Guide Big Pharma: Exposing the Global Healthcare Agenda

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Full Text. This article is short, but is just that much more proof of how these drug companies influence the consumer. This article discusses the conflict of interest between psychiatrists and drug companies. It also explains the effects that it has on the psychiatric industry. Healy, David. Industry and Depression. This reference is helpful to me in that it goes into great detail about the importance of marketing tactics, costs, and other conditions for marketing of these drugs to be successful at first light and for years to come. This book also contains information about the subject in areas other than just the United States, helping to prove this to be a widespread problem.

This article has indepth information about the dilemma of gift giving by the drug companies, and the influence it many have on doctors. It holds great information about the ethical value of this issue. Law, Jacky.

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Big Pharma: exposing the global healthcare agenda. Here is yet another author with experience pertaining to the field, with more than 20 years as a pharmaceutical journalist. This book has good reference about the political workings associated with the pharmaceutical industry, also providing a good financial aspect. The author does a good job in explaining some of the marketing tactics of the pharmaceutical companies.

Marx, Wendy. A great article on how the drug companies are maximizing sales by utilizing consumers directly. It also stresses the importance of their recruitment of the prescribing physicians in order for their marketing to be profitable. Melville, Arabella, and Colin Johnson. Briarcliff Manor: Stein and Day, This book is a good resource because it explains the situations and also goes into giving some examples to better explain the situation.

The fact that this is an older book helps to support the fact that this problem has been around for quite a while. It also gives some details showing this to be a problem since manufactured drugs first came into existence. Miller, Vin. This article provides a great insight into exactly how the pharmaceutical industry influences and deceives.

It contains good detailed explanations.

This article shows the influence of the drug companies. It also recommends viewing a documentary to get a greater idea of the problem with the pharmaceutical industry coupled with the psychiatric industry. Opar, Alisa. This is a good article on how some medical students perceived gifts from drug companies. They took a stand against it. New York: Sarah Crichton Books, For this book, the title says it all. This is a source of countless bits of information. It goes into detail of how these companies influence our thoughts and decisions, even influencing the status of our health.

Companies even go as far as creating disorders that their drugs are used to treat. A whole chapter dedicated to the push of marketing tactics. The author speaks of how the industry started out, and also explains the rapid expansion of the market. Pizzorno, J. A great editorial on the trend of drug companies creating syndromes to fit their drugs in order to.

It shows evidence of increased drug costs and expenses. It is very informative with charts and numbers. Independent Media Institute. It explains how influential they can be on consumers and how deceptive and misleading they can be. This article is short, but none-the-less, information packed.

Ruiz, Rebecca. This article talks about the ads from drug companies being misleading. It is fantastic in supporting my research in that it gives ten clear examples of these ads, and how they were misleading. Singer, Merrill, and Hans Baer, eds. Lanham: AtlaMira Press, Now for a story.

In an April obituary, the New York Times described Maurice Hilleman as the man who "probably saved more lives than any other scientist in the 20th century. Hilleman himself, it seems, "credited much of his success to his boyhood work with chickens. The technique was known before Hilleman arrived, but isolating and then safely breeding a pathogen requires the touch of a very delicate artist. By farming eggs, Maurice Hilleman saved tens of millions of lives, and prevented deafness, blindness, and other permanent disabilities among many millions more.

No Albert Schweitzer or Florence Nightingale could ever post numbers like his. Doctors and nurses save lives one on one, and are paid by the hour. Big Pharma's critics do not even try. Pricing is indeed the key. It complicates things immeasurably. It also largely explains the gulf between the industry's perception of reality and that of the critics.

The market price of a drug always drops sharply when the patent expires and competitors roll out generics. The heights vary, but cliff-like economies rule throughout the industry. The cliffis still higher if you compare the cost of manufacturing the last pill that rolls out of the factory against its value to the person who desperately needs it. A generation or two ago, the diseases that would be rubbed out by Hilleman's green thumb cost humanity countless billions in lost productivity, premature death, and time spent attending to the sick.

Hilleman's egg farms saved lives at pennies a shot. Any scheme is, from one perspective or another, inefficient, unreasonable, or worse. Big Pharma's critics have much to say about Merck's Vioxx, the arthritis painkiller that, because of suspected side effects, was pulled from the market in They rarely mention the company's vaccines. Sometimes you can. A drug called eflornithine was developed in the 's to treat cancer. It didn't suppress cancer very well--but it did, unexpectedly, cure something else: sleeping sickness. Endemic in many parts of Africa, sleeping sickness trypanosomiasis is the second most deadly parasitic disease on the planet.

