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DBL%20Hendrix%20small.png College chemistry, 1983

Derek Lowe The 2002 Model

Dbl%20new%20portrait%20B%26W.png After 10 years of blogging. . .

Derek Lowe, an Arkansan by birth, got his BA from Hendrix College and his PhD in organic chemistry from Duke before spending time in Germany on a Humboldt Fellowship on his post-doc. He's worked for several major pharmaceutical companies since 1989 on drug discovery projects against schizophrenia, Alzheimer's, diabetes, osteoporosis and other diseases. To contact Derek email him directly: derekb.lowe@gmail.com Twitter: Dereklowe

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« Dinner the Night Before | Main | More on Brazil and Kaletra »

July 6, 2005

Brazil Pulls Out the Pin

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Posted by Derek

Just how much should an anti-HIV drug cost? What if you're selling it in a place where most of the patients can't afford it? These questions have been fought out in Africa and other parts of the developing world over the last few years (and the stagnating world, too, unfortunately.) Now Brazil may be making good on a threat of outright patent confiscation.

The Brazilian government is unhappy with the price of Abbott's combination therapy, Kaletra (PDF), which they already pay just over $100 million per year for. Mind you, that's the lowest price in the world outside Africa. Online pharmacies claim that the average US retail for Kaletra tablets is about $4.06 each, and they offer it at about $3.60. Brazil's paying $1.17, and they're saying that they'll issue a compulsory license if the price doesn't come down to 68 cents.

They've threatened to do this before, but have never come this close to following through. The worry for Abbott is that once the Brazilian generic companies start making the stuff, it'll end up all over the rest of the world at a base of $0.68/tablet. And where do you think demand for it will be strongest? In the countries where it's already the most expensive, which Abbott is counting on for their profits.

Opinions vary a bit, as you'd figure. You can find no shortage of activists cheering the Brazilians on. To wit, from the AP article linked above:

"We are the hostages of these companies, and compulsory licensing is a defense against the abuse of monopolies," said Jorge Beloqui, the leader of a Sao Paulo-based AIDS support group.
Beloqui, a university math professor, has taken 30,000 anti-AIDS pills provided free by the government since 1991. If Brazil breaks the patent, he says, activists will pressure Brazilian politicians to go a step further and let its generic drug makers produce much more of Abbott's drug so it can be shipped around the world to needy patients.
"These medicines are essential to the world, and I think Brazil should sell them," he said.

Actually, Prof. Beloqui is the hostage of a retrovirus, but his comments seem pretty representative of the "stick it to The Man!" point of view. Well, speaking for The Man (to crib a line from Tom Wolfe), I have to say that Brazil seems to be playing to the galleries here. There are accusations that the country is spending less on anti-HIV medications than it did five years ago, and they turned down $40 million in US money not so long ago. There's another problem, too. Brazil is acting according to WTO language about breaking patents in case of a public health crisis. But you have to wonder

Allowing Brazil to use the "public health crisis" justification creates a dangerous and perverse incentive for governments of the developing world: if you as a government are responsible and work hard to uphold a fiscally manageable public health program, then you will be punished by having to pay for expensive drugs, but if you fail or simply ignore the problem and cry "crisis," then you will be rewarded with permission to trample on intellectual property rights.

I've known some pretty good Brazilian scientists, but the country isn't up to being able to discover and develop its own new ones. (Very few countries are; you can count them on your fingers.) So I've saved my usual justification for last: if Brazil decides to grab an HIV medication that other people discovered, tested, and won approval for, who's going to make the next one for them?

Comments (43) + TrackBacks (0) | Category: Drug Prices | Infectious Diseases | Patents and IP


COMMENTS

1. David on July 6, 2005 10:28 PM writes...

"if Brazil decides to grab an HIV medication that other people discovered, tested, and won approval for, who's going to make the next one for them?"

Maybe, just maybe, this is what it will take to get the world to realize the good Big Pharma actually does. Why is it that people are outraged that pharmaceutical companies charge so much for their products, and yet go spend billions to watch sporting figures and movie stars get paid millions to do something that requires very little cerebral activity? Should I appologize that my talent can save lives but has no entertainment value? The entertainment industry does a fantastic job promoting their trade, everyone knows what baseball and football and basketball players do. Why is it that the scientific community has burried its head in the sand hoping this problem will just go away? What would happen if we just stopped making drugs...

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2. daen on July 7, 2005 4:52 AM writes...

Why is it that people are outraged that pharmaceutical companies charge so much for their products, and yet go spend billions to watch sporting figures and movie stars get paid millions to do something that requires very little cerebral activity?


Well, people view the things that they spend their money on in very different ways. It's probably something to do with Maslow's hierarchy of needs, that pyramid where higher needs require the needs in the layer below to be satisfied before they become important. The lowest level of the pyramid are physiological needs (air, food, water, sleep, sex etc). Basic health also belongs here. But entertainment is a higher need than this. So there will be unhappiness if fulfilling the physiological layer of needs is more costly and difficult for some (those with HIV) than for others. On the other hand, very few people will choose to complain about the relative costs of going to a ball game or going to the opera : not being able to afford to go to Covent Garden every week won't kill you in the long run.

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3. Eric on July 7, 2005 7:36 AM writes...

Your case would be helped if, you know, you were actually right. Specifically, the CIA World Factbook (http://www.cia.gov/cia/publications/factbook/index.html) estimates US PPP GDP at $40100 and Brazil at $8100, or 20.2% of the US figure. Apply that to your $3.60 per tablet price and you get... 72.7 cents. Inept statements like this are what is killing the reputation of the pharma industry.

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4. Derek Lowe on July 7, 2005 8:30 AM writes...

Applying a strict GDP deflator, though, misses several important points. Brazil has a more serious problem with the disease than the US does.

The CDC estimates that at the end of 2003, just over 400,000 people in the US were living with the disease. The corresponding figure for Brazil is estimated at 650,000, and they have only 63% of the population that the US does.650,000.


The US is most certainly a wealthier country. But that's how a much larger amount of HIV therapy is paid for by individuals and companies here rather than by the government. And that's also how we were able to discover these drugs in the first place - it takes a wealthy economy to do that.


At the same time,Brazil isn't Congo. They have a space program and are a supplier of commericial aircraft to the US and many other countries. Do they require Congo pricing?

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5. qetzal on July 7, 2005 9:56 AM writes...

Eric, I don't understand your criticism of Derek's piece.



From your GDP comparison, it sounds like you're arguing that Brazil's desired price of $0.68/pill is justifiable, as if Derek argued that it isn't. But the main point of Derek's post (IMO) isn't whether the Brazilian price should be $0.68 or $1.17 or $3.60.



Here's the key phrase:



"The worry for Abbott is that once the Brazilian generic companies start making the stuff, it'll end up all over the rest of the world at a base of $0.68/tablet."



The reason this product exists is that Abbott spent a lot of time and money to develop it. The reason Abbott did that is because they expected to make a profit. That is, by the time they're done selling pills, they expect to have more money than if they'd just invested in the stock market.



The reason Abbott expected to make that profit is that they expected to be able to sell the pills for ~$3.60 in the US and other developed countries. If you had told Abbott 10+ years ago that in reality, they'd only be able to sell the pills for $0.68, they would almost certainly never have developed them in the first place.



Now apply that to the present situation. Suppose Brazil declares a crisis, breaks Abbott's patents, begins making the pills, and allows them to be shipped worldwide at $0.68 each. (Note that this is precisely what some in Brazil are advocating, as Derek makes clear.) People in the US and EU won't want to continue paying $3.60 each, they'll want to switch to the Brazilian generic. Now Abbott's chance of making the profit they planned on is much lower.



Of course, this drug is already developed, so making it generic by breaking Abbott's patents won't make it disappear. What it will do (among other things) is this. Next time Abbott or any other major pharma is considering whether to develop a potential drug, they'll assume there's a much bigger risk that if it works, someone will decide it's OK to break the patent. That means there's a much lower chance that they can make a profit on the drug (assuming it ever makes it to market in the first place, of course). And that means they're more likely to decide it's not worth investing the money in developing the drug. In other words, things that Brazil does today can significantly impact the availability of new drugs tomorrow.



None of that makes Brazil's proposal automatically wrong. One could reasonably argue that moral considerations justify such actions, and that saving known lives today outweighs the potential impact on unknown drugs tomorrow. One could further argue that we could implement some system to ensure that only sufficiently poor people could access drugs at the $0.68 price. I'm not sure such a system could work very well in practice, but it's a reasonable topic for discussion.



However, I think your specific criticism of Derek's post is off target, and suggests you missed his real point. (Or else, I missed his point, or yours, or both!)

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6. Petros on July 7, 2005 10:57 AM writes...

Of course arguements of this type are rather negated by the action that the Canadian government took and that the US Government nearly took with regard to Cipro and the anthrax scare of several years ago.

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7. jsinger on July 7, 2005 11:17 AM writes...

People in the US and EU won't want to continue paying $3.60 each, they'll want to switch to the Brazilian generic.

For that matter, where do you think the online pharmacies are getting the pills they sell at $3.60 instead of the average US price of $4.06?

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8. Derek Lowe on July 7, 2005 11:43 AM writes...

No, I wouldn't say that those arguments are negated by the Cipro story at all. I was opposed to that action as well, and for the same reasons. This case is potentially even worse.


Brazil is entitled to negotiate as low a price as it can, certainly. But a government has a bad-faith option available (patent seizure) that complicates the transaction. Frankly, I just don't think that Brazil should get to stomp all over intellectual property rights in order to save perhaps 10% on its retroviral costs. The precedent isn't worth it.

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9. WBurke on July 7, 2005 11:59 AM writes...

In response to David's question: "What would happen if we just stopped making drugs..." - without a question mark which would leave me wondering if it were a threat or a real question if I weren't accustomed to dealing with egotistical Big Pharma droids - let me just say this: Without the drugs you guys use to poison and destroy human life the world would be far better off.

Take away your restrictive efforts to knowledge of natural cures and you've got no future revenue sources. Billions of dollars are spent to restrain information from the consumer - case in point your beloved Codex Alimentarius' recent accomplishment.

Take away your billions funneled into governments throughout the world to control their reporting of the millions of lives harmed by properly administered, "approved" and altogether dangerous drugs or drug cocktails and you've got very little prospects for long-term viability on effort and value alone.

Considering that 50% of advertising during major network news comes from the drug industry it is no wonder the word about your scam never breaks through - who in this day and age has the courage to stand up to the moneymen and kick 'em where they deserve to be kicked? It's not just that few are willing - but you clowns have most of the world taking your worthless toxins and buying the whole fable.

Final analysis - STOP making them David - I'll take that world over this one that your Big Pharma has polluted anyday.

Hey Derek - keep pushing your manure in here all you want buddy - it doesn't change the fact that you're a liar in a liars paradise.

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10. Bill on July 7, 2005 12:32 PM writes...

Kaletra is most commonly prescribed at 6 pills a day, making the daily cost (@ $3.60 per pill) $21.60 or $7,884 a year per patient. And it's taken in combination with at least 1 or 2 or 3 other similarly priced drugs. How many of us, even at our "big pharma" salaries, could afford to pay for that out-of-pocket without government or insurance co. subsidy?

Abbott is particulalry egregious when it comes to pricing. In December 2003, they quintupled (!) the price of Norvir (ritonavir, one of 2 drugs contained in Kaletra) from $648 per year to $3,180. For two reasons:

1) to ratchet up the revenues of the 8-year-old drug (whose revenues had already more than returned an adequate profit (aka r&d risk incentive) on its development costs), but more importantly

2) to make other (competitor) protease-inhibitor-based regimens boosted with Norvir more expensive than Kaletra. It was a defensive/competitive maneuver in response to new (potentially better) PIs (like Reyataz and Lexiva) coming to market. (Which in most cases would need the Norvir booster.)

The result, a physician opting for a less toxic prescription for his/her patient causes to be spent more healthcare dollars because of Abbott's greed. And who pays? you and me and our employers who pay insurance premiums and taxes.

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11. SRC on July 7, 2005 12:33 PM writes...

Of course arguments of this type are rather negated by the action that the Canadian government took and that the US Government nearly took with regard to Cipro and the anthrax scare of several years ago.

Which were straight-up demogoguery, and also wrong. Cipro was a) going off patent, b) not in short supply, and c) not even actually being used against anthrax to speak of (only planned to be used, if necessry), and d) not having any material effect financially.

So there was no need to negate Bayer's patent rights, except on the part of certain politicians who wanted to pose as if they were actually doing something.

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12. Derek Lowe on July 7, 2005 12:48 PM writes...

So, Mr. Burke, if I'm reading you correctly, the government of Brazil is run by dupes of the pharmaceutical industry, paid off by billions of dollars. And your take on the dramatic decline in HIV mortality that's been seen in every country using antiretroviral drugs is that the whole thing is a scam.

So, let's add this up: these bought-and-paid-for tools of the drug industry are threatening the drug industry in order to get a better price for something that doesn't work. Extra points if you can explain that head-scratcher without quoting anything from the Book of Revelations.


To my other readers: sorry, folks. I just couldn't resist. I'll try to be better in the future.

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13. WBurke on July 7, 2005 2:39 PM writes...

NEWSFLASH Derek: Less than 5% of ALL deaths are ever autopsied so for ANYONE to claim that a specific disease induced death, in this case AIDS, have been reduced in any state or country requires nothing more than a megaphone and an ability and willingness to spew lies.

The CDC's list of the "Leading Causes of Death is a joke as it doesn't even include Iatrogenic Deaths which JAMA put at #3 and "Death By Medicine" put at #1. It doesn't include infections which kill 88,000 per year according to:

Weinstein RA. Nosocomial Infection Update. Special Issue. Emerging Infectious Diseases. Vol 4 No. 3, July Sept 1998.

