He gets his medication through a retirement health care plan that includes a pharmacy benefit program. Recently his employer negotiated a contract with a new benefit program. Suddenly, the man finds that one of his generic drugs, which costs more than generics usually do, will not be approved until the program's in-house consultant physician, who lives 2,000 miles away, has never seen the patient, and knows nothing about his health status beyond his personal doctor's diagnosis -- determines if the requested generic is necessary or appropriate. If the drug is approved he will have to mail order 90-day supplies, which ensures that the patient doesn't go directly to the local competing pharmacy sooner to fill the prescription.
Like him, I also get my two regular meds via a health care plan that includes pharmacy benefits. The plan is CVS/Caremark. It is therefore distributor and pharmacy all rolled into one. That means that essentially it is a monopoly that exercises complete control over my access to medication. CVS/Caremark rules that I must receive my meds through the mail from them, and that means that I can no longer work with my own personal (RiteAid) pharmacist -- who knows me well - should problems arise over future medication. It is a ludicrous corporate-America bind that I and countless others are being subjected to, all for the sake of profit. And it ought to be illegal.
These examples paint a picture of profit-driven Big Pharma behavior rather than patient-centered health care; they are examples that could have dire consequences for people, but they keep shareholders happy.
Pharmaceutical companies have been behaving badly for years, and getting away with it. In his book Big Pharma: How the World's Biggest Drug Companies Control Illness, published in the US in 2012, Ben Goldacre writes, "the whole edifice of medicine is broken" because so much of medical practice is based on distorted information provided by Big Pharma. "Drugs are tested by the people who manufacturer them, in poorly designed trials, on hopelessly small numbers of weird, unrepresentative patients, and analyzed using techniques which are flawed by design, in such a way that they exaggerate the benefits of treatments."
Having served on the Food and Drug Administration (FDA) Consumer Consortium years ago, I know these claims are true. I know that trials are designed to produce results favorable to manufacturers, and when the results are unfavorable they are hidden from physicians, the FDA and consumers until untoward events are too big to ignore.
I know that some medical journals, like many research docs, are funded by pharmaceutical companies, and that academic papers are often not as objective as we would wish.
Not even the Supreme Court seems to be on the consumer's side. In 2013, by a 5 to 4 vote, the Court ruled that 80 percent of all drugs are exempt from legal liability.
Ironically, generic drugs account for 80 percent of all prescriptions written in America. And in 2013, federal prosecutors tried to get the Supreme Court to end "pay for delay" deals that profit drug companies while adding billions of dollars annually to consumers' drug bills. These deals involve paying generic drug competitors to delay release of their cheaper versions of brand-name drugs.