Tag: pharmaceutical companies

Are You Healthy?

To understand whether or not your healthy, you have to first understand what it means to be healthy. It seems straightforward, but in the modern age, this is a complex question.

We might at first be inclined to think that being healthy means that you don’t have any illness or injury. But is this always true? What if you have an illness that is managed by medication? What if a person has a disability but the disability doesn’t disrupt their daily life? What if you’ve been diagnosed with pre-hypertension but have no symptoms?

Joseph Dumit, Director of Science and Technology Studies and Professor of Anthropology at the University of California, Davis, discusses various changes to our view of health and illness since the rise of the randomized control trial in his book Drugs for Life: How Pharmaceutical Companies Define Our Health (Duke University Press, 2012). He argues “that being at risk for illness is often treated as if one had a disease requiring lifelong treatments, drugs for life” (6).

Dumit discusses a few prediseases in depth, looking at pre-hypertensive, pre-diabetes, and borderline high cholesterol. “Literally, a disease-sounding syndrome is produced by correlating risk factors and naming it in such a way that it becomes common sense to think about treating ‘it’ as a disease in and of itself” (165). Hence, health becomes a matter of risk where we are all bodies constantly at risk of disease. If you have pre-diabetes, are you healthy? How do we understand our health in a risk economy of health?

This intersects interestingly with Donald A. Barr’s claim, in his book Health Disparities in the United States: Social Class, Race, Ethnicity, & Health, that despite investing so much of our economy in health, US health indexes rank rather low; “[p]erhaps, our basic assumption–that more health care will lead, necessarily, to better health–is flawed.”

Healthcare Costs – What’s the Role of “Big Pharma”?

As “Obamacare” reform rolls out, the US health system is in the international spotlight. The goal of healthcare reform was both to increase access to and decrease the costs of healthcare provision over the long term. It turns out some of this may be happening in unexpected ways, according to a new HHS report reviewed here by ModernHealthcare. Indeed, from Congress to our family dinner tables, much about the finances of how we seek and receive medical care has come into sharper focus in recent months. This includes a conversation about  what we pay for drugs, diagnostic tests, and other forms of medical treatment and intervention, as well as how we access health insurance to afford these components of medical care.

So, what’s so costly about healthcare in the US? A number of responses could follow this question: but most have something to do with lobbying interests. Lobbyists influence both legislators (making health policy), and health providers (doing direct work) alike. This includes those invested in medical equipment manufacturing (think diagnostic tests), insurance schemes (even those deemed “non profits”), and the pharmaceutical industry (companies that research or purchase research from universities, to produce and market the drugs we are prescribed).  Pharma reps have the ear of physicians and health providers (through fierce marketing tactics, fancy lunches and paid “educational trips” or vacations), and it turns out they also have the ear of our Congress members. So what does this mean? Many researchers are finding that the legislative decisions about what to pay for, and the health providers’ arguments for why it is or isn’t needed, will be shaped according to these lobbying tactics and priorities.

“Bad Medicine,” a report just released this weekend  through the Alliance for a Just Society, explores some of the key facts and figures about the Pharmaceutical Lobby, and what it may have to do with costs passed to everyday Americans. What comes in focus most starkly is the way “Big Pharma” can influence members of congress, particularly regarding publicly-funded programs such as Medicare. In 2006, a “Medicare reform” plan was instated to include medicines for low-income seniors through Medicare via “no bid contracts”, thus raising the costs the government pays for drugs provided to low-income seniors and people with disabilities. (This in turn gets more funds into the coffers of pharmaceutical companies producing and marketing these drugs). A recent bill, the Medical Drug Savings Act was proposed in congress to reverse some of this policy, and is projected to save more than 142 billion dollars over the next 10 years.

However, this same report also lists that the pharmaceutical industry spent $2.7 billion on lobbying expenses between 1998-2013, 42% more than the next biggest lobbying industry, which are health insurers. The Bad Medicine Report goes on to list more (fascinating) ways the pharma industry is tied with congressional politics and practices, including staffers who rotate between industry trade boards and congressional committees.

So, it appears there’s a lot of investment in keeping the pharma industry and members of congress “on the same page” in terms of their interests…. if that’s the case, what hope do we have for reducing the costs our government pays for health care, specifically for prescription drugs?

 

prescription drugs

Consumers get clear info for food, so how about for prescription drugs?

A recent editorial in the New York Times argues that proposals for so-called “fact boxes” on prescription drugs should be made law. As the editorial staff writes,

Bombarded with pharmaceutical ads listing what seems like every conceivable side effect, American consumers might think they are already getting too much information. But they — and their doctors — are not getting what arguably matters most: independent, plain-English facts about the medication.

Fortunately, there is a simple model for getting such information across. The government should follow through on proposals to require fact boxes, similar to those that appear on food packaging, in every ad drug makers produce and along with every package of medication they sell.

Loads of research shows that too much information all at once can result in confusion, frustration and lack of understanding. Regulations such as the proposed fact box would lend further momentum for the patient rights movement that puts more power in the patient’s hands.

Would fact boxes similar to the nutrition data found on cereal boxes work for people who take prescription drugs? How would doctors react to the simplification of complex information? Would fact boxes lead to people demanding certain drugs more or less than they already do?