View from the Zoo


Value-Driven Health-Care System: Value for Whom?

I feel like I have come full circle. Eight years ago, in my first column for Drug Topics, I wrote about pharmaceutical companies and direct-to-consumer advertising. Tongue in cheek, I wrote  that maybe I should get continuing education credit for watching 60 Minutes, as some of the commercials were more useful than the courses I took to renew my license.

Now I’m writing about Pharma advertising again. This time with not quite such a bemused tone.

The Pharmaceutical Research and Manufacturers of America (PhRMA) has  launched what they said would be a  “multi-year advertising and public affairs initiative” to “showcase the industry’s unsung heroes driving cutting-edge advances in science and highlight the tremendous opportunity that exists to tackle our most complex and devastating health conditions.”

Read more from David Stanley

PhRMA President and CEO Stephen Ubl told reporters at the outset of the campaign: “We’re serious about moving to a value-driven health-care system,” which sounds pretty good, until you realize “value-pricing” is a buzzword the industry uses to justify the astronomical prices it charges for the products those unsung heroes deliver. It is very valuable to you not to have cancer, you see, so in comparison with the alternative, coming up with a couple hundred thousand dollars to eradicate it from your body sounds pretty good, right?

Please no one tell them how valuable water and oxygen are to maintaining life!

I have a suggestion for the people behind this ad campaign. If you don’t want your industry to be seen as a bad guy, then try not collecting six-figure sums every time someone faces a fatal disease. If you want the focus to be on the good science you do, then stop doing things like changing the primary endpoint being measured in a major cholesterol drug study after the data are in, or refusing to publish studies that show things that don’t fit into your marketing plan.

If you don’t want your bad conduct to be the only thing people remember about your industry then, maybe, cut down on the bad conduct. Instead of spending in the “high tens of millions of dollars every year” to convince us of your dedication to care, why not launch an initiative to cut down on the estimated one-quarter of cancer patients who do not fill a prescription due to cost? Because being OK with a business model that limits access to 1-in-4 cancer patients makes you look pretty bad, no matter how many ads you run. The best way to convince us you’re being better corporate citizens would be by actually being better corporate citizens.

David Stanley on labels

I don’t expect the pharmaceutical industry to start taking my advice any time soon, so how can we stop their draining the wallets of patients, insurers, and taxpayers without stopping the flow of breakthrough medicines?   
A variety of proposals exist, ranging from the socialistic (a universal health-care system) to the free-market oriented (allowing Medicare to negotiate what it pays for drugs).

I’m almost ready to pull an idea out of a hat and go with it. Because I don’t think a system that impairs access to millions of seriously ill people while forcing the state of California to spend more on just two drugs (Sovaldi and Harvoni) than it does to maintain its entire parks system is OK, no matter how many commercials try to convince me otherwise. I want a way for people fighting for their life to focus on getting better, not on staying out of bankruptcy, while pharmaceutical companies still make a fair profit for their work.

And I want to go back to watching 60 Minutes in peace. Is that really too much to ask?

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