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Robert Reich

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How Not to Get Big Pharma to Change Its Ways

Posted: 07/06/2012 8:23 am

Earlier this week the Justice Department announced a $3 billion settlement of criminal and civil charges against pharma giant GlaxoSmithKline -- the largest pharmaceutical settlement in history -- for improper marketing prescription drugs in the late 1990s to the mid-2000s.

The charges are deadly serious. Among other things, Glaxo was charged with promoting to kids under 18 an antidepressant approved only for adults; pushing two other antidepressants for unapproved purposes, including remedying sexual dysfunction; and, to further boost sales of prescription drugs, showering doctors with gifts, consulting contracts, speaking fees, even tickets to sporting events.

$3 billion may sound like a lot of money, but during these years Glaxo made $27.5 billion on these three antidepressants alone, according to IMS Health, a data research firm -- so the penalty could almost be considered a cost of doing business.

Besides, to the extent the penalty affects Glaxo's profits and its share price, the wrong people will be feeling the financial pain. Most of today's Glaxo shareholders bought into the company after the illegal profits were already built into the prices they paid for their shares.

Not a single executive has been charged -- even though some charges against the company are criminal. Glaxo's current CEO came on board after all this happened. Glaxo has agreed to reclaim the bonuses of any executives who engaged in or supervised illegal behavior, but the company hasn't officially admitted to any wrongdoing - and without legal charges against any of executive it's impossible to know whether Glaxo will follow through.

The Glaxo case is the latest and biggest in a series of Justice Department prosecutions of Big Pharma for illegal marketing prescription drugs. In May, Abbott Laboratories settled for $1.6 billion over its wrongful marketing of an antipsychotic. And an agreement with Johnson & Johnson is said to be imminent over its marketing of another antipsychotic, which could result in a fine of as much as $2 billion.

The Department says the prosecutions are well worth the effort. By one estimate it's recovered more than $15 for every $1 it's spent.

But what's the point if the fines are small relative to the profits, if the wrong people are feeling the financial pinch, and if no executive is held accountable?

The only way to get big companies like these to change their behavior is to make the individuals responsible feel the heat.

An even more basic issue is why the advertising and marketing of prescription drugs is allowed at all, when consumers can't buy them and shouldn't be influencing doctor's decisions anyway. Before 1997, the Food and Drug Administration banned such advertising on TV and radio. That ban should be resurrected.

Finally, there's no good reason why doctors should be allowed to accept any perks at all from companies whose drugs they write prescriptions for. It's an inherent conflict of interest. Codes of ethics that are supposed to limit such gifts obviously don't work. All perks should be banned, and doctors that accept them should be subject to potential loss of their license to practice.

ROBERT B. REICH, Chancellor's Professor of Public Policy at the University of California at Berkeley, was Secretary of Labor in the Clinton administration. Time Magazine named him one of the ten most effective cabinet secretaries of the last century. He has written thirteen books, including the best sellers "Aftershock" and "The Work of Nations." His latest is an e-book, "Beyond Outrage." He is also a founding editor of the American Prospect magazine and chairman of Common Cause.

 

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HUFFPOST SUPER USER
safara
09:06 PM on 07/08/2012
Ommited from the fallout damage was the fact that patients, and government healthcare agencies paid for much of the drug company profits. Then, of course, there was the personal harm and deaths that result from this kind of profiteering.
HUFFPOST SUPER USER
safara
08:56 PM on 07/08/2012
This has been going on for years. At least these latest settlements do involve serious amounts. There was a time during the 1960's when drug co. executives were worried about being held personally responsible for capers like this. And for a very brief time they behaved. There was a pause in some abusive marketing practices resulting in a hiatus of dubious "me too" products and some policing of how pharmaceutical cos. promoted them. Soon with propaganda, pr and stepped up lobbying they captured the regulatory agencies (FDA etc.) resulting in what we're seeing now. The answer is to clean up the regulatory agencies, levy fines in proportion to the crime, curtail lobbying and hold corporate officials responsible. Both government and voters should stop being intimidated by Pharma's threats of harm to patients etc. We need perp walks along with bigger fines.
HUFFPOST SUPER USER
claraluz
Per aspera ad astra!
10:57 PM on 07/09/2012
The solution starts with the repeal of whatever laws permit lobbying by special interest groups. As long as there are lobbyists with fistfuls of money and goodies, there will be bought-and-paid-for politicians, along with Big Pharma business practices that harm patients. And that also goes for Pharma's courtship of doctors.
02:16 PM on 07/08/2012
Thank you, Robert Reich; you are one of the few sane voices in America. I appreciate your realism.

