According to this article in the New York Times, lobbyists for the nation’s pharmaceutical industry plan to spend $150 million on television commercials touting President Obama’s health care plan.

That’s really bad news for the rest of us.

PhRMA President & CEO Billy Tauzin

Former Louisiana Representative Billy Tauzin, who shepherded through congress the 2003 Medicare Prescription Drug Act which forbids Medicare from negotiating for discounts on prescription drug prices, is now gainfully employed as the President and CEO of Pharmaceutical Research and Manufacturers of America, or PhRMA. In that capacity, he has promised to shave $8 billion a year, or $80 billion over a period of ten years, off the price of prescription drugs. In return, the White House has agreed not to seek deeper cuts.

This is an astonishing announcement. Besides being a blatant violation of a key campaign promise, this is a virtual admission that the pharmaceutical industry has been gouging us. Wasn’t the invisible hand of the marketplace supposed to keep that from happening?

Of course we all know the answer to that one. There is no free market for prescription drugs – unless by the phrase “free market” you mean “shoveling as many taxpayer dollars as possible into the coffers of giant corporations.”

Common sense would tell you that if the pharmaceutical industry is willing to own up to gouging us out of $8 billion a year in excess charges, the actual figure must be much higher. And, as usual, common sense would be right.

According to a study published by the Institute for America’s Future, if Medicare were able to negotiate the same drug prices that the Veteran’s Administration already gets, the taxpayers would save $30 billion a year, or $300 over the next ten years.

So, in plain English, