Health reform: Big Pharma escaping again

I’ve written before about the evils of Big Pharma and expressed my outrage at President Obama’s behind-the-scenes deal to leave Big Pharma’s big profits out of the planning for health care reform. But until now, I’d only seen bits and pieces of the total picture.

Now comes David Evans at Bloomberg.com, with his excruciatingly detailed account of how far Big Pharma is and has been willing to go to make a buck. Or a billion. It can’t have been easy compiling all those numbers (really big numbers) into a history of Big Pharma’s profits and penalties ($7 billion in penalties and fines just since May 2004).

It’s a long story and tough, discouraging reading. The drug companies keep breaking the laws. The courts keep levying fines. Yet even as a company is settling a suit and paying a fine, it is launching some new campaign that intentionally violates the same laws. The fines are simply part of the cost of doing business, and a relatively small part at that.

The violations almost always involve aggressively, knowingly promoting a drug for “off-label” uses — those not approved by the FDA. That’s illegal. But the drug companies do it anyway because there are huge profits to be made; the fines and penalties incurred are mere speed bumps in comparison.

Evans reaches a conclusion that no one wants to hear:

One reason drug companies keep breaking the law may be because prosecutors and judges have been unwilling to use the ultimate sanction — a felony conviction that would render a company’s drugs ineligible for reimbursement by state health programs and federal Medicare.

This would be a potential death sentence for a drug company.

Evans warns that busy doctors often don’t or can’t keep up with the latest information on approved vs. off-label uses of drugs and that some don’t even know the difference between “on-label” and “off-label.” Worse, many get their information from the drug company reps.

Until someone, somehow puts the brakes on Big Pharma, the only thing consumers can do is be aware of the problem and educate themselves about the drugs they are taking. Always ask the prescriber whether a prescription is for an FDA-approved use, and if not, whether strong evidence supports using the drug, particularly if it can be dangerous.

Meantime, health care reform marches on through Congress while Big Pharma execs keep marching to the bank, undeterred by warnings, fines, penalties, adverse court rulings, professional ethics, or personal conscience.