Malaria is first. Treated with eflornithine, the near-dead sleepers arise, take up their pallets, and walk. But they are too poor to pay on the way out. In , the manufacturer stopped producing the drug. The reason was obvious: sub-Saharan Africa cannot cover even the second-pill cost of manufacturing Western drugs to Western standards. And the really poor, or those that assist them, can barely afford the last-pill cost. Then Bristol-Myers-Squibb discovered that eflornithine impedes the growth of women's facial hair, and began marketing it in a beauty cream called Vaniqa.

Yes, the rich get Viagra, and Vaniqa too. The poor still get malaria, but they can now beat trypanosomiasis. This, roughly, is what is meant by "price discrimination," or charging both more and less at the same time. The best scheme all around, for sellers and buyers alike, is a wide range of wealth-adjusted or, technically speaking, "demand-elasticity-adjusted" prices. Business travelers get soaked, college students fly almost for free, and the jumble of prices in between drives most people nuts. But the planes are packed full, and that drives the average price of a ticket way down.

The rich fly, and the much less rich fly, too.

Non-profit Alliance for Patient Access uses journalists and politicians to push Big Pharma’s agenda

Well, not exactly. Shareholders paid for the drug's development. Complexions paid for the factory. Big Pharma gave WHO a license, and then, later, the cash to buy plenty of eflornithine at last-pill prices. Where then is the scandal? IT IS pretty easy to package and market eflornithine in such a manner that a New York matron will not look to buy her face cream by mail order from a relief agency in Burkina Faso.

In more prosaic circumstances, though, discriminatory prices can be difficult to sustain. Typically, resellers step in to buy low and sell just a bit higher, until the price gap all but disappears. It takes a lot of branding, packaging, peddling, and flacking to make one thing look like two or more different things. The no-name box in the supermarket contains exactly the same cereal, but you pay extra for Wheaties in order to partake in the Breakfast of Champions. Big Pharma does Wheaties all the time, which infuriates the critics.

Angell reports that, after its original patent for Prozac expired, Eli Lilly got a separate patent, and a separate FDA license, to use the old chemical for a new purpose: the treatment of "premenstrual dysphoric disorder. There is, Angell believes, no possible justification for such nonsense. But there is. Somehow or other, the average price of the pill has to end up high enough to pay off the up-front cost.

No law of economics decrees that you can always accomplish this. Competition ordinarily pushes price down to marginal cost, paying no heed at all to costs that were sunk years ago. The problem is especially acute with drugs, where so much cost lies in the original chemical design. The pioneer also shoulders the considerable financial burden of persuading the FDA that the drug is safe and effective, while me-too applicants can, in principle, just photocopy what the pioneer has already filed.

It is not impossible for the pioneering company to end up as the only player that fails to profit from its discovery. Patents address this problem by granting a monopoly for a fixed term, during which the manufacturer can keep prices high or, better still, calibrate them to each buyer's willingness to pay. The Food and Drug Administration's "data exclusivity" rule places a separate hold on photocopy-licensing: for five years, competitors have to conduct their own, independent tests.

The rules keep patent and data-exclusivity rights quite narrow. Establishing the safety and efficacy of one drug-dose prescription for one disease wins an FDA license tailored to that drug-dose-disease combination, and the right to market the drug only for that single "on-label" use. A patent can likewise secure just the chemistry, or it can protect a novel method of use. Taken together, these conditions ensure a manageable licensing process, facilitate incremental improvements, and promote the search for new uses of old medicines.

But they also let a drug company elude competition by differentiating one pill from another much like it, coloring a green pill pink and wrapping it in new legal paper. Some green pills, indeed, are not given a patent until they are turned lavender or pink. Genetically engineered forms of life can be patented, but not "pure products of nature. Similarly when it comes to promoting the search for radically new uses of old man-made drugs. Many important therapies almost certainly lie hidden in biochemically active entities developed years ago; academics and government researchers continue to look for them, but private capital may have little incentive to do the same.

If a patent expires before even a first good application is found, manufacturing facilities will not be built, and any further search for useful effects will then depend on the ability of a small research lab to brew the chemical from scratch.

Patent and data-exclusivity rules that protect the discovery of new uses of old drugs serve a valuable purpose here, too. Much could be lost without them. Pills often work in mysterious ways, and happy surprises sometimes lie hidden at the bottom of the bottle. Rogaine and Viagra were both developed to lower blood pressure.

