy and buying power, the price vary sometimes very significantly, it could be over hundred percent.
Canadian government subsidizes in part the cost of drugs, it was in press. Good for Canadians one could say, but then the issue of re-export arise. When Canadian pharmacies sell drugs back to America they actually steal money from Canadian and Americans. Pharma companies have loses by losing a part of the local market. To keep business running they will definitely manipulate with the price of drugs in the future to cover this loss. Who is the winner? Take a guess.
The same valid for every country when local price comes to ‘profitable’ disproportion to prices in others, usually wealthier, countries. Who benefits from that? Go to internet and check the number of pharmacies on-line.

Sorry, I like use cars for making analogy, because they are complex, easy to imagine, distinctive, well-known brands, people usually know the cost of car related expenses.

I believe that if you deliver Mercedes in developing country for the price of Civic it will be back, re-exported, in couple of weeks. Someone will put the difference into the pocket and buy a Civic. This is very usual situation for developing countries.
I believe that you could not secure the delivery o high-priced drug door-to-door, and if you even could, there are always will be people who will re-sell them by themselves (or forced to sell back) instead of take them.
I have met guys who made a fortune working as suppliers for developing countries under UN umbrella, with UN programs. You will sleep better if I don’t tell you their experience.
As Hamlet said: "Something is rotten in the state of Denmark."

My point in previous post was that creation of confrontation between medics and Abbott, using such controversial issue as a reason, is far from fair play. I see the situation that medics being used as a cover for financial disagreement only, it has nothing to do with the fate of sick people in developing country.



I think Pharma companies do charity always, even for purpose to keep a good image, but I also think they do what they can afford in their current situation. Maybe they will afford it next year, maybe never, I don’t know.
Frankly speaking, I don’t understand why Abbott must have a headache with “prevention of diseases in developing countries” at all. This must be a function of local government and supervising NGO.
American or Canadian farmer (UK, EU, name it) don’t feel themselves guilty despite of fact that somewhere in the world people still having hunger.
What the difference?

Humanity must start at home first. When all people in your family, neighborhood, home country got everything they need, only then it could spread abroad. It is a shame that retired American must hop on the bus and go to Canada or Mexico on the ‘drugs tour’, who will help them?

Kind regards,
Tony

_________________
"All truth passes through three stages.
First it is ridiculed.
Second it is violently opposed.
Third it is accepted as being self-evident."
Schopenhauer

Tony,

Yes, the entire sale of drugs around the world is a very complex situation and when so many people are involved, you are going to get all kinds of strange happenings.



In effect, what these pharmacies are doing is using the very same market force effects that the drug companies are using.....sell the product to the person who will purchase it!! What some of the drug companies have done in the past year or so is if they see a particular pharmacy selling their product back to a US customer, they cut off all supply of their particular drugs to that pharmacy.

Harry

Tony, although your English isn't perfect, it seems that I agreed with everything you said in that last post.
Bob

Quite agree with the comment about my english, some of my posts are not 'polished' and spell-checked, sorry guys, sometimes it's simply matter of having not so much time.
I'll improve it.

Kind regards,
Tony

_________________
"All truth passes through three stages.
First it is ridiculed.
Second it is violently opposed.
Third it is accepted as being self-evident."
Schopenhauer

Sorry Tony, my intent honestly wasn't to find fault.

You do very well with English but the occasional misplaced word sometimes causes me to wonder if I'm understanding the point you're trying to make.

If necessary, I'm sure you won't mind if I ask you to clarify something.

Bob