Drug-peddlers

Written By: - Date published: 3:30 pm, May 15th, 2011 - 50 comments
Categories: health, International - Tags:

Good story from Rob O’Neill in today’s SST. Lobbyist Mark Unsworth of Saunders Unsworth is campaigning against Pharmac, ahead of the Trans-Pacific Partnership free trade negotiations with the US. They want more money spent on patented drugs. Lloyd Morrison and Gareth Morgan have come to the defence of Pharmac. Morgan describes the messages being spread by Saunders and Unsworth as “misleading and dangerous to our health sector.” Morrison sees Pharmac as a model for the broader public service.

Unsorth is lobbying on behalf of the drug companies’ front organisation, Medicines New Zealand. In this he will be joined by the US Embassy, as Wikileaks showed. The 2004 cable is signed by Geoff Swindells, the Bush-appointed ambassador to New Zealand. Some excerpts:

A possible U.S.-New Zealand free-trade agreement (FTA) offers one last avenue for changing government policies that limit access to pharmaceuticals, several U.S. companies said. Meanwhile, Geoff Dangerfield, chief executive of the New Zealand Ministry of Economic Development, told a U.S. drug company that his government terminated its study of patent term extension for pharmaceuticals to keep the issue as a bargaining chip in the event of FTA negotiations. If FTA talks go forward, most of the drug companies will be looking to the U.S. government to win serious concessions from New Zealand on pharmaceutical issues. Pfizer, which withdrew from RMI early this year, will oppose free-trade negotiations until the New Zealand government alters some of its policies, especially its patent law and reference pricing.

To complement the industry’s efforts, post will work with companies to identify U.S. speakers to be brought to New Zealand and possible International Visitor Program participants, with the goal of educating New Zealand’s health practitioners, policymakers and consumers on pharmaceuticals’ role in health care.

Unsworth says the MedicinesNZ campaign is open and transparent, but I couldn’t find the slides referred to on their website. On the other hand, they clearly are lobbying for concessions to be made in relation to the Trans-Pacific Free Trade agreement. That is certainly not being conducted in an open and transparent way.

We get a good deal for our drug-buying through Pharmac. As the story says, Morrison and Unsworth clashed on Morrison’s Facebook page. Morrison says “I am able to purchase drugs here (from the drug companies) in New Zealand cheaper than they sell to their fellow Americans – the US system is not a system we should seek to replicate in New Zealand.”

50 comments on “Drug-peddlers”

  1. ianmac 1

    Pharmac is admired overseas. The British equivalent does not have the autonomy that Pharmac has.
    The autonomy and freedom from political interference was breached by Key when he made a unilateral political decision to authorise the Herceptin drug, even though the science did not support a 12 month treatment. Imagine a Pharmac which loses its independence and becomes tossed around to political whim and the avarice of Drug companies.
    Surely our negotiators would not betray our trust for the sake of a few pieces of silver? Trust John Key? You sure…sur…sure ccccan.

    • higherstandard 1.1

      Actually the science at the time only supported a 12 month treatment in the adjuvant setting.

      That being said U believe PHARMAC generally does a very good job on behalf of the taxpayer.

  2. Colonial Viper 2

    Drug peddlers who want to hike prices on users and move more tax payers funds into corporate coffers.

  3. Jim Nald 3

    Saunders and Unsworth

  4. Adele 4

    Teenaa koutou katoa,

    The Herceptin decision was never about hard science and rigid rationality overseeing the day. It was about human emotion, and the fear of loss.

    Pharmac should not be solely about the rigid application of science to its decision-making, there should always be room for a heart.

    • Draco T Bastard 4.1

      If buying more of a drug makes no difference then why would we buy more?

      • Colonial Viper 4.1.1

        Not only might the drug make no difference, it might actually cause harm and therefore additional costs and strains on our health system.

      • McFlock 4.1.2

        especially if buying more means that we can afford less in the way of drugs that will actually have a demonstrably positive effect.

    • I think you’re right that, for the women and men who were lobbying for Herceptin to be funded, it was about human emotion, and rightly so.

      I don’t, however, think human emotion came into National’s decision to highlight it during the election campaign. That was quite a deliberate, ‘rational’ decision to back a drug that would win women’s hearts and minds (that part of the vote that had persisted with Clark in 2005).

