Yesterday in Iowa, Hillary Clinton presented a plan to stop Big Pharma from the dramatic price profiteering it is engaging in. The plan would allow Medicare to negotiate lower drug costs, cap out-of-pocket expenses for individuals with chronic health problems and require Pharma to reinvest profits into research and allow for more generic and imported drugs.
In a tweet, Clinton called "price gouging like this in the specialty drug market" "outrageous."
It is no secret that now that Lipitor, Seroquel, Zyprexa,
Singular, Concerta, Cymbalta, Abilify and other blockbusters have gone off
patent, Pharma is pricing drugs in the four digits to stay a Wall Street
darling. Even generics, are ballooning in price as part of the profit party-- though
there are no R&D costs attached to them and it is pure caprice. Thank goodness Clinton sees it and is addressing it.
Not only is Pharma looting our Medicaid tax dollars and
raising everyone's health care costs, courts are enabling its greed.
In August, U.S. District Judge Paul A. Engelmayer ruled that the First Amendment allows a drug company to "engage in truthful and non-misleading speech promoting the off-label use" of drugs and that the FDA cannot bar such "speech." The ruling, pertaining to the drug Amarin, which targets high triglyceride levels, is likely to be appealed and only applies to the 2nd U.S. Circuit Court of Appeals, which includes New York, Connecticut and Vermont. But patients had better beware.
Off-label marketing is irresistible to Big Pharma because it saves years and millions spent on clinical trials which may not assure FDA approval anyway. It allows drug companies to circumvent the pesky and slow FDA altogether and get on with the business of making money-- bringing their sales pitch to doctors and patients directly. Almost all major drug companies--GSK, Eli Lilly, Abbott, AstraZeneca, Pfizer, Johnson & Johnson, Amgen, Allergen, Bristol-Myers Squibb, Cephalon, Novartis and Purdue (which makes Oxycontin)----have agreed to huge settlements which include charges of off-label marketing .
In court-released confidential memos, Pfizer (then Parke-Davis) admits why it chose to off-label market Neurontin (only approved for postherpetic neuralgia and adjunctive seizure therapy) for the unapproved indication of bipolar disorder. "The U.S. market for Bipolar Disorders is an attractive commercial opportunity that warrants clinical development of Neurontin. Based on the current patent situation, an investment in full clinical development is not recommended at this time since completion of two pivotal trials and regulatory filing and approval would occur close to patent expiration," says the memo. Translation: It would take too long to get legal approval--our patent would expire. Instead, says the memo, "it is recommended to implement only an exploratory study in outpatients with bipolar disorders with the results highlighted through a peer reviewed publication." Translation: Let's not do the studies and plant some info in medical journals that looks like we did.
Pfizer paid a $430 million fine and signed a corporate integrity agreement for off-label marketing of Neurontin which was linked to wrongful deaths and suicides. But that did not stop Pfizer from off-label marketing Lyrica, sometimes called "son of Neurontin," soon afterward. Who can say incorrigible?
Nor did Eli Lilly's guilty plea in 2009 to the off-label promotion of the antipsychotic Zyprexa deter it from requesting permission from the FDA to market Zyprexa to children three months later. The FDA said---yes! At the same time, Pfizer and AstraZeneca also requested permission to market their antipsychotics, Geodon and Seroquel respectively, to kids though both agreed to off-label marketing those exact drugs months later.
Another off-label marketing scheme centered around the selective estrogen receptor modulator Evista. Eli Lilly, its manufacturer, had noted fewer incidences of breast cancer in an Evista trial and wanted to market it not just for its approved treatment of prevention of osteoporosis but for prevention of breast cancer. A group of doctors told Lilly the anticancer marketing claims were "an egregious stretch" and that Evista's high risk of stroke canceled out any anticancer benefits.
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