Dear FRONTLINE,Drug Marketing and advertising floods the public "free" TV stations costing big advertising $. In these commercials, without any explanation of what these drugs treat, they will state: "Ask your doctor about (whatever the drug name is)"- Does this make sense? We have to pay more (we don't have drug coverage with our medical plan), so they can push their drugs to many who don't need it. And then we do go to the doctor: He has a Clariton clock, note pads & pens; and we walk out with a Celebrex plastic bag fill of Celebrex free samples.
Lorraine Baron
lockport, ny
Dear FRONTLINE, I only became aware of the drugs I am taking: Vioxx, Zocor, Flomax, Ditropan XL when they were prescribed to me by a doctor.
It was only afterward that I saw them advertised in Magazines and TV as "the drug" to take. Was a generic ever suggested? No! Which I assumed meant my doctor thought that they were not as good as the name brand. In fact one of my doctors was unaware of its cost and was surprised it was so expensive locally. I now buy ALL my drugs on line from Canada at half price but after viewing Frontline I will be researching and testing the generics and make my own decision.
morristown, nj
Dear FRONTLINE, Price control of prescription medication is not a solution for accessible drugs for people who need them. As a matter of fact it worsens the problem by killing future drugs making them inaccessible to everyone. To understand why, I use the following simplified model. 3 men: A, B, C. A is 80 years old, B 70, C 60. 10 years ago A paid high price for drug x which allowed research of new drugs to continue. Now patent of x ran out, B gets drug x for pennies. Profit on drug x allows drug y to develop which improves life. B now has a choice. He could pay the high price of drug y, that will allow for development of future drug z. Then, in the future, C can get x, and y cheaply, and at a cost, drug z. This perpetuates research, ensuring that future generations always have better medicine. Or B can lobby for price control, that can stifle research. B will get y cheaper, but C will not even have the option of paying for z because it won't be developed. I use this model to illustrate the following point: In the present, drug y may be relatively (due to economic reason) inaccessible to B. Drug y will not be forever inaccessible after patent ran out. However by taking the price control route, drug z will be absolutely inaccessible to C whether he can afford it or not, because it won't be developed. The irony is that B may actually benefit from z, a drug which he stifled, 10 years later. To simplify the message, price control is to kill the goose that lay the gold egg (golden egg in this case Americans' health). I am a physician and I do not have any financial interest in pharmaceutical companies.
Peter Cheung
ann arbor, michigan
Dear FRONTLINE, The solution to high drug prices involves less government intervention, not socialism. That's the wrong solution. However, coercion works both ways and government already creates the problem when it grants the pharmaceutical companies lengthy patent periods and renewals. Reduce or remove those and you engage the true "free market" the pharmaceutical companies claim to support. Prices will drop, competition will be alive and well, and the American way prospers.
John Tebera
baltimore, maryland
Dear FRONTLINE, Price controls may have to be implemented, as they are in other contries. However, I do believe the R&D of the drug companies is very costly, and provision must be made to continue drug development, possibly by protecting the drug companies from the total costs of development. Subsidized drug development would be tolerated by the people, just as we subsidize farmers and other industries. Then price controls would benefit the consumer, but not "kill" the drug companies. Benevelent price controls, are the only way to bring prices down, and still derive benefit from new drug development.
wallington, nj
Dear FRONTLINE, As I watched your program I had to wonder to myself what the drug companies are really saying when they claim innovation would stop if they were forced to charge more affordable prices in the United States?
Are they claiming that the science and innovation would move on to another country? This seems highly unlikely given America is the only "rich" country willing to be chiselled on such a grand scale. Does not the American public has the upper hand in this situation?
Even if you cut their profits by 60% is it not still one of the most profitable businesses in the world so therefore would they not want to continue to make such relatively large profits?
Also, forgive my ignorance about your President's new drug reforms but from what I have heard it all seems to propose that drug prices continue to stay high but the taxpayer subsidies the private insurance and drug companies profits. This seems like a very bad idea in light of the increasingly large federal debt that the same taxpaying American public will alone be responsible for.
Robert Hecker
montreal, canada
Dear FRONTLINE, I was very surprised to find no mention on your program of the frequency with which new drugs are developed in the United States with government money rather than simply with the revenues of drug sales as the industry would have us believe. What this means is that the supposed high-risks of R&D are often borne by the US taxpayer rather than by the drug company. That same taxpayer loses out again, when the government hands over the patent of such drugs to the sponsored pharmaceutical company which is then allowed to determine pricing and marketing policies with no further interference from the government. By rights, it seems to me, the public sector should remain an active partner in this process rather than serving as a facilitator of private profit-making at the expense of the American public. Why is there no outcry about this significant transfer of wealth?
Ellen Leopold
cambridge, ma
Dear FRONTLINE, Although much of the discussion concerned whether controlling prices is a good solution, the reality of Maine Rx is that it uses a business model of the lure of higher market share or the threat of lower market share to induce drug companies to negotiate prices -- voluntarily. So let's be honest: when drug companies oppose Maine Rx, they are really opposing the use of the marketplace to lower drug prices.
