The pharmaceutical industry has a massive public relations problem, and it knows it. Even our new, unapologetically pro-corporate president says drug companies are "getting away with murder."Americans name prescription drug prices as a top concern, and a January poll showed only 9 percent of people in the US feel that pharmaceutical companies prioritize patients over profits.
Pharma's critics have a lot of evidence to support their low opinion of the industry. Beyond high-profile scandals like the 500 percent increase in the cost of the life-saving anti-allergy EpiPen, drug prices overall rise each year far above the rate of inflation. Those prices fuel drug company profits and executive pay that are even higher than the amounts pulled in by other megacorporations. One example: Pfizer earns more than $17 million each day from a pneumonia vaccine that, until recently, was priced so high that millions of children around the world couldn't receive it.
Those sky-high prices mean that as many as one in four Americans skip taking prescribed medicine doses because they cannot afford them, including one in five cancer patients. A US Senate investigation showed only about 2 percent of US Medicaid patients were being treated with a Hepatitis C cure, which is remarkably effective but priced at a massive $84,000 for a 12-week course. Globally, 10 million people per year die because they cannot afford the medicines they need.
These are people, not abstract statistics. At our law school clinic, we see people in our own US community who cannot afford to fill prescriptions for serious illnesses like diabetes and heart disease.
Last year, I spoke with a young South African mother, Tobeka Daki, who could not afford to have her breast cancer treated with the medicine trastuzumab, marketed as Herceptin. Although a year's dose can be manufactured for as little as $176, the price in South Africa was marked up to $34,000, many times higher than Tobeka's income. She died in November, never having received the medicine. Roche, the corporation that holds the monopoly rights to trastuzumab, made $11.6 billion in profit during the last full year of Tobeka's life.
Last month, pharma companies announced that some of their windfall profits will be dedicated to addressing the industry's PR problem. In January, the Pharmaceutical Researchers and Manufacturers Association (PhRMA) launched the first commercial in an image-bolstering campaign called "Go Boldly," on which it plans to spend as much as $100 million. The first ad in the campaign features handsome actors in lab coats peering intently into microscopes, alternating with scenes of grateful patients, superimposed with the words: "Today's breakthrough becomes tomorrow's medicine." A soaring instrumental score is accompanied by a stentorian-voiced narration of the Dylan Thomas poem, "Do Not Go Gentle." "We have a great story to tell," PhRMA President and CEO Stephen Ubl said when announcing the campaign.
The problem is that the story being told is profoundly misleading. A truth-in-advertising version of the new ad would include:
* A Costume Change
The actors' lab coats would be swapped out for $5,000 power suits, because the heroes of the pharmaceutical industry's financial success are its lobbyists, not its researchers. The industry reliably spends more than any other on lobbying expenses and political campaign contributions. Thanks to those lobbyists, generations of well-established law and cultural practice that treated medicines as a public good have been reversed, replaced with a global system of government-granted patent monopolies to corporations. These same lobbyists have also managed to make the US the only large nation that prevents itself by law from negotiating down the price the government pays for medicines, specifically in the Medicare system. The result of their efforts is a guaranteed no-competition market on life-or-death products, assuring that the record-breaking profits keep rolling in.
* New Sets
In the more truthful version of the ad, patients would be shown in debtors' court, because health care costs are the leading cause of US family bankruptcies. Other scenes would occur in kitchens where seniors cut their pills in half, and even in morgues occupied by the millions who could not afford the costs of the prescribed medicines.
* Wardrobe Adjustment
A few researchers would remain in the new version of the ad, but their lab coats would now be emblazoned with the logo, "Paid for by US Taxpayers." The necessary-evil justification offered for huge drug price markups and corporate profits is that those dollars are needed to support research and development. But research and development for the most valuable medicines -- particularly the research that is conducted at the most risky stages of the process -- are more often funded by governments and nonprofits than by corporations.
Worse, the government plays a role described by some as the "dumb venture capitalist." Governments pay billions per year for medicines research, hand over the resulting monopoly patents to corporations (the 1980 law that allows this give-away was another signature triumph for drug industry lobbyists), and then pay monopoly mark-up prices as purchasers of the very same medicines. For example, the US National Institutes of Health and Department of Defense funded the research that led to the discovery of the prostate cancer drug enzalutamide, then allowed the patent to be privatized. Now, the US government pays a Japanese pharmaceutical corporation $100,00 per year, per patient for the medicine it paid to discover, which can be manufactured for 1/20th of that cost.
* A New Camera Angle
At some point, the advertising and production companies that created this commercial would turn the cameras on themselves, because they are a big part of the pharma story, too. The industry spends more on marketing than it does on research. That ratio reflects the industry's need to pitch new products that are predominately "me too" drugs, so named because they offer no new therapeutic benefit. Instead, they are aimed at carving out a piece of existing lucrative markets for products like erectile dysfunction drugs or cosmetic medicines. In fact, far more industry dollars have been spent on marketing erectile dysfunction drugs than on researching for cures for diseases that kill millions each year.
Of course, this more truthful version of the pharma ads will never run. But the good news about the current ad campaign is that the industry feels it is needed. Although the president's meager fulminations on drug prices are more than counteracted by his many proposals that would reduce access to medicines, lawmakers have heard the populist anger at drug companies. They are proposing reforms ranging from treating drug companies as utilities to allowing Medicare drug price negotiations to mandating basic transparency on the costs of drug research and marketing. With so much government money already in the system, there is a menu of major reforms that can quickly direct those dollars away from windfall profits into much-improved access and more meaningful research.
That is what Americans want. Hopefully, a misleading ad campaign won't distract them from demanding it.