The clinical trials didn't pan out, but participants reported new hair and better sex. Another chemical that suppresses hair growth also kills a parasite. Gemzar, developed to counter viral infections, is used to treat cancer. In the 's, the FDA officially classified as an "orphan drug" a compound derived from a deadly bacterium that causes botulism. The drug was needed to treat a rare, incapacitating disease characterized by uncontrollable twitching of the eye muscles, but liability concerns had driven its one supplier out of the market. Plastic surgeons now use botox to smooth out wrinkled faces.

Angell is quite certain that Big Pharma is economically sheltered to a far greater extent than it needs or deserves to be. Patents, she writes, "have relatively little to do with stimulating innovation, which usually occurs outside the industry. We should therefore run a six-year patent clock after a drug is licensed and scrap the FDA,s data-exclusivity rule. But there is no "therefore" there.

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Why not, instead, grant thirty-year patents and ten-year exclusivity? Might that not help interest Big Pharma in all the drugs that it currently will not touch at all? To see why not, we have to return to the conundrum of pricing. This seems obvious enough in the case of a disease that afflicts people who survive on a dollar a day.

But the calculation has to be made every time, in every case, and it does not become easier just because people paying for the pill happen to have more money. Very Big Insurance can and frequently does flex its muscles to flatten and lower the prices a drug company would otherwise charge. In Canada, the government, acting as a buyers' cartel, may force the pioneer to choose between selling at a cut-rate price or not selling to Canadians at all. If it chooses to sell, residents of Detroit may then shop at Canadian prices by hopping on a Greyhound bus.

Online shoppers can skirt the law and shop at Canadian prices anywhere. Or Medicare, Medicaid, the Veterans Administration, Anthem, Aetna, Kaiser Permanente, and all the other institutional buyers in Washington, Ottawa, and elsewhere may simply take their time deciding what they are willing to pay; and while they reflect, the patent clock ticks.

Other drugs are just too important for their own economic good. Supplies of vaccines are especially precarious, Angell notes: three out of four companies that were making vaccines twenty years ago no longer do so. Unfortunately, that is pretty much how things work already.

If Merck ever develops a vaccine for avian flu, it will end up selling most of what it produces to the government, and the government will get a very good deal. Every other drug that Merck sells is already sold at the government regulator's pleasure, and much of what it sells is paid for by the government's insurers. In these circumstances, Merck might quietly conclude that the government price for an avian-flu vaccine is bound to be too good, and decide to let some other drug company's shareholders deliver the thank-you.

Before a company decides to seek or manufacture a vaccine, cancer drug, or diet pill, a miracle breakthrough, a me-too variant, or an exact clone of a drug already on the market, it must also weigh the various risks of delay, failure, or worse. Although Angell complains that Big Pharma often out-sources the scientific risks inherent in searching for a new chemical that will cure a disease, at least as important are risks encountered beyond the lab: at the FDA, in the factory, and in the courts.

The first U. A junior official took her time reviewing the original application. While she did, a German scientist identified thalidomide's dreadful power to halt embryonic limb development in the early stages of pregnancy. Delay was all the FDA contributed, but that alone prevented thousands of birth defects in the United States.

Thirty-seven years later, the FDA authorized use of the drug to treat a rare condition associated with Hansen's disease leprosy. Persuading the FDA and the medical community that the correct lines have been drawn to separate good drug-dose-disease combinations from bad requires a great deal of money and a long and often unpredictable amount of time. Exact chemical copies of drugs already approved are fast; me-too variants only somewhat slower.

By contrast with these, drugs used by pregnant women and children are difficult; and vaccines, because they are administered to large numbers of healthy children, are especially problematic.

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Manufacturing adds another tier of expense and risk. Development of the vaccines that eradicated polio from most of the Western world was funded mainly by the March of Dimes. That charitable foundation also oversaw the first field trials establishing the safety and efficacy of Jonas Salk's vaccine. It then handed the project to the government, which licensed five private companies to produce the vaccine. Although the government prescribed exactly how it was to be manufactured, the instructions were not quite the same as those the foundation had promulgated prior to the first trial.

The Cutter Company, the smallest of the five licensees, followed the government's instructions to the letter, but failed to kill all the virus in the vaccine. Seventy thousand people suffered mild forms of polio. Two hundred were paralyzed. Ten died. The Cutter tragedy helped spark changes in liability law that made it much easier to sue drug companies for their failures, even in the absence of negligence.