Thomas Bradley
portland, maine
Dear FRONTLINE, The drug companies threaten less innovation if bulk purchasing lowers prices. Yet they spend 16% of earnings on promotional advertising and lobbying and 13% on research. (These are numbers which you used). Why could they not choose to reduce the advertising to 10% and continue the research at the present amount? And/or they could reduce profits from the current 18% to something like 12% and reduce the cost of the drugs. The companies have other choices, why would they insist on cutting back on research if they are interested in getting their product to the greatest number of people at a cost they (the cusumer) can afford?
northampton, ma
Dear FRONTLINE, I think that there is another way to fight the rising Healthcare ad perscription costs. I am a consultant for a company that offers Retirement and Benefit products. One of the products that we offer is a new program called HRA - Health Reimbursement Arrangements. Primarily, an HRA plan is a wrapper around a high deductible PPO allowing the employee an opportunity to rollover unused deductible dollars for next years medical expenses. Aside from it being a savings to the employer, it makes the employee aware of just how much the cost of their health care is outside their responsibility, such as a co-pay. The point that I making is that there is another angle to consider, and that is not only educate the public of their choices and benefits, but also give them incentive to do so.
Laura Pickei
rumson, nj
Dear FRONTLINE, The unexplored issue in this extremely informative show was: it appears the U.S. consumer subsidizes the rest of the world's use of these critical drugs. In a wildly simplified example: if a drug costs $100 to develop, and only $20 can be recouped in overseas sales due to price controls, then the remaining $80 has to be recovered in the unregulated US market. Maine's "solution" to regulate the price is not to the approach to take however, because the money has to be there to pay for the expensive R&D effort. The "solution" is to figure out how share reasonable costs more equitably across the entire user base (Note: 16% of the costs being Marketing expense points to some cost controls the pharmaceutical companies should be addressing). Arguably an AIDS patient in Africa can't afford to pay 1st world prices for life-saving medication, but - I don't know why other first world countries (e.g., Western Europe, Canada, Japan) can't share the burden of discovering and testing medicines that benefit mankind. Just as certain technologies can't be shipped abroad without US Government approval, what if the pharmaceutical companies had to get approval from the US government to ship their products abroad (for all I know they already have to, but if so - why doesn't the US Government come up with a better win-win solution in the export of our pharmaceuticals?)
Mort Mumma
richmond, va
Dear FRONTLINE, As long as the drugs from Canada are of equal quality as in the US, I believe we should get the drugs from Canada. The Pharmaceutical companies are interested only in making money with no regard for the people who can't afford them. I have no problem with the companies making a profit, but the profits they make are obscene. If they make less profit by lowering prices in the US, they will continue research. It is only in making new and better drugs that they will stay in business. Sooner or later one of them will break away from the group and go back to research - the rest will follow. The desire for more profit will overcome their desire to frighten the public.
Margaret Cook - Fanwood, NJ
Margaret Cook
fanwood, nj
Dear FRONTLINE, I believe that controlling the cost of prescription drugs could limit Research and Development. It costs pharmaceutical companies billions of dollars to develop one drug. After the drug gets approved, the companies only have so many years before their patent expires to make up for those billions spent and expand their pipeline to new, improved, or even curing drugs for the future.
attleboro, ma
Dear FRONTLINE,
Where on earth comes the notion that health care providers get all their information about drugs and are at the mercy of drug representatives? We are in far greater trouble than that which was so well discribed if our decisions about prescription are coming from information gleaned in discussions with salespersons. I believe the drug companies are willing to believe this is true and to a large degree I think they do. Pharmacy is only part of the remedy, one that is complimented by behaviors directed at wellness. Knowing this relationship requires far greater insight than knowledge of a particular drug. If providers are not making decisions based on refereed articles in journals reputed for their internal validity, we have given up the the trust given us to reliably advise health care interventions responlibly.
George Farrell
clarksdale, ms
Dear FRONTLINE, Your prescription drug program was interesting but I am not sure just why you devoted so much time to PHARMA. Especially the time devoted to the "expenditures for research". Why was it not mentioned that forty-five percent (45%) of the drug companies research dollars come from the Federal Government through grants and taxwrite-offs and yet the government receives nothing in return in the way of a cut on the profits. It is also common knowledge that some 60% of their expenditures are for marketing and administration. My second point is, why was not Vermont and the Northeast Prescription Drug Association and their work not mentioned. Working together for group buying are also all New England states, New York, DC and Pennsylvania. They are making a real break through. You could have mentioned our Representative Bernie Sanders who was really the first to take busloads of seniors to Montreal for their drugs. My wife is on Tamoxifen through Cigna with a 50% co-pay. The cost locally was $356.00 for a three months supply. Her primary care physician now orders it through a Canadian pharmacy for $35.00 plus $10.00 shipping! Same product... and it is even unit-dosed! There is something wrong here, don't you think?
Berkeley Bennett
new haven mills, vt
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