Forth Decennial International Conference on Nosocomial and Healthcare-Associated Infections, Morbidity and Mortality Weekly Report (MMWR), February 25, 2000, Vol. 49, No. 7, p. 138.

That would make infections #6 on the LCoD chart but no mention from the CDC thus their accuracy is suspect to say the very least.

Nobody but God knows what causes ALL people to die from any given country, it is all speculative that they died from AIDS in the first place as the disease has been blamed for deaths from a multitude of other illnesses.

As for the other question, not such a brain-buster as you seem to imagine it is. They've got X-number of dollars and a bunch of pre-programmed zealots clamoring for ARV drugs (100% toxic drugs which when packaged for other uses are labelled with a SKULL & CROSSBONES) which at current prices would break the bank - what else are they gonna do? Besides - when they succeed the drug companies still know they'll be able to rely on the Billions of dollars coming from the UNAIDS and USAIDS efforts to throw money their way.

Only question is - Will Big Pharma's unquenchable greed keep it from accomodating Brazil?

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14. Sigivald on July 7, 2005 3:07 PM writes...

Bill: ... and your entire comment ignores the immense price of drug development and testing.

"Greed"? Drug companies that don't make money go bankrupt and then never develop or make another drug.

The only alternative I see to this "greed" is a lack of drugs at any price. (By way of example, cheap aspirin doesn't do you any good if you need an antibiotic.

Stifling development by demanding that new, expensively developed treatments somehow be made cheap [by main force of the State, I imagine? I can't imagine what else would suffice.] has such an immense negative long-term effect that I'm amazed people suggest it.

I can only assume that people just ignore it or wave their hands at it since it's unpleasant.)

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15. Eric on July 7, 2005 3:45 PM writes...

Derek principally and qetzal:

Your problem is that you are conflating two realted issues. Issue A is 'Is Brazil's price demand reasonable?' and Issue B is 'What is the likely fallout if the nuclear option is used?' Issue B could be discussed as a standalone item, but it was not presented in that way. Because of that, the conclusions you reach here are dependant on what you conclude for issue A. Since you do not understand issue A, what you have concluded about B are erroneous.

In paragraph two of the orriginal post, you stated 'Mind you, that's the lowest price in the world outside Africa.' The inclusion of Africa is a straw man, the size on the epidmic combined with minimal income make it unreasonable to expect any significan profit from this region. You are therefore accusing Brazil of condicting a shakedown to abtain the best world price, when the requested price is on the same level as the US price. I dont have any data, but the lowest world prices are almost certanly in Europe. Inded, you have made the same argument, in the form of 'Europe is failing to pay its share of drug development costs.' You reinforce the acusatuion if paragraph five: 'Actually, Prof. Beloqui is the hostage of a retrovirus, but his comments seem pretty representative of the "stick it to The Man!" point of view. Well, speaking for The Man (to crib a line from Tom Wolfe), I have to say that Brazil seems to be playing to the galleries here.'

Now hopefully you can see that your arguments about issue B are starting from the wrong point; the nuclear option is being brought up not because Brazil is seeking unfair advantage, but because Abbot is rent seeking. Indeed the situation could be worse, the money that is paying for treatment should be coming from disposable income, not income for basic needs. On this measure Brazil much porrer than the US, and could reasonably claim a correspondingly lower price.

If I am Abbot, or the pharma industry as a whole, I would formalize the relative imcome argument for drugs that treat HIV: trade defined pricing (adjusted periodically) for assistance building a local manufacturing plant. This would eliminate the nuclear option, at a cost a revenue drop. If the damage from unlicensed products is really that great, it would be a justifiable project. In fact, I am not sure that revenue would drop that much, since so many people are going untreated.

If the industry was really gutsy. they would look to expand this to other nations and perhapse other products, protecting themselves on the downside. Locking us China and India would be desirable. Later this would help refute likely European demands for lower pricing, as the WTO makes the nuclear option unavalablet to Euros. At minimum, the industry would be on the moral high ground for once. (For the humor impaired, the last paragraph should be read with a slightly whimsical note.)

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16. PsychicChemist on July 7, 2005 7:22 PM writes...

Being employed in the pharma industry myself, I understand how expensive it is to develop a new NCE.

However the industry as a whole spends 14.2% of its total revenues on R&D vs 30.2% on Sales and Administration (Glass, G.; Nature Reviews Drug Discovery, 2004, 3, 1057). So we cant continue to make the argument that it is only R&D that is driving up the costs of pharmaceuticals (Do we really need all those commercials for Viagra, Cialis etc).

That being said, I think that the goverment needs to help out the pharma industry and increase the time that a company can sell a drug after it is approved by the FDA. This should ease up some pressure on the industry to make as much money as possible before the drug becomes a generic.