      I’m left wondering, Adele, where the room is for other hearts (e.g., those suffering from other conditions – and their families)? They feel loss too yet Pharmac – under instruction – hasn’t come to their emotional rescue. (I speak as someone who’s had three family members recently treated for breast cancer, none of which I would want to lose and one of which has had herceptin as part of her treatment.)

      If, as you advocate, drug buying decisions are to be partly driven by ’emotion’ (and, hence, by associated activism in the public sphere) then I expect drug companies very quickly to get into the business of setting up local astroturf organisations fronted by sufferers. I can’t imagine how a remotely just allocation of the drug budget could ever be achieved under those circumstances.

      Also, those who are least articulate, media-savvy, educated and middle class are unlikely to get much action on medications for illnesses that particularly afflict them compared with those illnesses afflicting the articulate, media-savvy, educated and middle class.

    • terryg 4.3

      Sorry Adele,

      but thats the worst thing Pharmac could do.

      Consider the problem of health spending. there is no upper limit on health spending. And EVERY serious case is a tragedy for those involved.

      the ONLY way Pharmac can do their job is by using a purely scientific approach. Because on emotional grounds, everybody is worthy of essentially unlimited expenditure.

      Pharmac were correct with the Herceptin decision; Shonkey was wrong – its just another part of his populist, smile-and-wave technique of getting everyone to like him (rather than, say, think carefully about his performance).

  5. Hilary 5

    We should also get rid of Direct to Consumer advertising, which are all those drug ads cluttering up the media, so that people rush of to their doctor and ask for them by name. Such advertising is only legal in the US and NZ, and no other country allows them.

    • higherstandard 5.1

      Which drug ads are those Hilary ?

      The only things i’ve seen advertised on TV are the PDE5 impotence medications.

      • rosy 5.1.1

        Losec. It drives me mad that there was an ad that people used to pressure GPs to provide a glorified antacid so they can continue with rubbish diets. (Pharmac is now funding only a generic – ‘dr reddy’s’ that is cheaper – but the demand has been built).

        A huge number of people are taking this stuff, although it’s only meant to be used for serious stomach problems, not indigestion, while others who cannot make changes to influence their health status are being denied access to some of the more advanced drugs for their condition.

        • Jim Nald 5.1.1.1

          Saunders and Unsworth.

          Mmm.

          Re direct-to-consumer advertising (note that this post by Mike Smith is about Pharmac) has attracted the response of Barrie Saunders who described it as a “non-problem”,
          eg in the New Zealand Medical Journal 2003 at:

          http://www.nzma.org.nz/journal/116-1180/556/

        • higherstandard 5.1.1.2

          Losec is an OTC medicine (i.e. can be bought from a pharmacist without a Rx from a clinician) OTC medicines are advertised in many countries.

          Omeprazole is also an extremely effective medication and at around $2 per patient per month it’s also pretty cheap medication.

          • rosy 5.1.1.2.1

            I was using Losec as an example -When the losec ad started on TV it was an exhortation for people to have the GPs prescribe it. The aim was clearly to create demand. And was around $70/mth (if I recall). Clearly Pharmac have changed to Dr Reddy’s (omeprazole) because it is available at a seriously reduced price.

            It’s one of those dilemma ads for me – I take omeprazole to counter-act the effects of anti-inflammatories because I can’t get access to the drugs that might make the anti-inflammatories unnecessary (they are too expensive). So the losec ad, in particular annoyed me, if they were not able to create demand for trivial uses of the drug, rather than it being for the serious conditions it treats so well, there might be more money for more important conditions than being unable to eat fried chicken.

  6. Adele 6

    Teenaa koe, Hilary

    But aren’t those same ads providing consumers with more choice in terms of controlling their own health care. This discussion is really about how stupid do we believe the average New Zealander really is.

    • Campbell Larsen 6.1

      Adele – ads do not generally ’empower’ anyone, they exist in the most part to convince people to spend their money purchasing something.
      You speak of choice, well I say to you there can be no choice without knowledge and that’s not what people are getting from these ads. The TV is not a doctor. Pharmaceutical companies care about their profit, not about you.

