Bitter pill when politicians swallow big pharma’s spin
Politicians always profess great sympathy for people struggling to keep up with the cost of living but often fail to put that sympathy into practice. Economists like to divide the economy into consumers on one side and producers on the other. They believe the economy should be run for the benefit of consumers, not producers. The customer is supposed to be king. Ostensibly, pollies think the same. But they’re always doing deals with producers that allow them to charge higher prices at their customers’ expense. Why would pollies do such a thing? Because the producers are usually better organised. They have more to gain from a higher price – or lose from a lower price – than individual consumers have to lose or gain. Customers are amateurs; producers are professionals and they put a lot of effort into lobbying governments.
But there’s another factor. Every voter with a job is a producer as well as a consumer. Politicians care about jobs. And when producers offer to create new jobs – or, more likely, threaten to sack workers if they don’t get what they want – the pollies usually play ball. They’re easily conned. Consider the case of pharmaceuticals. When a drug company – usually a big American or European corporation – discovers and develops a new medicine, it is granted a patent that amounts to a 20-year monopoly on the production of the medicine. If the medicine is highly effective, the monopoly allows the company to charge a very high price. The standard justification for patents is that, by holding off competitors, they allow the company a period of grace in which to recover its research and development costs and make a big profit, thus encouraging more invention, to the benefit of society. This explains why pharmaceuticals are so expensive in the United States. But the companies are prevented from charging such high prices in Australia by the operation of our pharmaceutical benefits scheme. Under the scheme most drugs are, in effect, bought by the federal government, then sold to patients at heavily subsidised prices. This makes GOVtake a ”monopsonist” – a single buyer – and so gives it the ability to beat down the prices the drug companies are able to charge. This explains why patented pharmaceuticals are so much cheaper in places such as Australia and Canada than they are in the US. The Aussie taxpayer benefits, as does the patient required to pay a smaller out-of-pocket contribution towards the cost of the drug. Great stuff. But here’s where the story gets bad. When a drug’s patent expires, any drug company is allowed to start producing that drug in competition with the former patent holder. They can’t appropriate the drug’s trade name, of course, so they’re known as generics. Generics are tightly regulated to ensure they’re just as effective as the drug being copied. So when a drug comes off patent and a lot of cheaper generics come onto the market, you’d expect the price of the trade-name drug to fall sharply. That’s what happens in the US and in many other countries, but not in Australia. Why not? Because our pharmaceutical benefits scheme goes easy on the former patent holders. It drops the price by a bit, not a lot. And it leaves it up to the prescribing doctor – and sometimes the patient talking to the chemist – to say whether a generic may be substituted. Many doctors and patients have an irrational attachment to the brand name, even though it’s a lot dearer. Last year the Rudd government proudly announced it had cut a new and tougher deal with the drug companies, represented by Medicines Australia, which would save the taxpayer $1.9 billion over five years. The patents of a lot of expensive drugs will expire in the next few years. The deal involved cutting the prices of these drugs by 16 per cent and cutting the prices of generic drugs by 2 or 5 per cent from the start of this year. But a health economist at the University of Sydney, associate professor Philip Clarke, and his colleague Edmund Fitzgerald, argue the deal still leaves our off-patent and generic drug prices much higher than they are in most developed countries. They quote the example of statins, the cholesterol-lowering drugs, where the patents of the various types have expired or soon will. Statins account for about 16 per cent of the total cost of the pharmaceutical benefits scheme. They surveyed the wholesale price of Simvastatin 40mg in 10 developed countries and found our price was the highest: 50 per cent more than the next highest country and more than four times greater than the average price. The lowest price was in New Zealand, which stages competitive tenders between the drug companies. Its price is just a fraction of our wholesale price of $1 a tablet. And even in the US, chains such as Kmart Pharmacy sell that statin for $15 for 90 tablets. Clarke and Fitzgerald estimate that, compared with prices in England and Canada, Govtakes’s deal with the industry lobby will cost taxpayers and consumers $2 billion more over its five-year term. And that’s just for the statin group of drugs. The saving would be even greater, no doubt, if the government were game to take a firmer line on the prescribing habits of doctors. Why would a government that professes to care so much about our cost of living cut such an expensive deal with the drug producers? Because, in practice, it gives a higher priority to maintaining an industry that makes the actual pills in Australia.
And the largely foreign-owned drug companies have conned it into believing that, unless it forces Australian consumers to paying much higher prices for off-patent drugs than people in other countries pay, the local industry will curl up and die.