And finally when the heck is burke going to infect himself with HIV and go on his vitamin diet.

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17. Richard on July 7, 2005 8:56 PM writes...

Think how it must play in Brazil, save the lives of locals or build the bank account of a foreign Pharmaceutical company. I think even a majority of Americans would give up IP rights in that scenario.

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18. qetzal on July 7, 2005 10:44 PM writes...

Eric,



Thanks for replying, but I confess I still don’t see the logic in much of what you say. If anything, I respectfully suggest that you're the one mistakenly conflating these issues. (BTW – all my comments are meant in the spirit of reasonable discussion. If anything sounds snarky, it’s not intentional, just poor writing skills!)



You define Issue A as 'Is Brazil's price demand reasonable?' and Issue B as 'What is the likely fallout if the nuclear option is used?' I don’t see how one’s conclusions about Issue A can lead to erroneous conclusions about Issue B. If Brazil uses the “nuclear option,” the fallout isn’t going to depend on whether their original price demand was reasonable. We can argue over what we each think the outcome will be, but the actual outcome would almost certainly be independent of Issue A.



I wonder if you really meant something else (call it Issue C): ‘Is Brazil justified in using the nuclear option if their price demand isn’t met?’ If that’s what you really meant, then I agree - one’s answer to Issue C could easily depend on their answer to Issue A.



Regardless, I contend there are no absolutely true or false answers to Issue A. One’s answer depends on how one sets the standard for ‘reasonable.’ Your GDP approach is one such standard, and assumes that price should be indexed to income. But that’s not the only ‘right’ standard one could use. You may think it’s the best one, but others can reasonably disagree. Going back to your first comment, then, Derek’s opinion may differ from yours, but that doesn’t make him wrong and inept. (Besides which, I’m still not convinced that Derek was really arguing against Brazil’s price demand per se.)



Your suggestion regarding local manufacturing plants wouldn’t help the situation, I’m afraid. Here again, I think you may be mixing up Issues A & B.



Assume Abbott’s main concern is not making enough profit in Brazil if they sell at $0.68 (Issue A, more or less). Opening a local plant is unlikely to make things better. Unless there’s a capacity issue, it would probably be easiest for them to supply Brazil from their existing plants. The cost of opening a new plant would probably just make the economic equation even worse. Unless, of course, the Brazilian gov't subsidizes the new plant. But if they're willing to do that, wouldn't it be more efficient to just apply those subsidies directly to purchasing the drug?



OTOH, assume Abbott is mainly concerned that $0.68 pills will get resold in the US and EU, undercutting their main source of profit (Issue B). In that case, if they’re going to have to sell for $0.68 in Brazil anyway, they’d like to minimize any drug export out of Brazil. That will be easier if Abbott is the only one making the drug for Brazil. But I don’t think their control will be significantly greater if they make it in Brazil, versus shipping it to Brazil from elsewhere.

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19. WBurke on July 7, 2005 10:47 PM writes...

Hey Psycho - when you're ready to infect yourself and go on ARV's I will happily expose myself and opt for the vitamin therapy, but I thought I already said that?

As for the government giving Big Pharma more concessions - they already pay for your immunization liabilities(see the National Vaccine Injury Compensation Program), cover your back from lawsuits galore through legislation written by BP execs(see the Patriot act pre-revisions), another case in point is the Medicare reform, or should I say the Multi-Year/Multi-Trillion Dollar Gov't Handout to BP?

Then Bush goes and pays back all the campaign contributions by committing what $15 Billion to AIDS funding? Another BP windfall.

You guys really have to be the most worthless bunch of ungrateful leeches to ever walk this planet. But no surprise that you're of that mindset Psycho - you're leader Derek is among the most prominent EPIC FAILURES of all time. What is it Derek 16 Years and never one successful product?

Most failures of your caliber would have lost their job years ago - you must really know how to kiss up because I doubt it is just that your blind allegiance to them justifies these continual failures, or does it?

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20. WBurke on July 7, 2005 10:50 PM writes...

Oh, dude I'm sorry - was it Psychic?

Well Psychic/Psycho what's the difference really?

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21. qetzal on July 7, 2005 11:08 PM writes...

PsychicChemist,



Re:



"However the industry as a whole spends 14.2% of its total revenues on R&D vs 30.2% on Sales and Administration (Glass, G.; Nature Reviews Drug Discovery, 2004, 3, 1057). So we cant continue to make the argument that it is only R&D that is driving up the costs of pharmaceuticals (Do we really need all those commercials for Viagra, Cialis etc)."



I assume that Pharma spends what it does on sales and marketing because it expects to make more net profit as a result. In that case, if Pharma is forced to spend less on S&M (how's that for a Freudian acronym?!), net profits should logically go down, right? If drug development becomes less profitable, isn't that likely to make things worse?



