Recent blogs have highlighted the dirty dealings of the Mr. Bigs of illicit drugs, and their dirty law enforcement allies. But those Mr. Bigs are small fry in comparison to the Mr. Bigs of the Pharmacuetical industry, whose profits are even more unjustifiable and obscene.  Frequently, we are told that the pharmaceutical companies need to charge very high prices to cover the cost of research and development of newer, better drugs, and in order to subsidize drugs for less common diseases that would otherwise be prohibitively expensive. Many of us have swallowed this line. But it is a lie.

Some years ago, while working in community mental health, I saw the free weekends at 5-star resorts that were routinely given to doctors, and the luxurious free dinners at top restaurants, among other bribes, in return for listening to a brief sales pitch for their drugs - with the expectation that these same doctors would then prescribe more of these drugs. Once, I even became Dr. Roger XXXXX (a little hard to imagine a woman named Roger!), and enjoyed one of these waterfront restaurant dinners, when Roger was unable to attend, and didn't want to waste the invitation, if his mere mortal psychologist colleague could enjoy the benefit. I thought this level of influence over doctor's prescribing practices was ethically very questionable. But nothing prepared me for the aggressive assault of the pharmaceutical industry on both patients and doctors in the USA. I'd never seen advertising for drugs on television in Australia, so when every second television commercial on television in the USA seemed to be for a sleeping pill, or a restless leg treatment or an antidepressant, I was shocked. I've since learned that the drug companies actually spend billions MORE on advertising than they do on research and development. So their argument that the price of drugs is high because of R & D costs is just a lie - its because of the billions they spend on television advertising, and bribes to doctors through luxurious "gifts", sponsorship of so-called Fellowships at their research institutions, and sponsorship of whole research facilities - presumably intending that those medical researchers will provide endorsement for their products by way of favorable clinical trials.

Another way that drug companies rip off the consumer is by their devious schemes to thwart the law that allows their patents to expire, and opens their money-makers up to cheaper generic production. After several years, in order to meet the requirements of  the Waxman-Hatch patent extension legislation, the drug companies simply change a molecule of the active ingredient and claim that they now have a new, and better drug, and that it qualifies to extend their patent, thus denying it to generic companies. This was claimed by Pulmicort's manufacturer, Astra Zeneca - although Budesonide was the sole active ingredient two Pulmicort ptoducts in the UK in 1981 and 1982, Budesonide was still protected by a basic patent in 1993 - but it was an "old" active ingredient and could not be brought within the patent extension regulation. So its manufacturer, Astra Zeneca, claimed that it was now "additive free budesonide in the form of aggolmerated micronised particles" and that a patent extension should be granted on the basis of a later marketing approval in 1990 for the Pulmicort Turbuhaler device. So, now in 2008, Astra Zeneca is still rakingin massive profits on this old active ingredient that is being kept from generic manufacturers.

This has meant that pulmicort still sells for around $175 for a 4 week supply in the US. If it had gone off-patent, the same active ingredient (budesonide) in an inhaler would probably cost one quarter from a generic company.

Given that life-saving drugs are unavailable to many who need them because of the exorbitant cost,  especially in third-world countries, but even in America with its 50 million uninsured, its time someone dared to challenge governments everywhere to nationalize pharmaceutical companies. OMG!!! Nationalize an industry for the public benefit? quell horreur! Governments everywhere have been all about privatizing industries, not nationalizing them! But if any industry cries out for nationalization it is the pharmaceutical industry. Are you listening Hugo Chavez? 

Astra Zeneca's application was turned down by the British Patent Office. On appeal, they argued that extensive research had been required to adapt the formulation of budesonide for the Turbuhaler. This argument was rejected. The difference in legal opinions on this subject accounts for some of the differences in prices paid for the same drugs and devices in the US and other countries.  The US, not surprisingly, given the massive amount spent on lobbyists, manage to maintain their patents - and profits - longer than in other countries.