Creep

A fascinating article surfaced. “Big Pharma Quietly Enlists Leading Professors to Justify $1,000-a-Day Drugs” by Consumer Reports 2-23-17. The article is Yuuuuge and has the potential of several Analysis essays. A brief synopsis would be as follows: Drug makers have priced their products in the past based on the costs of marketing, production costs, composition availability, regulation, and research/development. All of these and the anticipated profit margin. “Pharmaceutical companies have traditionally justified their prices by citing the cost of research and development, but recent research on drug pricing has challenged this argument. Many of the largest drug companies spend more on sales and marketing than on developing their drugs.” But has this justified the $1K a day drugs? Turns out not. The companies are increasingly collaborating with academics who act as consultants to come up with a new pricing justification. One of these is “Precision Health Economics [which] has become a prominent booster of a new way of setting drug prices—based on their overall value to society. Value is determined by comparing the drugs’ cost with their effectiveness in saving lives and preventing future health expenses.” Precision Health Economics is composed of various academics who not only teach/do research at institutions of higher learning, but free lance as consultants for the large drug manufacturers, many of whom fund the research done at the universities the consultants are part of. According to Ohio’s Governor, this would be a win-win. The educational institution is working with the business sector and both are benefitting. Unfortunately, the academics at Precision Health Economics are arguing for and justifying the cost of drugs that are in most cases 3-4 times what they cost in other countries. The research squabble that ensues over the “overall value to society” ends up in the specialty academic journals, many of which are likewise published, funded or edited by Precision Health Economics (or one of its members) or the drug industry itself. The current brouhaha over Ohio teachers doing externships with businesses in order to renew their licenses, or mandatory unelected and “non voting” business membership on school boards misses the point made by the Consumer Reports article. Analysis finds this to be a kind of legitimacy creep in that at first, it is just the wonderful folks who run the local bank or car dealership who will “get involved with the kids”. Eventually this may end up with a reciprocal relationship, not necessarily chosen, elected or agreed upon where the business interests, policies and interactions are justified by their “community involvement” with the schools. Analysis leaves it to the reader to imagine the various different scenarios — from curricula to contractual services to real estate “opportunities” to product pricing as well as work force selection and grooming. Legitimacy creep is not entertained by “Aw shucks, we want what’s best for our kids” conversations.

“Gilead Sciences’ $84,000 list price for its highly effective treatment for the hepatitis C virus prompted dozens of state Medicaid programs and prison systems to restrict treatment to only the sickest patients. A congressional investigation in 2015 found that Gilead, which purchased the drug from a smaller pharmaceutical company, had set the price of the treatment at the peak it thought the market could bear, more than double what the drug’s original developers had suggested. “Gilead pursued a calculated scheme for pricing and marketing its hepatitis C drug based on one primary goal, maximizing revenue, regardless of the human consequences,” said Sen. Ron Wyden, D-Oregon, when he presented the findings of the congressional investigation.” “Raising her two sons on her own, [Emily] Scott barely supports the family with her weekly income of about $350 from sewing shirts at an apparel factory. She is one of more than 11,000 Tennesseans on Medicaid who have been diagnosed with hepatitis C, according to the most recent state data. If all of them received the new medication, the state estimated that it would cost over $1.6 billion, more than double what Tennessee’s Medicaid program spends on drugs in a year.” ““The drug companies do not have people’s interest in mind, they have money in mind,” Scott said. “It’s not fair that they are playing with people’s lives.”” Analysis indicates this is something to bear in mind when promoting business persons on boards of education (Citizens United extends personhood to corporations) and collaborations between academics and businesses. The bottom line may creep into “the learning.”

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