I especially don't understand this logic as applied to Viagra et al. Surely pharma isn't jacking up the price of cancer drugs to pay for more Viagra ads.



If anything, Viagra and Cialis are the perfect examples of where drug advertising should be least objectionable. They're arguably just 'lifestyle' drugs and are rarely covered by insurance (AFAIK). People are usually voluntarily buying them with discretionary income. They always struck me as the worst examples one could possibly cite. If anything, we should be glad if pharma can make bigger profits by advertising ED drugs. Bigger ED profits means more money to develop drugs for more important indications.

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22. PsychicChemist on July 7, 2005 11:15 PM writes...

Ah Burke, at attempt at humor! Do you have a day time job - probably not. You are too busy making money selling snake oil to sick people. Shame on you

(I am out after this one)

Permalink to Comment

23. PsychicChemist on July 7, 2005 11:42 PM writes...

qetzal, like it or not big pharma is starting to acquire an image problem (jacking up prices of medications for senior citizens, but spending huge amounts of money on ED commercials - and all this to support R&D). I think we should quit making the argument that drug prices are high to support R&D, but instead, pharma needs to make more money to jack up their already bloated S&M budget to market more me-too drugs. I dont know whats the way out. That is why I suggested longer patent protection for new drugs. It might take some pressure off the industry to not have to aggressively market their products during the time they have before the patent expires. Of course, this strategy might not work at all. In any case, wasnt there a recent case where child molesters were being supplied Viagra through Medicaid!

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24. WBurke on July 8, 2005 9:40 AM writes...

Yeah I do have a day job Psych - and unlike you yahoo's who hover near the lower end of your profession, my work recieves praise and reverence as the BEST seen by a 30 year veteran in all the years he's been in the industry.

Of course you'll never respond to this or read this because you're out of here, but that is no surprise either. The offer is on the table Mr. all talk no action - ARV's for you and Dr. Rath's Vitamins for me - do you have the conviction and trust in ARV's?

I thought not!

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25. David on July 8, 2005 1:03 PM writes...

"my work recieves praise and reverence as the BEST seen by a 30 year veteran in all the years he's been in the industry."

Well... The best rat is still a rat.

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26. simon on July 9, 2005 8:28 PM writes...

Brazil does have a serious problem ... respect property rights and create a just society or play the politics of vistim. The answer is clear the choice is not. Brazil has no right to appropriate the property of others for a false good. The problem of HIV/AIDs is larger than they the context that they have set. They need to confron the issue in an honest manner rather than attack those who are working to solvethe problem.

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27. simon on July 9, 2005 8:29 PM writes...

Brazil does have a serious problem ... respect property rights and create a just society or play the politics of victim. The answer is clear the choice is not. Brazil has no right to appropriate the property of others for a false good. The problem of HIV/AIDs is larger than they the context that they have set. They need to confron the issue in an honest manner rather than attack those who are working to solvethe problem.

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28. WBurke on July 10, 2005 11:07 PM writes...

David - no rat traits in what I do 40 hrs a week - the projects I work on actually come to market and are built and used by many consumers and they actually work (unlike our host who admitted that in 16 years in the drug industry he's yet to have a drug come to market, a record of failure after failure and yet he's still employed, doesn't make any sense to me but hey I work with engineers not misguided scientists).

And now the words on the latest from the drug industry:

WOMEN taking the Pill are twice as likely to suffer a heart attack or stroke,

http://www.heraldsun.news.com.au/common/story_page/0,5478,15887962%255E662,00.html


Teenager abuse of prescription drugs 'epidemic'


http://www.chron.com/cs/CDA/ssistory.mpl/nation/3257470

The FDA Orders Label Change for Impotence Drugs

U.S. Food and Drug Administration on Friday ordered updated labeling for the impotence drugs Viagra, Cialis and Levitra to reflect a small number of reports of sudden vision loss among users.


The agency is advising consumers to stop taking these medicines and call a doctor or health-care provider immediately if they experience sudden or decreased vision loss in one or both eyes, a condition known as NAION (non arteritic ischemic optic neuropathy) that occurs when blood flow is blocked to the optic nerve.

http://www.forbes.com/lifestyle/health/feeds/hscout/2005/07/08/hscout526767.html


I know I know it's not that drugs are dangerous, it's just that people don't take them right, right?

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29. Slocum on July 12, 2005 7:50 AM writes...

Next time Abbott or any other major pharma is considering whether to develop a potential drug, they'll assume there's a much bigger risk that if it works, someone will decide it's OK to break the patent.