OBS
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HUFFPOST SUPER USER
Kyrani99
that Eternal Flame is the source of my shrine
03:43 PM on 07/07/2012
Yes I agree with you company executives should be held responsible, but even so executives are expendable. The company remains unchanged. The only way to get big pharma to change is for the humane people to roll up their sleeves and examine core issues like ESP WITHIN RELATIONSHIP, how emotions are rational changes to whole body function and comfort zone, sound psychological but not so. It’s somatic too!. In a crisis, it can be deadly. When people realize they can be in control of their health and their lives, then big pharma feels the heat.
Kick-backs to doctors and research professors all equals corruption alright BUT, no matter how deadly the side-effects, if we believe they are our only hope then we are bound hands and feet. When we discover that diseases, such as heart disease, cancer, diabetes, strokes and mental disorders are simply pathological stress that has reached fever pitch levels and that this stress is not happening due to “the hectic lives that we live in the 21st century” but toxic relationships, then the tide has turned. When we understand how they come about then we can get well and stay well WITHOUT DRUGS. This is what I am sharing with others on my blog at http://kyrani99.wordpress.com/ to help others achieve what I have achieved -no need of a doctor in 20 years and I have dealt with diseases such as cancer in that time with 100% satisfactory results. You can too!
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68Namvet
Sioux, French, German, Jew, American mutt
01:51 PM on 07/07/2012
One wonders, with Citizens United finding that corporations are people, why these people do not see jail time for producing a substance that, when taken per directions, can lead to severe side effects including death. If I were to feed my neighbor a hamburger laced with arsenic for flavoring, and he died, I would be serving jail time for manslaughter. Why are these "people" granted rights of an individual but, not liable for their criminal behavior?
HUFFPOST SUPER USER
claraluz
Per aspera ad astra!
11:01 PM on 07/09/2012
That's the million dollar question!! Obviously, they are "people" only when it comes to their influencing political elections or enjoyng tax cuts, but not to criminal liabilities.
12:34 PM on 07/07/2012
Every point you make, Mr. Reich, is a good one and worthy of scrutiny and explanation. Some commercials make it seem "hip" to be on a certain medication. Like the "Smiling Bob" commercials which it seems have fallen off the fact of the earth, Thank God.
02:30 AM on 07/07/2012
Big Pharma spends twice as much money on marketing than they do R&D-read the book "What the Drug Companies Won't Tell You and What Your Doctor Doesn't Know" by Michael T. Murray,N.D. Also, I'd like to see independent, third party research and studies/testing done. The studies are financed by Big Pharma, so it is in their best interest (profit) to ensure that their drug(s) and medical devices receive favorable or excellent results. Another good book to read is "Our Daily Meds" by Melody Peterson. Since corporations are people, I say prosecute, prosecute; fines are meaningless...jail time, now that will have an impact.

Also, Big Pharma and Big Agra pretty much own the FDA-look at how many people who used to work for the drug companies are appointed by the government to positions within the FDA or hired by the FDA. Also, some Congressman become lobbiysts for Big Pharma. Greed and corruption seems to have replaced "Do no harm." Very sad.
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HUFFPOST SUPER USER
dixonpa
05:36 PM on 07/06/2012
I agree that advertising of drugs should be stopped. This would be one way to save Americans from becoming more addicted to prescription drugs. I also think we should go to a single payer health care system with fixed costs for all medical procedures across the country. The only way to control health care costs, is to control the delivery system, and that includes the pharmaceutical industry and the insurance companies.
02:30 PM on 07/07/2012
You make too much logical sense, but Republicans would never let that happen. Their health care donors would not make the huge profits they have now under the rigged system.
HUFFPOST SUPER USER
claraluz
Per aspera ad astra!
11:09 PM on 07/09/2012
YES, that would be the logical solution, bu the Big Pharma lobbyists have way too much influence in Washington and won't let that happen. Countries with a single payer system have been able to contain health care costs and keep drugs affordable, which benefits patients but is seen as a big threat by the health care industry. Fanned and faved.
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HUFFPOST SUPER USER
Nichole Francois
My micro bio!
04:30 PM on 07/06/2012
Executives of corporations can't be charged with crimes. They're corporate entities and as such are legally protected by business law. It's a nice idea though.
06:52 PM on 07/06/2012
Of course, they can. Remember Enron? Lucky Ken Lay died before being imprisoned,
07:10 PM on 07/06/2012
"Corporations are people, my friend." Someone in the news recently said that.
02:35 PM on 07/07/2012
Exactly. The Supreme Court made that decision just like the Koch Brothers told them.
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TommoB
Restore sanity! Add Haldol to fracking fluid...
04:29 PM on 07/06/2012
"The Department says the prosecutions are well worth the effort. By one estimate it's recovered more than $15 for every $1 it's spent."

And this money has gone...where?