      • Adele 6.1.1

        Teenaa koe, Campbell Larsen

        So, in effect, you think, New Zealanders are in fact stupid.

        • Campbell Larsen 6.1.1.1

          No, I think that advertising has the power to overcome rationality, especially when given a veneer of credibility (think infomercials and Family Heath Diary)

          Attempts to undermine NZ’s Pharmac and the role it plays in affordable healthcare are shameful.

          The TPP must not go ahead, no consultation, no partnership.

        • Puddleglum 6.1.1.2

          Adele, you should read your first comment on this post.

          Human beings are much more than rational decision makers. Their psychology is set up (designed) to respond to rough and ready cues for action – which in the modern environment has a higher chance of being maladaptive than it did in previous social environments.

          Advertisers are very aware of this, which is why advertising operates on a completely different view of human psychology than does the discipline of economics – a discipline which makes a lot of the ‘choice’ argument you have just employed.

    • Draco T Bastard 6.2

      Self-medication, especially when you aren’t trained as a doctor, is usually a bad idea.

      • Murray 6.2.1

        Its an equally bad idea to have blind faith in the medical profession. especially with the huge amount of lobbying directed at GP,s by the drug giants.
        I was one of the unfortunate people who had an adverse reaction to statin drugs as a result I now suffer from a permanent and disabling illness.
        All thanks to doctors who never warned of possible side effects.

        • NickS 6.2.1.1

          The sooner drug companies are forced to publish the full results of drug trials, the better, as they’ll often massage the data sets to ignore low incidence side effects and there’s various other statistical sins, though mostly those apply to the big block buster drugs.

          As for the muscle wasting statins can cause, if I’m remembering my biochem course right, the main issue was that they weren’t tested on large enough populations in the human testing phase. So it was only when it was approved for human use and became widespread that set of side effects become visible. And generally, because animal tests on later statins didn’t show muscle wasting at therapeutic dosages etc compared to earlier discovered statins, it was assumed that it wouldn’t be a significant side effect.

          Though with Cerivastatin Bayer A.G. didn’t release vital fucking test results that indicated it had a much higher risk of causing muscle wasting.

          Generally though, statins should only be used when exercise and dietary changes aren’t available, or when high LDL (the protein that carries cholesterol in the bloodstream) is a congenital condition caused by under active cholesterol regulation. The marketing of them is the classic example of why marketing in the drugs industry should be regulated the ever loving fuck out of because the idiots involved cannot be trusted to present information truthfully.

        • Draco T Bastard 6.2.1.2

          My mother was, for many years, diagnosed as having arthritis and then some other ailment. Finally the doctor sent here to hospital for scans and she was diagnosed as having cancer. She died nine months later.

          So I can assure you I’m not about to have blind faith in individual doctors but I’m going to have a lot more faith in their ability to diagnose and prescribe than mine. If I think the doctor I see initially is wrong, I’ll get a second opinion but I still ain’t going to go around prescribing medicine for myself which is what advertising drugs will encourage some people to do.

          • terryg 6.2.1.2.1

            DTB, its the Bell Curve at work.

            A few professions have the public into believing that every single one of them is utterly brilliant at their job (doctors, lawyers, accountants) – but its just not true.

            even those professions requiring years of university study, and many degrees.

            Alas all having a degree actually proves is that you have a degree, and probably passed at least the bare minimum requirements to get said degree.

            it says nothing about whether or not you are any good at your job.

            by way of example, I know a number of people who were disciplined and studied hard, and were able to remember vast amounts of complex material for weeks on end, and therefore scored very well in exams. All without any real understanding at all. So a few months or years later – its all gone.

            ultimately any human endeavour will obey the Bell Curve (Gaussian Distribution) if there is a reasonable number of people involved. Most will be about average in their abilities, some will be good, some will be bad, a few will be excellent, a few will be utterly atrocious.

            And it doesn’t matter what the job is – this is as true of Ditch-Diggers, Chippies and Schoolteachers as it is of Lawyers, Surgeons and Astrophysicists. because we’re all just people.

