The “Bad Boys” of American Healthcare
When it comes to assigning blame for America’s healthcare crisis, public opinion polls show that Americans point the finger most at pharmaceutical companies. Yet we consume far more of their products than ever before – and than do patients in other developed countries with equal or better outcomes than us.
U.S. spending on medications has more than tripled over the past twenty years due in no small measure to our cultural obsession with quick fixes and miracle pills. Of course, that’s been amplified by a medical profession eager to keep their patients placated – and their office visits brief – by reaching for their handy prescription pads.
Despite the disregard in which Big Pharma is held as an industry, the American public can’t get enough of its overpriced, and often harmful, products. We pop pills at record levels that far exceed other developed, and healthier, countries.
It reminds me of the Seinfeld episode where George learns the girl he covets goes for “bad boys” and – as only he could – adopts the facade of what he perceived as the “bad boy” (mostly a lot of gum-chewing, as I recall). This was also the episode ending with George’s father – the unforgettable Frank Costanza – and Elaine about to get into it in the police station where George ends up (“You want a piece of me?!”).
Americans generally want a piece of their health insurers, who’ve also earned a top spot in our healthcare hall of infamy. But when it comes to Big Pharma – that swaggering, gum-chewing and excessively profitable titan of infamy – we’re willing and eager to entrust our very lives, and those of our loved ones, to the baddest boy on the block.
The Pharma Con
According to the Public Citizen’s Health Research Group – whose worstpills.org site I recommend to anyone taking medication – U.S. spending on prescription drugs tripled in the twenty year period (1990-2010) covered in its report on pharmaceutical industry fraud on American taxpayers.
That’s a three-fold increase in less than a generation. It sure doesn’t seem like our distrust of Big Pharma has prevented us from devouring their often suspect products, does it?
The Public Citizen’s report goes further than the single-year snapshot I reveal in Our Healthcare Sucks. There I show that healthcare companies – mostly Big Pharma – accounted for all ten of the top ten fraud settlements with the federal government in 2010 (get free chapter in sidebar for details).
Even worse, healthcare companies accounted for 80% of all fraud settlements – four times that of all other industries combined!
Makes it seem more like a healthcare con than a healthcare system, doesn’t it?
And guess who the marks are.
More Brazen Than Ever
The Public Citizen’s report shows that this wasn’t a one-year fluke. Their report shows how the pharmaceutical industry has overtaken the defense industry as the biggest perpetrators of fraud against the American people.
It also details a number of other disturbing facts that leave you wondering why we aren’t more cautious in consuming their products…
Illegal off-label promotion of pharmaceuticals is responsible for the largest amount of fraud penalties – a practice that can be prosecuted criminally as well as civilly because of its potential to harm rather than help patients (so why isn’t it criminalized more?);
The pace of pharmaceutical fraud has accelerated – 75% of penalties occurred in the last five of the twenty years studied;
Four companies accounted for over half of all financial penalties – GlaxoSmithKline, Pfizer, Eli Lilly and Schering-Plough; and
While they’ve grown significantly, the financial penalties for these repeat offenders are a minor cost of doing business compared to the enormous profits these illegal practices help generate.
And having lost much of their patent protection since 2010, isn’t it rather likely these publicly-traded companies will become even more aggressive in order to meet shareholder expectations for ever-growing profits?
This highly realistic prospect doesn’t bode well for our ongoing healthcare spending – or for our patient safety prospects.
America’s Most Wanted
I address a few other practices by what should be “America’s Most Wanted” in Our Healthcare Sucks, including their purposeful cover-up of the risks of their medications. Here’s a brief excerpt:
Requirements that drug manufacturers properly inform consumers of risks of side effects and other adverse effects that might occur in using their products have proven woefully inferior.
Other developed countries require clearer and more understandable consumer disclosures. A study comparing legibility and comprehensibility of patient leaflets dispensed by drug manufacturers with their drug products – using adherence to U.S. consensus criteria – rated such disclosures at…
90% for adherence in Australia,
81% in the U.K., and
Only 68% in the U.S., with a dismal 60% score for legibility and comprehensibility. 
Some other findings from this study:
“U.S.(drug) leaflets achieved 50% or less adherence for contraindications and precaution information…
“Omissions included warnings about preexisting allergy and illness information about drug interactions; and…
“U.S. leaflets had significant shortcomings with the omission of vital information for the safe and effective use of the medications.”
This suggests the FDA has failed to protect the American public by requiring clarity and understandability by drug companies in disclosing the risks of their medications. Of course, it also suggests drug companies have no interest in honest consumer disclosures, since they could voluntarily apply the superior disclosures they’re using in the U.K. if they were so inclined.
Obviously, they must believe honest disclosures that reflected, rather than omitted, “vital information” consumers need for the safe and effective use of their medications – as cited in the above study – might negatively affect their sales.
And sales trump patient safety every time, so they do what they can get away with.
And we pay twice as much for their products as other developed countries despite these duplicitous practices that expose us to physical harm.
We really are a nation of suckers, aren’t we?
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 Consumer medication information in the United States, Europe, and Australia: a comparative evaluation. J Am Pharm Assoc (2003)