The Politics of Prescription Drugs

Let me see if I understand this correctly. The Bush administration is arguing that Americans shouldn't be allowed to buy drugs from Canada because foreign drugs might not be safe. As it turns out, though, American companies produce many of their drugs overseas because it's cheaper to produce them there than it is to produce them here? And the tendency is to move more and more production offshore, is that correct?

Are we supposed to blindly trust that because it's American companies, and not American citizens, who are allowed to import drugs that users can trust their safety? If that's so, how does the Bush administration explain the major screw up over the flu vaccination? If Chiron's process for producing flu vaccine is so contaminated that British authorities revoke their license and prevent them from shipping anything from their plant, how safe is our drug supply? Does that suggest that drugs produced by American companies in foreign countries may not meet the standard of drugs produced in American plants? What if Chiron had been producing the flu vaccine in a third-world company? Would that have meant that we would have ended up with a contaminated vaccine? If the government is so concerned with the quality of "foreign" drugs, why do they allow drug companies to produce more and more of their drugs overseas?

In the process of trying to understand the recent flu vaccine snafu I found myself reading CNN's article on Why we pay so much for drugs, a must-read article for anyone concerned with rising medical costs. It's the article Kerry should have referred listeners to in response to Schieffer's question: "We are talking about protecting ourselves from the unexpected, but the flu season is suddenly upon us. Flu kills thousands of people every year. Suddenly we find ourselves with a severe shortage of flu vaccine. How did that happen?" While the article was written before the flu vaccine snafu, it does offer insight into the forces that are currently driving the pharmaceutical industry.

Critics point out that the pharmaceutical industry is the most profitable industry in America:

The prices Americans pay for prescription drugs, which are far higher than those paid by citizens of any other developed country, help explain why the pharmaceutical industry is"and has been for years"the most profitable of all businesses in the U.S. In the annual Fortune 500 survey, the pharmaceutical industry topped the list of the most profitable industries, with a return of 17% on revenue.

Considering this profit margin, one might well ask why Congress has been so supportive of the industry. One doesn't have to look far:

One reason the industry does so well in the capital is its potent lobby. It maintains more than 600 lobbyists"more than one for every member of Congress. It spent $435 million to influence Washington from 1996 to 2003 and handed out $57.9 million in contributions from 1991 to 2002, according to Common Cause.

Although there seems to be even larger questions involved, the CNN points out that the current debate over the price of drugs focuses on the importation of drugs:

... the U.S. forbids the import of prescription drugs by anyone other than the original U.S. manufacturer, and even then only when the drugs meet all the approval requirements of the U.S. Food and Drug Administration (FDA).
Although the FDA argues that it is just trying to protect the American consumer, the real effect is to protect the drug companies, not the consumer or even American jobs:

During the early 1990s, according to the U.S. International Trade Commission, imports and exports of pharmaceuticals were "almost equal at just under $10 billion each." Since then the U.S. trade deficit has spiraled from nearly $600 million in 1995 to more than $20 billion in 2002, the last year for which complete data are available. The trend is continuing. Singapore is on track to be a potential Ireland. Lured by tax breaks and other incentives, American drug giants like Merck are investing heavily in the Southeast Asian country. According to the Singapore Economic Development Board, Merck has invested more than $500 million to build two plants, which will produce the cholesterol drugs Ezetrol and Zocor. For its part, the FDA maintains that all these facilities are perfectly safe, that they have undergone inspections and that their manufacturing processes have been certified as meeting the agency's standards. But while the FDA does indeed inspect plants before opening, after that the oversight trails off.

Is the FDA going to continue to argue that Chiron's contaminated flu vaccine took place under the careful "oversight" of the FDA? How can the agency argue that it bears no responsibility for the contamination problem while at the same time arguing that its oversight ensures the safety of drugs overseas?

One would hope that legislators would be aware that more and more "American" drugs are actually being produced overseas, but many continue to defend their efforts to block importing cheaper drugs from Canada and other countries:

Influential lawmakers have given unqualified support to the FDA's anti-Canadian stance, among them Orrin Hatch, a Republican Senator from Utah. Says Hatch: "Many of my constituents have written, asking why they cannot use the lower-cost medications from Canada.

The answer is easy: it is just irresponsible for Congress to jeopardize public safety by allowing the unchecked reimportation of drugs ... If we truly care about our seniors and other patients who depend upon prescription drugs, we should not expose them to what amounts to pharmaceutical Russian roulette."

I suppose it's irrelevant that there is no evidence to indicate that Canadian drugs are any less safe than American drugs:

At a June 2003 hearing, members of Congress quizzed William Hubbard, the FDA's associate commissioner, on the issue:

"As far as adverse events, where people have been harmed by Canadian drugs coming across the border, did you bring any of those examples for us?" asked Representative Burton of Indiana.

Hubbard: "We have very little evidence."

Later, Representative Gutknecht, the Minnesota Republican, pressed Hubbard along the same line:
"But the bottom line is, there's no evidence of anyone who has died from taking a legal drug from Canada. Isn't that a fact?"

Hubbard: "I have no evidence. That's correct."

One might want to ask Senator Hatch how much money the pharmaceutical industry donated to his campaign funds. Although there is some bipartisan support to allow the importation of drugs from other nations, only 40 per cent of Republicans voted to allow them to be imported. It's clear where the Bush adminstration stands on the issue.

As I said before, the CNN article is a must-read article. Of course, it's probably not accidental that when I checked it today there was a Kerry campaign ad running next to. Unfortunately, this is not a 2-minute campaign issue. In my opinion it's not even a good "blog" issue because it requires investigative reporting and considerable space to explore the issue. All I've done here is highlight some of the issues and leave it up to the reader to pursue them further.

Tuesday October 19 UPDATE

Here's an interesting perspective on this problem from The American Voice 2004: A Pocket Guide to Issues and Allegations

4 thoughts on “The Politics of Prescription Drugs

  1. Which is why I was surprised that Kerry let Bush go when GWB stated that one solution to the flu vaccine shortage was to see if we could get some vaccine from Canada. Kerry should have immediately pounced on the administration’s refusal to allow drugs to be imported.

  2. I agree, Harry, in fact too often I was disappointed that Kerry, like Bush, didn’t answer the question asked and instead concentrated on presenting the latest “party line.”

    It seems to me that if the moderator lobs a pitch up to the plate you ought to hit a home run, not settle for a single.

  3. If they allowed third parties to participate, it wouldn’t be sufficient to settle for singles. As long as it’s a two party system, they’re going to continue reciting the party line. These candidates are on common ground concerning most issues. They only differ marginally, in my opinion…

  4. I think we heard that line from Ralph Nader last election, and I’m pretty sure the Bush Administration’s environmental policy is quite a lot different than it would have been under President Gore.

    That said, democracy certainly seems to head for the middle, doestn’t it? Perhaps that’s it strength, that it doesn’t allow vocal minorities to swing the government back and forth to radically. Perhaps that’s also it’s greatest weakness, at least if you happen to disagree with where our country is going.

    I’m afraid tha the greatest enemy might actually be capitalism, or at least businesses that put making a profit ahead of any other values.

    I find it truly ironic that the Christian conservatives have allied themselves with businesses, when too often it’s precisely those businesses that seem most intent at corrupting those conservative Christian values.

    Anyone who thinks that the Fox Network as a whole is in the business of promoting Christian values apparently hasn’t taken a good look at the rest of their entertainment schedule.

What do you think?