Another appalling development of the last couple decades: Law enforcement as a profit center. See drug law seizures and traffic cameras, for example.
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HUFFPOST SUPER USER
DrHopeful
Retired teacher, honors program director, author.
03:31 PM on 07/06/2012
What Reich says is embarrassingly obvious. How can the law permit the advertisement of prescription drugs? How can the law let those responsible for fraudulent and illegal actions go unscathed and continue to collect their compensations as if nothing had happened? To fine the corporation obviously does not get at the perpetrators. In effect, corporate CEO's and their executives are using their stockholders as insurance to bail them out when they get caught swindling!
02:38 PM on 07/07/2012
Now how many people on Wall Street were prosecuted for causing the 2008 collapse? Zero.
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HUFFPOST SUPER USER
ProgressiveChange
03:30 PM on 07/06/2012
Reich doesn't go far enough. Some physicians are curbed by parent organizations from accepting bribes ... but most are not. Many specialists are still engaged in ordering questionable tests and unnecessary procedures under the guise of defensive medicine. Of course, their allies in Congress play the game by pushing Tort Reform. Healthcare costs haven't been impacted in several states after caps on mealpractice awards were capped. Professor Reich should visit any of the medical specialty annual meetings to learn more about the depth and scope of physician-Big Pharma co-dependence.

America provides incentives for corporations to conduct criminal activities, kill or injure people through negligence or risk-taking, and retain ost of their ill-gotten gains. In principle, there is no difference between what GSK, Merck, Pfizer, and dozens of pharmaceutical companies do ... and what BP, Goldman Sachs, BOFA, Wells Fargo, Monsanto, etc. do. All of them imperil millions of people ... get exposed sometimes ... and write checks to settle claims.

So, here we are and have been as spectators in the sport of egregious behaviors, massive ill-gotten gains, exposure, investigations, and ... corporate checks written in settlement of claims. Executives take the hit with shareholders ... but $3 Billions in fines pales in comparision to ... Aandia which earned $10.4 billion, Paxil which earned $11.6 billion, and Wellbutrin which earned nearly $6 billion during the years covered by the settlement.

Congress: A Real Hoot!!!
HUFFPOST SUPER USER
claraluz
Per aspera ad astra!
11:17 PM on 07/09/2012
You are soooo right!!! And the people put up with it.... I have been saying for several years that corporations of all kinds are in charge here, as they play such a major role in government decisions affecting every aspect of our lives. Several decades ago, America Inc. used to be a staple of science fiction, but it is here now. F&F
02:59 PM on 07/06/2012
During the last 30-40 years while Big Pharma and its cousin Big Insurance increased their grasp on healthcare we have now created a society of unfit Americans where only 25% of our high school graduates can pass the military physical and entrance exam. Our high school drop out rates now hover around 30%.

Most Americans don’t understand the healthcare system; it’s complexity, and reimbursement system. They think doctors are getting rich which like in any business is true for some individuals but not for the majority. The real shift in wealth has been the healthcare dollars that go to Big Pharma and the Insurance industry. The claims management process, executive compensation, and unreasonably high profit margins alone account for most of our health care costs while increasingly placing less emphasis on wellness and prevention.

Big Pharma has also been placing increasing pressure on Congress and the FDA to prevent the use of natural supplements and labeling on natural foods that define their health benefits. It appears that over the last 30-40 years profits have become more important than protecting the health of the nation and its citizens.

What ever happened to integrity??
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HUFFPOST SUPER USER
Sharon Hanson
Skeptical of the *pseudo-skeptics*
03:50 PM on 07/06/2012
It is despicable isn't it? But I'm taking a wait and see attitude. Why? Because when the population is so sick the insurance companies see higher claims. Now they are regulated to spend 80% of premiums in payment of claims or return it to policy holders and they now have access to unlimited claim information. As a former data guru I can tell you that the largest employers and health insurance companies are frothing at the month to have such access. And I can also say they know what is making us sick (i.e. toxic pharmaceutical drugs, toxic scans and medical devices that malfunction like surgical mesh and metal on metal hip implants. This kind of relationship (i.e. profits of insurance companies being inversely impacted by pharma's profits has set up a built-in control over pharma that will be hard to undo. That is the single most important reason I think the ACA will have a positive impact on patient safety. They have been incentivized to keep us healthy.
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HUFFPOST SUPER USER
Sharon Hanson
Skeptical of the *pseudo-skeptics*
08:32 PM on 07/06/2012
I agree with what you say. But I also think that the insurance companies may be able to reel them in a bit because their profits are inversely related to pharma's profits. Health insurance companies have been incentivized to keep us healthly...they make more money that way whereas pharma just wants to sell drugs. Hopefully this will be good news for patient safety. Another thing, take a look at all the negative comments. No one is defending them. Most people don't trust them anymore. This has changed recently, within the past five years. People know they are up to no good.
02:48 PM on 07/06/2012
So if I go into a convenience store and steal $275.00 can I just pay a $30 fine and keep the rest of the money with no admission of wrongdoing and no jail time? I think not. We need to put corporate executives in prison when they steal. And we need to confiscate ALL of the profit as we would with any other category of criminal. There is no incentive for corporados to be ethical. We the people need to stand up to our legislators and demand better enforcement of better laws.
02:00 PM on 07/06/2012
How will the American public benefit from the $3B fine??? That is of course if and when the entire $3B is actually paid.

It would have been more befitting to take all of the profits made from these harmful drugs as ill-gotten gains in addition to the $3B. As it is now, they made a profit from doing harm.