Friday, July 05, 2013

The Sickest Joke Is the Price of the Medicine

First published in the Western People last Tuesday.

Anglo is spilt milk. If it serves any purpose now, other than making otherwise sensible people gnash their teeth and jump up and down in impotent fury, it should be to ensure that this sort of messing will never, ever, happen again.

Of course, that’s not what it’s doing. Forget Oireachtas enquiries. Those things do nothing, as discussed in this space before, and besides, there have been four enquiries into the bank guarantee already. How will the fifth one make any difference? The odds are never on your side when you draw to an inside straight.

We cannot change the past. We can only learn from it, and hope it will aid us in the future. But something happened last week that suggests that, as ever, we have learned nothing, and our regulatory practices remain firmly on the side of the fat cat and against the interests of the citizen.

Some years ago a proposal was enacted that would have pharmacists prescribe generic medicines instead of brand name medicines, as the active ingredients are just the same and it’s only the branding that makes a difference. This was seen as quite a considerable step, as the pharmaceutical industry is one of the most lucrative in the world.

We live in a vain age. Drugs that promise to make us look older, younger, fitter, fatter, taller, shorter, darker, lighter and any combination of the above abound in the shops and in advertising. Feeling peaky? Drink this, it’ll cheer you up. Feeling perky? Better eat this, it’ll calm you down. At every crossroads in daily life, there’s a box of pills to help you turn left, turn right or stay exactly where you are.

A lot of these pills have got brand recognition, which means that civilians have heard of them and then demand that brand from their doctor. For instance – there are a wide variety of anti-depressant pills but Prozac has become the most famous, just as people think of Hoover when they think of vacuum cleaners. A woman called Elizabeth Wurtzel wrote a book in the early 1990s called Prozac Nation about her own reliance on the drug and all of a sudden it was seen as the glamorous cure-all for the blues.

Good news for the company that makes Prozac. And good news for the pharmaceutical industry in general, as the idea spreads that there’ll always be a pill for what ails you.

Business being what it is, the pharmaceutical industry is inclined to make many types of pill for ailments, real or perceived, for which there is a market demand. As for ailments that are fatal but sufficiently rare to have no market traction – well. Every rose has its thorn, doesn’t it? Very sad, very sad. Here – take a few of these with a glass of water, they’ll cheer you right up.

That’s what made the decision to encourage doctors to prescribe generic medicines so worthwhile. It took the marketing glamour off the drugs and presented them in their most basic form. To move from the esoteric world of pharmacy and medicine to the everyday world of the breakfast table, it was as if householders were on an economy drive and decided to buy the supermarket’s own brand corn flakes for breakfast, rather than that other familiar one with the rooster bedecked in the beautiful green and red. It doesn’t seem fully quite the same but it does the trick and it’s a good deal easier on the pocket.

Imagine, then, everybody’s surprise when the Economic and Social Research Institute published a report last Thursday that said the price of the generic meds and the fancy-schmancy meds turns out to be pretty much the same.

How could that happen? How are the own brand cornflakes the same price as the famous ones in those beautiful boxes, with that Mayo-liveried rooster crowing to break the day? Either the own-brand price is too high, or the expensive price isn’t expensive any more at all.

In this world, prices don’t come down. The doctors have been doing their bit – prescriptions for generic drugs have doubled in the past few years to fifty per cent of all prescriptions filled. But why do that when the only reason to make a distinction, the price, doesn’t exist? If the price is exactly the same, why bother?

This leads to some questions.

  1. When did we find out the prices were the same?
  2. Were the prices always the same?
  3. If the prices were always the same, why bother with this dog and pony show over the generics in the first place?
  4. If the prices of the generics went up, when did they go up?
  5. Who benefited from the price increase?
  6. What is going to be done about it?

If the nation has learned its lesson from Anglo, these questions will not only be asked but answered. This isn’t a trivial thing. The Government has to save money. The generic drugs initiative was an attempt to save the money. The taxpayer would have some of the burden lifted from him or her because medicine would be cheaper, and the Government’s medical card bills would be cheaper because cheaper drugs were being prescribed.

But money isn’t being saved if the generic drugs are the same price as the branded ones. And if money is not being saved here, the Government must then save money elsewhere, by laying off teachers and nurses, by closing hospital beds and burdening the people even more.

Anglo is the spectacular abuse of money. But in its way, the price of drugs is just as bad. The difference is that while Anglo is now a thing of the past and something that we cannot change, we can do something about how the price of generic drugs went up right now. The question is: will we?