Well, yes, and there's a more insidious effect to worry about. Pharma companies will focus their efforts on lifestyle drugs for the wealthy for which there will be little pressure for patent negation and they will put less money and effort into drugs intended to treat serious illnesses that affect the developing world.

And then there's the export (or re-export) problem. Even now, with the current price differential between what Brazil pays for ARVs and the US price, there is an opportunity to reap large profits by re-exporting the drugs back to the US rather than dispensing them to poor Brazilians--patent negation is not necessary for this to happen.

A messy, messy issue. What would I propose? I would say that with critical life-saving drugs (for which there are no 'me too' alternatives to give purchasers bargaining power), the wealthy nations ought to come up with the cash to buy the patents and place them in the public domain. That way, the pharma companies are fully compensated so the incentive to develop new drugs remains and yet poor people in the developing world do not die needlessly because of drug economics.


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30. NanoPundit on July 12, 2005 8:02 AM writes...

Andrew Sullivan says:

It has been imprinted on an entire generation that Big Pharma is the source of all evil. But the only reason I'm writing this blog at all is because of Big Pharma. They're not angels in America. They're capitalists. But the profit motive has been the most progressive force in pioneering specific medical breakthroughs that we have yet found.

Brazilians with HIV would be dead without the actions of Abbott and other members of Big Pharma, and this is the thanks they get. Looking at GDP of the US versus Brazil seems telling, but compare Congo ($800 per year) with 7 times the HIV infection rate. Part of the price that is paid in the US to Abbott subsidizes nearly free drugs going to Africa. Brazil's action make these subsidies more difficult. Brazil is an international welfare queen and is as Mr. Sullivan says “pursuing policies that will consign many people with HIV to earlier deaths.” You can read more at www.nanopundit.blogsot.com.

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31. Mark Buehner on July 12, 2005 9:42 AM writes...

WBurke, you're a psycho. I only wish you could relinquish your polio vacination or test your vitamins against small pox. Get a grip. Healthy diet sure as hell isnt the reason the American lifespan has practically doubled in the last couple centuries. I wouldnt give a crap what you say except that its poisoned minds like yours that talk sick and desperate people out of their best hope for treatment.

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32. Edson on July 12, 2005 11:40 AM writes...

I second the motion on Burke. Get real. The only reason we exist today is because of the vaccinations we recieved as kids as well as a dose or two of antibiotics over the years we (or our parents) have likely recieved to fight off some nasty infection that probably would have otherwise had more dire consquences than just a visit to the doctor's office. You can sit around and cook up all the conspiracy theories you want, but the simple fact is that people now live longer and healthier lives due, at least in part, to modern medicine. If you have a meaningful contribution to make, please do so. Otherwise, sell crazy somewhere else....

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33. Ted on July 14, 2005 5:33 PM writes...

So, out of curiosity, when is HIV considered a crisis?

Interesting point I do not see mentioned: the developed world is where it is because they stole each other's patents. The industrial revolution consisted of Western nations stealing ideas and inventions from one another. Just pointing that out, how it relates to this topic is up to you.

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34. qetzal on July 14, 2005 8:23 PM writes...

"[T]he developed world is where it is because they stole each other's patents. The industrial revolution consisted of Western nations stealing ideas and inventions from one another."

I have no idea what (if anything) you are implying by this.

Out of curiosity, can you point to any evidence to support the 'patent stealing' claim? (Much less, the claim that patent stealing had a causal role in the Industrial Revolution....)

Not saying you're wrong, necessarily; just seems a rather bizarre claim.

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35. WBurke on July 15, 2005 6:21 AM writes...

Mr. Buehner - You certainly are entitled to your own opinion, I wouldn't and certainly couldn't deprive you of that, but tell me this Einstein - have your read the opposing viewpoints that are chock full of data that contradicts Big Pharma and the Medical Industries claims that vaccinations/immunizations are responsible for eliminating diseases? Much less that they are even safe?


Maybe you ought to visit some sites and be informed rather than simply being an industry stooge with only one side of the story:


Provided are a listing of Medical hyperlinks:


The best web site I know for vaccine related information is the National Vaccine Information Center (NVIC)
http://www.909shot.com


Dr. Classen's excellent vaccine site
http://www.vaccines.net/


Vaccine Information and Awareness (VIA) Web Site
http://www.access1.net/via/


Concerned Parents for Vaccine Safety
http://home.sprynet.com/~gyrene/index.htm


The best site for Anthrax Vaccine Information
http://www.anthraxvaccine.org


Sandy Mintz is an Anchorage mom and longtime vaccine safety/rights advocate. Her site is dedicated to vaccination news/information and related topics.
http://www.vaccinationnews.com


As for your Edson - tell me this wiseguy - how is it that a flu bug takes out an entire office of people but one? How is it that this one person is able to avoid the flu when every last one of his coworkers is hit with a wicked bug? You see I've experienced that, as I'm certain have others, and the one difference between the rest of the employees and myself was that I was on the Vitality Pak - multivitamin/mineral supplement which reinforced my immune system such that the flu could not infect me. An empowered immune system (IS) is the greatest weapon a person has against illness - all your immunizations and vaccines are not even close to the effectiveness of the IS. In addition to this the benefits of providing the body the resources it requires to function in all areas at the cellular level far exceed anything Big Pharma has come up with to date.