  7. locus 7

    Having a heart and funding expensive patented drugs because desperately ill people need them is one thing. It’s another thing to do this without a substantial increase in budget as this may preclude or reduce the chance of funding drugs which other desperately ill people need. Being ‘informed’ by rampant lobbying and marketing by drugs companies that aim to feed the hopes of recovery from terminal illnesses or debilitating chronic pain is yet another.

    • Draco T Bastard 7.1

      Having a heart and funding expensive patented drugs because desperately ill people need them is one thing.

      Actually, it’s just bloody stupid. We cannot afford to try to keep people alive indefinitely.

  8. Clipbox 8

    This doesn’t make it right, but I believe its quite rare for trade agreements to be conducted openly for the public to read about.

    • Jum 8.1

      Clipbox
      The difference between the TPPA and average trade agreements is the control that the US gets over NZ in more ways than just trade.

      As for Herceptin – Key cynically used it as a ploy to get women’s votes even though the medical info stated that there was no proof 12 months use would be better than the Pharmac approved time.

      People aren’t stupid when they want people they care about to be well again. We are all stupid if we believe Key was funding the extra Herceptin use for the women of this country.

      If New Zealanders lived by the dictates of the heart no child would be bashed, refuges would be closed down because they were not needed and Kiwis would have voted for someone other than a narcissistic moneytrader.

  9. KJT 9

    Interesting when they interviewed the US ambassador in Q and A yesterday.

    The implication from what he said, which Holmes missed of course, is that NZ governments can ram through free trade agreements quickly. Unlike US politicians they do not have to answer to their constituents.

  10. Adele 10

    Teenaa koutou katoa,

    I have spent time in two spheres of human endeavour – the health field, and the legal arena. Pillars to rationality, medicine and law.

    Yet, I have seen surgery where even a physician resorts to hope, despite all odds. And, I have witnessed the legal defend even the guilty on matters of principle.

    Pillars of Salt.

    Human based policies, and dare I say, left ideology, should never begin with the numbers, otherwise, how is the left different from the right, again?

    Personally, I am, learning to respect Pharmac, for other reasons.

    However, in defending Pharmac, can we then also defend the WAI 262 claim – which would restrict if not prohibit the multi-national pharmaceutical giant from claiming property and patent rights over indigenous flora and fauna. That really sucks.

  11. felix 11

    Getting a bit sick of these bastards who make a living by actively working against their countrymen and women.

    Unsworth’s actions, if successful, will result in fewer people being able to afford the medicine they need. Some of his fellow kiwis will die for his fat fee.

    Hooten’s work for the tobacco companies directly kills his fellow kiwis.

    These mercenaries almost make John Key’s work to destroy the NZ currency seem mildly evil by comparison.

  12. PeteG 12

    Getting a bit sick of these bastards who make a living by actively working against their countrymen and women.

    Like those who actively try and undermine and disrupt the government of the day?

    • felix 12.1

      No, “One-Party Pete”, that’s obviously not what I meant.

      Trying to stop a government from destroying your country is called patriotism.

      You don’t hate your country do you Pete?

      • PeteG 12.1.1

        No, I don’t hate my country, I hate the whingy hissy fitters who who grossly overstate the situation because they didn’t get their way on election day.

        I support a positive input from multiple parties who have a mandate to be in parliament. You’re the one party stater, you want to destroy any party that doesn’t follow your foolishness, and stuff the country.

        pa·tri·ot·ism – devoted love, support, and defense of one’s country; national loyalty.

        Note the reference to “national”, that means everyone and not just your own selfishness. A patriot in a democracy would support the democratic process and will of the people.

        • felix 12.1.1.1

          Pete.

          You’ve been championing the one-party state here for a while now.

          I realise you’re too thick to know that’s what you’re doing, but nonetheless that’s precisely what follows from your “get-behind-the-ruling-party-whether-you-agree-with-them-or-not” bullshit.

          If you have a coherent argument to show that this isn’t the case then now is the time to state it, but as you’ve declined every previous opportunity to do so I won’t be holding my breath.

          • PeteG 12.1.1.1.1

            As usual you are totally misrepresenting what I say with factless bullshit.

            Supporting a four party coalition that was voted for and is still supported by the majority of the people plus encouraging non-coalition parties to contribute positively is not supporting a one party state.

