opinion

Big Pharma cash taints policy, politics, patient advocacy: Silvestrini

Big Pharma money seems to be seems everywhere anyone is making policy or taking any kind of action involving drug manufacturers. As a general statement, this is probably no surprise. But the details of how much Pharma money has influenced and potentially tainted policy making, medical education and even patient advocacy are sobering. They also raise questions about how the U.S. should refocus healthcare priorities to better benefit patients.

Consider:

• Doctors who write prescriptions and researchers who investigate drugs have been paid billions by drug companies, according to the government’s Open Payments database.

• Least surprisingly, the Center for Responsive Politics has documented that the industry contributes millions to political campaigns to support legislative policies that would benefit it.

• But even non-profit groups that are supposed to represent the interests of medical patients have received millions from Big Pharma, as documented separately by Kaiser Health News and at least one U.S. Senate investigation report. For example, the Crohn’s and Colitis Foundation received $2.7 million from AbbVie in 2015, according to Kaiser. AbbVie makes billions from its drug, Humira, which is used to treat conditions including Crohn’s. The drug costs patients as much as $63,000 a year. The American Diabetes Association benefited from $2.9 million from Eli Lilly, which raised the price of its insulin product, Humalog 30 times over two decades.

• As detailed in a report by the Project on Government Oversight, federal law has fostered a cozy relationship between Pharma and the agency that’s supposed to regulate the industry, the Food and Drug Administration. The FDA depends heavily on funding from the industry and is required to work closely with drug manufacturers in developing regulations and procedures. “Some observers fear that such approaches may not be scientifically sound, that they could be more susceptible to manipulation, and that they could lead to lower standards,” according the POGO report.

In New Jersey alone, drug and medical device companies gave $111 million in general contributions, not counting research funds, to doctors and hospitals in 2016, according to the government database. The largest chunk — $16.5 million — was for consulting fees, followed by more than $11 million for food and beverages and nearly $10 million for travel and lodging.

New Jersey-based companies did their part. For example, Allergan gave $66 million in general payments to doctors and hospitals while Novartis spent nearly $442 million on research grants.

Patient advocacy groups may be the most troubling benefactors of all that pharma money. Kaiser defines patient advocacy groups as nonprofits devoted to assisting patients with a particular disease, disability or condition. This assistance would go beyond just providing services or care. It’s true that patient advocates and pharmaceutical companies should work together at times and often share the same interests. But patients’ needs — both financial and medical — and drug manufacturers’ fiduciary priorities are not identical. Groups can work with Pharma where they share goals, without depending on the industry for money.

According to the KHN investigation, Allergan gave $716,500 to patient advocacy groups in 2015, while New Jersey-based Johnson & Johnson gave more than $6 million.

Pharma has a history using money to shape policies that benefit its bottom line at the expense of the patients it is supposed to help. This is illustrated starkly by the role that drugmakers played in creating the opioid crisis. As I documented at Drugwatch, drug companies profited handsomely by employing a multi-pronged marketing push that redefined the way the medical community treated pain. This all-encompassing effort succeeded resoundingly, drastically increasing prescriptions for opioids while obscuring the very real risks of addiction that had deterred such approaches in the past.

Now, some in Congress are complaining that drug makers’ marketing efforts are being subsidized by taxpayers to the tune of $6 billion in tax deductions in 2015 alone.

And there’s plenty of evidence demonstrating that all this money Pharma is spreading around is yielding results for the manufacturers’ bottom lines.

A study last year found that 65 percent of U.S. patients visited a doctor who received money from drug companies, although most patients didn’t know about the payments. A 2016 study by researchers at the University of California found that doctors who were given free meals worth less than $20 were significantly more likely to write prescriptions made by the companies that provided the meals.

A similar study in 2018 found that doctors and teaching hospitals in the U.S. receive about $7 billion a year from drug manufacturers. When researchers focused on certain cancer scenarios, the payments were linked to higher rates of costly prescriptions from the drug makers.

Drug prices are rising in the U.S. at rates that are endangering patients and contributing to the overall cost of health care. Policy makers and citizens should understand just how pharmaceutical companies use their windfall to effect policies to make them even richer.

Elaine Silvestrini, a former Asbury Park Press reporter, writes for Drugwatch.com, a consumer education and patient advocacy website based in Orlando.