Funny you should challenge my beliefs when it is your own psychic chemist who is too chicken to pur ARV meds to the test against a vitamin program to overcome HIV or AIDS. Ask him why he doesn't take me up on my offer. Get the press involved, worldwide and we'll have a public case study wherein we're both exposed to the virus and he takes ARV's and I'll rely on my own regimen and Dr. Rath's vitamin formulation and we'll let the truth be revealed worldwide. My life and his life on the line for the betterment of mankind - yet he refuses to take me up on it. Why?

You guys are all long on words and short on action - take me up on it, go ahead, MAKE MY DAY!

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36. spec on July 17, 2005 9:56 PM writes...

Here's a link to an interesting article on the topic. I was somewhat surprised by the following quote:

"Of course, like every good crook, the Brazilians have found a way to justify and rationalize their piracy. See, there's a clause in the World Trade Organization (WTO) agreement, which both Brazil and the U.S. have signed, commonly known as TRIPS. As Drug Industry Daily explains, TRIPS "allows a developing country to temporarily ignore drug patents to bring affordable drugs to its population in times of health emergencies."

But here's where the Brazilian pirates get tripped up over TRIPS.

First, Brazil is not a developing country. Brazil is the 10th largest economy in the world; larger even than Russia, Canada or Mexico. It not only has a subsidized airline company, it even has a space program. In the meantime, it spends only about 2 percent of its GDP on health care (the U.S. spends about 28 percent).

No, Brazil CAN afford the AIDS drugs its socialist government offers its citizens for free; it just has "other priorities" it wants to spend its money on.

Second, while AIDS is indeed a serious health care concern in Brazil, as it is all over the world, it is NOT a national emergency. The HIV-infected population in the United States is approximately 0.5 percent. In Brazil, it's about 0.6 percent. This, according to the Population Resource Center, compares with countries in sub-Saharan Africa with HIV-infection rates of 20 percent or more.

No, Brazil does not have a "national emergency" which would allow its piracy under TRIPS."

http://www.commonvoice.com/article.asp?colid=2252


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37. peej on July 19, 2005 12:06 PM writes...

I bet WBurke still uses (and recommends to his 'clients') Vitamin E as a cardioprotective antioxidant. And of course, any evidence to the contrary that this might not work he will dismiss.

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38. WBurke on July 19, 2005 1:07 PM writes...

Peej - only an idiot would sway with each bit of news that comes out regarding what is good or bad for health. If you took the time to learn more about Vitamin E you would understand the lameness and insignificance of the latest report that supposedly, in your contention, would close the book on Vitamin E and CV health.

I suppose you would take statins and ace inhibitors to maintain your CV health?

I'll tell you what, you revel in your ignorance of natural health and your struggles to maintain your own health by following the Big Pharma paradigm - and I'll keep doing what I'm doing that by medical standards would classify me as a foolish non-compliant patient, and we'll see who enjoys their latter years more. K?

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39. Nelson Muntz on July 19, 2005 3:56 PM writes...

"only an idiot would sway with each bit of news that comes out regarding what is good or bad for health"

unless of course it supports your biases, in which case, autism is caused by vaccines.

hayzeus, the hypocrisy in this one is amazing! someone get burke a job in the white house.

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40. WBurke on July 19, 2005 10:30 PM writes...

Nelson, who names their kid Nelson?

Hey dude you wouldn't want me in the White House cause your industry money couldn't buy my silence about the worthlessness of drugs and their extreme dangers.

Did I tell you they (FDA approved prescription drugs) kill between 106K and 200K+ depending on whom you listen to?

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41. daen on July 20, 2005 8:02 AM writes...

Nelson, who names their kid Nelson?

Who names their kid after a serial killer, Mr William Burke?

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42. WBurke on July 20, 2005 10:40 AM writes...

Nice one daen, you're a riot!

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43. peej on July 22, 2005 12:45 AM writes...

Vitamin E.... last I saw, there were several VERY large, well controlled trials that showed the vitamin in typical megadoses (400+IU) was worthless for CV outcomes.

Not one, not two, but SEVERAL. All say the same thing - its the same as placebo. Of course, WBoyce is a big fan of placebos, especially if it puts money in his pocket and a sense of superiority in his heart.

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