            Your maths is as bad as your politics.

            When you grow up and actually want to debate rather than play little games you might be taken a bit more seriously, but that may not be what you want.

            • felix 12.1.1.1.1.1

              Do you deny that you’ve been calling for opposition parties to stop opposing?

              Do you want me to provide the links?

              • PeteG

                Provide the links.

                I haven’t suggested opposition parties should stop all opposing. I’ve called for opposition parties to stop being so pathetic, and to pick fights that are justified rather than continuously wailing wolf. They’d be a bloody sight more effective when it really mattered – and they’d have a lot more time to contribute positively.

                • PeteG
                   
                  The factor that has been sending a few of us spare is that your comments about supporting the Government seem to be based on the proposal that they are the Government therefore we should support them.  How about an issue by issue approach so that if the Government appears to be making a silly decision then the opposition opposes?
                   
                  If you accept that then the possible gutting of Pharmac is a doozy.  All that will be achieved is greater costs for drugs and enrichment of overseas corporations.  Why would any Government do it?
                   

                  • PeteG

                    MS, I agree entirely with an issue by issue approach.

                    I also think Pharmac should be maintained much as it is and that so called free trade agreements should not be used to try and force excessive drug prices on us. This topic is about lobbying, I’m not aware of any inclination by our government to give in to it, if that’s what they may do (rather than just being a potential being worried about) then I would speak against it.

                    I don’t like the drug advertising we see here. It’s more likley to put me off being sucked in but when you see the success of the Double Down campaign it’s obvious there are many gullible consumers.

                • felix

                  Ok here’s the first link, in which we discover that Pete thinks opposition needs to be “justified”.

                  To whom? To Pete?

                  Or to Pete’s mythical consensus of opinion in which everyone fundamentally agrees that there’s one right way to get things done and any argument to the contrary (“opposition”) is petty point-scoring?

                  • PeteG

                    That link does nothing to support your claim that I have been “calling for opposition parties to stop opposing?”

                    Do you think opposition parties would be less effective if they chose fewer more important issues to oppose?

                    • felix

                      Yes it does Pete.

                      In the link you state that opposition parties should only oppose when doing so is “justified”.

                      I’m going to walk you through this slowly: To whom do they need to justify their actions?

                    • PeteG

                      T o t h e v o t e r s felix. Is that slow enough for you?

                      If the voters see that opposition parties are dredging up endless trivial crap:
                      – they get the perception it is being done by a trivial crappy politicians
                      – important issues that really need opposing risk being lost in the noise

                    • felix

                      Which voters, Pete?

                      The ones who voted for the governing parties or the ones who didn’t?

                      (“both” or “neither” are also acceptable answers btw)

  13. uke 13
    “A patriot in a democracy would support the democratic process and will of the people.”
    National, then, have not been behaving particularly patriotically .
  14. Kay 14

    This whole pharmac business is terrifying me. I’m completely reliant on prescription drugs to stay alive. One drug I take was branded when I started it, and as soon as that drug lost the patent and generics showed up there were a few scarey moments that I’d have to switch to a generic, which is a very dangerous thing for people with my condition. Thankfully this was recognised by pharmac and I’m able to stay on the brand fully subsidised.
    The problem is, when a drug company isn’t making a profit on one of their products, said product is frequently pulled out of NZ. There are no issues with generics except for people who are settled on the brand and are forced to switch. One of the “incentives” that’s been mentioned in this big pharma lobbying is refusing to supply some of their drugs to NZ (ie blackmail) which means I could lose the branded drug I take.

    While it’s an awful situation for a minority who could benefit from drugs that aren’t subsidised here and who can’t afford to priveatly import it, I think the pharmac system is brilliant, especially for a country our size. That the vast majority of NZers can access medications for most conditions is a pretty good accomplishment.

    I’m sure all the US pharma lobbyists have fully comprehensive insurance that will supply them with any drug they may require. Pity the same can’t be said for their compatriots. They exist primarily for profits, the idea of helping humanity is only a secondary fleeting thought. Problem is we need them.

    Trade negotiators- letting pharma bully you and you’re too cowardly to stand up to them, watch hospital admissions and deaths go through the roof when the population loses access to their medications.

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