
Nonprofit Working to Block Drug Imports Has Ties to Pharma Lobby - happy-go-lucky
http://www.npr.org/sections/health-shots/2017/04/18/524363014/nonprofit-working-to-block-drug-imports-has-ties-to-pharma-lobby
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tomkinstinch
The price differences between domestic and international medicines can be
truly outrageous. I just got back from a work trip to a hospital in Sierra
Leone, where the anthelmintic medicine Albendazole costs the equivalent of $1
USD at a private pharmacy (or even less if you don't care about packaging).
The same treatment in the US (a single dose) cost me $430 USD (before
insurance). This medicine is out of patent; the R&D costs have been recovered.
There's no reason for it to cost as much as is does in the US, apart from
greed. It's more of a niche drug in the US than it is in sub-Saharan Africa,
but it is shelf stable unlike say the antibodies of an immunotherapy, or the
rabies vaccine, so it's not perishable. I trust the purity of the US version
more than the version sold internationally, but that is probably an irrational
fear. Even with added costs of laboratory purity testing and import tariffs,
those in the US would still be better off if we could import drugs from
overseas.

Some medicines are expensive for a reason: they're new and need to have R&D
(and FDA) costs recovered (this is why we have patents), they have niche use
and are produced in small quantities (cancer immunotherapies), they're
perishable (biologicals), or all three. Many others are expensive because we
have no regulatory protections against price gouging. Epi-Pens are another
example. A 1mL vial of epinephrine costs ~$5, and the syringe to inject it
costs pennies. Auto-injectors add some value, but not the $700 Mylan charges.
They're fundamentally a pre-filled syringe a spring, and an injection molded
case.

I wonder what the system would look like if we granted longer pharmaceutical
patents (say, 30 years), with the change that upon expiration of the patents
medicines would be produced by the government and sold at cost (or provided
for free).

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ams6110
> There's no reason for it to cost as much as is does in the US, apart from
> greed.

The reason is people don't "pay" for it. Insurance does, and so nobody cares.

Edit: Well, the insurance companies should care, but if it's something that's
rarely prescribed, it might be easier to just pay the claim instead of
devoting people to negotiating a lower price.

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mmjaa
Who pays for insurance? (Hint: its you and me, buddy.)

~~~
cmdrfred
A lot of those costs are taken indirectly via suppressed wages as many people
get insurance via employment. It seems to me that a great deal of effort goes
into hiding the costs of services and products from those who are paying them
in this market.

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dougmwne
This is a pretty standard play inside the beltway. Many, many advocacy non-
profits, some you have heard of, are really vehicles for increasing the ROI on
corporate lobbying dollars. A humorous example:
[http://www.motherjones.com/mojo/2012/03/fight-save-paper-
dol...](http://www.motherjones.com/mojo/2012/03/fight-save-paper-dollar-hits-
dc-subway-system)

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sureshn
In India most of the Doctors go on a vacation to foreign countries at least
twice a year, these are sponsored trips by non profit orgs of big
pharmaceutical brands. There is also a massive lobby working in india to block
generic drugs ; the present government thankfully did not yield to their lobby
, the price of Stunt is now reduced by 80% , thats how much the price was
marked up !

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niftich
This is such an oblique position for legitimately grassroots activism to take.
I mean, it's not like people are dropping dead en masse in Canada, out of all
places, from taking supposedly sketchy, industrially-produced medication.
Meanwhile, importing copycat generics from India is fine [1] (taken from an
article with an obvious slant against Walmart, one major importer of such
medications).

On the regulatory front, the difference is that India lets the US FDA work
there and inspect plants that export to the US [2], while Canada doesn't, and
although the US and Canada have been _slowly_ easing into formally trusting
the other's regulatory frameworks [3] by working up from food safety [4], they
are not quite there on the medical front. How much of this is legitimately
grounded in science, logistics, diplomacy, and protectionism are up for
debate.

This is good investigative journalism. It certainly raises some additional
questions that would have been difficult for an average person to learn on
their own -- including questions about this nonprofit, about whether both
parties' past attempts to allow Canadian drug imports have been comparable or
different, about whether an organic movement concerned about drug safety
exists at all, about the author's motivations for writing this piece; all good
questions worthy of more research and conversation.

[1] [http://www.huffingtonpost.com/al-norman/india-wal-marts-
drug...](http://www.huffingtonpost.com/al-norman/india-wal-marts-drug-
conn_b_108466.html) [2]
[https://www.fda.gov/forconsumers/consumerupdates/ucm333944.h...](https://www.fda.gov/forconsumers/consumerupdates/ucm333944.htm)
[3] [http://trade.gov/RCC/](http://trade.gov/RCC/) [4]
[https://www.fda.gov/food/newsevents/constituentupdates/ucm49...](https://www.fda.gov/food/newsevents/constituentupdates/ucm498611.htm)

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yalogin
Unfortunately, insurance is the reason we have this health care issue in the
US. There is no one to fight these special interest lobbys in the health care
world. The hospitals don't care and a good number of patients don't care
because of insurance. From what I see , people without insurance are treated
as losers and their voice is not heard. Without insurance hospitals and
doctors would fight the drug manufacturers on the patients' behalf.

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panzagl
Remember nonprofit is a tax status, not an indicator of morality.

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twothamendment
So very true. Nonprofit does not mean they don't have an agenda, backer,
motive or some reason to be "fair" when looking at an issue.

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refurb
_A bill cosponsored by Sen. Bernie Sanders (I-Vt.) would provide a mechanism
for Canadian drug manufacturers to sell to U.S. consumers and pharmacies._

They do realize that for branded drugs, the "Canadian drug manufacturer" is
the same as the US drug manufacturer, right?

~~~
dublinben
People looking to save money aren't buying branded drugs, they're buying
generics. Which are still far too expensive in the US, compared to other OECD
markets.

~~~
refurb
The US, with a few exceptions, actually has lower priced generic drugs than
other countries, including the EU.[1]

 _Interestingly, the study also shows that the U.S. has one of the highest
levels of generic drug use relative to total prescription volume, and that
generic prices are lower in the U.S. than in all the countries except Canada,
where the difference is 6%._

[1][http://knowledge.wharton.upenn.edu/article/analyzing-
brand-n...](http://knowledge.wharton.upenn.edu/article/analyzing-brand-name-
and-generic-drug-costs-in-the-u-s-and-eight-other-countries/)

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elihu
There was a story on NPR awhile back about how, if I remember correctly, the
U.S. government gives money away to drug companies to help fund drug research
in exchange for a license to manufacture the resulting drug in case there's
some kind of shortage or the drug is too expensive for anyone to buy it. This
right has never been exercised, but there are some who think that they should
start doing so to bring drug costs down.

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EGreg
What is the best argument to block imports?

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elihu
That depends on what the alternative is.

If you allow imports of drugs that are already approved by the FDA, then the
objections are mostly about economic incentives (i.e. high prices reward the
companies that made the drug, etc..)

If you allow imports on drugs that are approved in other countries but not by
the FDA (iirc this was advocated by Ted Cruz in his debate against Bernie
Sanders on health care a few months back), then the objection is that it
basically neutralizes the ability of the FDA to block dangerous drugs and
makes it easier to push drugs to market that aren't ready by promoting the
drug in whichever country has the loosest standards or is most corrupt.

~~~
EGreg
"High prices reward the companies that made it" \- so why not raise the prices
even higher if that argument resonates with the public? :)

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OliverJones
Ha ha. The senior VP of the Phrma lobbying group has the the name Scott
LaGanga.

