Friday, June 8, 2012

Big Pharma

Cyanide and Happiness, a daily webcomic
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Back in the USA I hated Big Pharma.

Now I work (in part) for them.

My reasons back home were due to, well, events like those discussed in this article - affording drugs is a problem around the world, and a two-pronged issue. On one side you've got areas so poor that even low-priced drugs cost too much, and on the other you've got the USA, where people generally have more money, yet drugs are so astronomically expensive that many still can't afford them despite their exponentially better overall standard of living.

From people I know in Big Pharma back home, I can say that the argument does ring true: drugs are sold in the USA at exorbitant prices, and at far lower prices elsewhere, because companies both want to recoup clinical testing costs and make a tidy profit (a little too tidy if you ask me), and feel that the USA is the market to milk, because we can apparently "afford it". Except we can't.

It also bothers me that they throw so much money behind lobbying the government in their own interests, which mostly counter the interests of the American people, but pretty much all industries do that.

Working at a lot of pharmaceutical companies in Taiwan, though, makes me dislike the whole industry a lot less. I wouldn't go so far as to say "like" or "trust", so I'll stick with "dislike less".

I think it has a lot to do with regulation. I know the health system in Taiwan is imperfect, but it's about ten kachillion times better than the travesty of a "system" in the USA. Don't even bother arguing with me on this, I have a mother who is facing cancer that is not going to go away, and the possibility of losing her company-backed health insurance and very few options after that, so seriously, do not even start. I will tear you to shreds.

Here, we have our imperfect-but-wonderful national health insurance, and a heavy hand in regulating drug prices. I don't agree with some of the laws: the idea that doctors are forced to give certain medications first and others can only be tried later, and that some can't be tried until certain symptoms or issues occur or criteria are met, ties doctors' hands unfairly: it takes away from them what should be their expert judgment regarding what would be best for the patient and puts it in the hands of people who can't necessarily make that call: either because they're bureaucrats, not doctors, or because even if they are doctors, they're not there with that individual patient assessing that patient's needs.

The price regulations, however, I support completely. A dearth of price regulation in the USA has brought unconscionable drug prices for things people need - seriously, it's not like you have a choice sometimes, so supply and demand doesn't apply - prices people can't afford and insurance companies don't want to pay. Regulations in Taiwan have kept most prices for the same drugs at reasonable levels.

You can argue this hurts the company, and many who work in pharmaceuticals in Taiwan would agree, but the fact is that those companies are still in Taiwan, still making a profit and still see being in the Taiwanese market as something worth doing. The price controls haven't scared them away. If it were truly unbearable, companies would pull their products and shutter their offices and Taiwan would be SOL. That hasn't happened.

Those same people in the industry, while they might tell you that the price controls are an issue, would generally not argue that there shouldn't be any regulation or any cost control. In my experience (and I have a lot of experience talking to people in many different firms), while they'd like more freedom, they'd agree that keeping drugs affordable is important, and that wouldn't be lip service: they mean it. They wouldn't say it the way a PR schlub for Big Pharma back home would rattle it off a press release and then look the other way as "reasonable prices" became "$1000+ for what should be a $30 compound".

Even if they would - business is business & all - the regulations are there, and it keeps things reasonable. Not perfect, but reasonable. People get their medicine, companies make a profit, and it becomes an industry that does not inspire so much hatred and animosity. Everybody wins.

So what is all this anti-regulation hullaballoo back home? Phooey.

1 comment:

glad blog said...

This is an interesting post as I'm about to be a British expat in the USA, and it's the healthcare thing that is a huge mental obstacle for me. I don't see it as a political thing, though I know plenty would disagree with me because the US and UK healthcare systems are almost polar opposites. It's certainly going to be a learning curve as I get used to being that much closer to the financial aspects of healthcare.