Big Pharma Is Capitalism Out Of Control

Too many Americans can’t afford to and simply do not–take their medicines as prescribed. That estimate is based on information from the (American!) Centers for Disease Control). I have had patients come into my office who take their medications –in both cases, for life-threatening infectious diseases — only every other day, simply because that is all they can afford. I explained to each one individually the idea of the half-life of a drug. They only stay in your body for a certain length of time, then they leave your body in waste products.  That is why taking a drug every other day is not really effective. They both gave me almost exactly the same response — It was all they could afford, and it was probably better than nothing.

The CDC has broken down the statistics a bit more. Some people can’t take their medications at all.  15% are at least trying to get lower cost alternatives. Me, I have no better suggestions than charitable foundations and churches. Me, the proudly American non-Christian who has always advocated a separation of Church and State.  I have no better ideas when it seems to me the State is not doing its job. By now, everyone has heard of Martin Skrelli, Turing Pharmaceuticals, and “Dataprim.”  The drug for Toxoplasmosis has been around about 60 years.  I prescribed it exactly once, to a gentleman with an infection secondary to HIV causing dementia, not to mention a seriously descending quality of life.

The rightfully maligned Skrelli — and I say rightfully because he decided to bump his profit margin by raising the cost of this drug from $13.50 to $750.00 a pill — was able not only to buy the company that made this, but also, as part of the agreement, to get the company (Impact Labs) to remove all of its product off the market, thus creating a perfect monopoly for him and his company. That insures that nobody is going to develop a generic alternative. There are too many examples of “price-gouging,” which seems to be the result of an unholy alliance between pharmaceutical corporations and Wall Street. Those who raise the prices of drugs well above what most folks can pay are in no way censured, and certainly not jailed. It is a strange permutation of capitalism at best.  Remember, I am the veteran and I am not a Commie and I swore I would take up arms if ordered.  And I don’t want to believe Americans are killing other Americans for profit — but they are.

They call it the “rentier capitalist” sector.  That is a Marxist term that means (according to Wikipedia) “the belief in economic practices of monopolization of access to any (physical, financial, intellectual, etc.) kind of property, and gaining significant amounts of profit without contribution to society.” Jack Rasmus’ wrote a super-helpful article describing how Big Pharma uses this tactic that was simple enough even for me, as I am neither a politician nor a business-human — Just a psychiatrist and psychopharmacologist who needs to know what is going on as I try to care for hurting people. His article lists examples of overpriced out of control drugs.  I am not going to repeat them because they break my heart.  People will be dying early because they cannot get these drugs.

As for “rentier capitalism,”  The only way I can find out about it is to read sources about Marxism.  This something I never thought I would have to do in order to take care of my patients. It is alleged a business that does this will self-destruct eventually, while other systems can re-invest profits and grow. Since we are generally in favor of capitalism, we view it as deviation from the norms of capitalism, although maximizing profit seems to be simply “nice work if you can get it” — making more money off something without adding value to it.  The added value comes from increased prices paid by consumers, or perhaps even at the expense of companies.

People simply seem to be transitioning from financial professionals to pharmaceutical professionals and they do this.  They do other things, too.  Mergers and aquisitions.  “Tax inversion,” which means buying a small company in another country so they do not need to pay U.S. taxes but can pay them in a less-taxed country. Estimates come to about 32 million people in the U.S. who do not take drugs as prescribed.  About 4 million, at least, of these people need drugs for diseases that can and will kill them.  Diseases like cancer, heart disease, Hepatitis, HIV, and Tuberculosis.

My initial reaction, and that of the very few people to whom I have mentioned this is “we need more law enforcement” or “we need more laws.”  I do not think this is about to happen. Our legislators make laws.  Our lobbyists “educate” our elected officials about things that are so numerous they may not otherwise know about them. About the only thing I do know about this august group of ladies and gentlemen is that they want to keep their jobs.  Remaining elected takes money and effort.

Rasmus’ estimates are that, since 2008, 1425 lobbyists officially designated as being from the pharmaceutical industry have spent about 2 billion dollars.  There are ways they have spent more that we may never be able to estimate. Can anyone actually believe that our legislators are going to write and pass any bills that oppose the self-direction of pharmaceutical companies?

Me, I always marveled at the complex set of “checks and balances” the Founding Fathers set up.  The U.S. is supposed to have some lovely antitrust laws.  Someone ought to visit with those lovely folks at the Federal Trade Commission. Thomas Jefferson’s quotes are a bit under dispute, but he seems to have said something like this: “Was the government to prescribe to us our medicine and diet, our bodies would be in such keeping as our souls are now.” Me, I would just as soon go visit one of Tom Jefferson’s effigies at Monticello, have a good cry with the man, and go visit the folks at the Federal Trade Commission. Unfortunately, I am booked to see patients all day tomorrow. Now my job seems to include helping them figure out how to pay for their medicine.