Thanks for the update, Dr., and for doing what you could.
[quote]2busy wrote:
Thanks for the update, Dr., and for doing what you could.
[/quote]
Thanks, but I do not merit any thanks.
I would hope that there be folks who will do as much for your kids, too.
Doc, to what extent would you say the astronomical cost of medication in the United States is attributable to collusion between the Food and Drug Administration and major pharmaceutical companies, to keep effective but less costly alternative medications off the market by denying approval? I hate to use the word “conspiracy”, but there does seem to be an unofficial alliance between FDA and Big Pharma, to the benefit of the pharmaceutical companies and insurance companies, but to the detriment of physicians and their patients. Your thoughts?
[quote]Varqanir wrote:
Doc, to what extent would you say the astronomical cost of medication in the United States is attributable to collusion between the Food and Drug Administration and major pharmaceutical companies, to keep effective but less costly alternative medications off the market by denying approval? I hate to use the word “conspiracy”, but there does seem to be an unofficial alliance between FDA and Big Pharma, to the benefit of the pharmaceutical companies and insurance companies, but to the detriment of physicians and their patients. Your thoughts?[/quote]
Ok, but any explanation digresses from the current thread. Some things to know:
–Although Pharmaceutical Companies conduct a lot of research in the US, and clinical and pharmacologic research here and abroad, almost all the manufacturing of the finished product occurs offshore, in France, England, ireland, India, Italy and Turkey. Very few of the most expensive drugs are actually manufactured in the U.S. of A.
–The FDA accommodates Pharma by certifying these plants, the production lines and the importation of drugs.
–With the notable exception of the US, the world negotiates a cap on the prices which Pharma commands for its products. MediCare is expressly forbidden to do so (although the VA system can.) As a result, the American consumer typically pays 25% or more than the European end-consumer.
–Ostensibly to “protect” Americans from the possibility of contamination–or cheaper prices–the FDA maintains a “closed system” whereby every drug is labelled and traceable. To ensure this, the Government mandates that each drug, each vial, each package, have a 10-digit code (the “NDC number”) and the rubric “by Rx only.” If a vial of medicine is made on the identical production line in the FDA-inspected plant, it may have the identical contents, the identical labelling and packaging…but if it lacks the NDC number, it is considered a foreign and unapproved drug. Drugs intended for the world market do not have this simple addition on the label. Emphasis: it is identical, but the NDC code in 6-point type determines whether it is intended for the cheaper European market or the extortion of the American market.
–These laws and regulations were explicitly reinforced by Obamacare; that was one of the concessions that Big Pharma bought for $15 billion in support. Monopoly purchased cheaply.
–(What about Canada, one may ask. Well, if a drug was made in the US, and bears the proper labelling and even has the NDC number, it is illegal to buy it from a Canadian pharmacy unless it has been returned to the manufacturer. The drug pricing is then adjusted upwards.)
–If one is unaware of this distinction, and buys the drug, the law provides that there is no defense: merely having an invoice is deemed a “strict liability” offense. There is no defense.
So, in short, without any overt collusion, the laws–ostensibly written to protect the American consumer-- comport to provide Big Pharma with a margin of profit not allowed in other countries. Beware the institution or practitioner who even inadvertently “imports” medicines into the US of A.
I feel some abivalence in all this. Someone has to pay for all the R&D, largely conducted in the US. But why does it have to be the most vulnerable among us? And why does the rest of the world benefit to such a degree without our lawmakers taking notice?
Thanks, Doc. That aligns pretty closely to what I suspected.