21-04-2014, 12:28 PM
The Pharmaceutical Industry
Pharmaceutical Industry[.ppt (Size: 875.5 KB / Downloads: 159)
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80-90% of illnesses cared for outside formal health care system
Family (women), friends, media
Non prescription drug use = 2 x prescription drug use
Non-prescription drug costs = 1/2 prescription drug costs
Self Medication
Enemas for diarrhea and fever
Mix benadryl and alcohol for insomnia
Educational brochures have variable effect on use of medical services, including OTC medication
Inappropriate Self-medication: The Common Cold
Greater than 800 OTC medications available
Not beneficial in children under 3 years old, except acetaminophen for very high fevers
1/3 of children less than 3 years old treated
2% received ASA
-risk of Reye’s syndrome
Inappropriate OTC Medication Use in Children
Ineffective
Potential for ADEs and ODs
Profile of users’ parents:
-better educated
-uninsured
Provider visits reduce use
Provider phone calls do not
Prescription Drugs
Over $300/person/year, or $22,500 over a 75-year lifetime
Increased life expectancy from 55-75 from 1920 to present; decreased morbidity (HTN, DM, BPH, PUD, RA, Psychiatric D/Os)
Cost effectiveness of drugs (cost/QALY < $50,000 for 48-65% of medications)
Economics of the Pharmaceutical Industry
Worldwide sales > $145 billion/year
US = Largest markets (40 % of worldwide sales)
Sales for the 10 largest drug companies = $28 billion in 2000, $37 billion in 2001
tax breaks - can deduct marketing and R & D expenses
Mergers and Acquisitions
Drug company mergers
- Pfizer-Warner-Lambert, Upjohn-Pharmacia, Glaxo-Wellcome-SmithKliine Beecham, etc.
Pfizer acquired Pharmacia in 7/02 for $60 billion to become the world’s most powerful drug conglomerate
Drug Industry Lobbying
$38 million donated to Congressional campaigns in the 1990s
$84 million in 2000 election (2/3 to Republicans)
GW Bush received $456,000 during his 2000 election campaign
Drug Development: Who Pays?
$20 billion in 1999
Pharmaceutical companies
R & D budget increasing
U.S. taxpayers
NIH-funded research (total NIH budget = 20.3 billion in 2001)
1995 Reasonable Drug Pricing
Clause removed
The Elderly and Prescription Drug Coverage
Elderly represent 12% of U.S. population, yet account for 33% of drug expenditures
17% of the 37 million elderly Medicare patients are poor or near poor (incomes less than $7,309 or $9,316 respectively)
The 64% of elderly Medicare enrollees with no coverage for outpatient drug costs are sicker and poorer then their counterparts with supplemental insurance.
Direct to Consumer Advertising
Pfizer fined $6 million for TV ads extolling benefits of Cipro over cheaper generic drugs (or no drugs) for childhood ear infections
In Spanish medical journals, nearly half of promotional drug ad statements not supported by cited reference
Bush administration has extended investigation period → more ineffective oversight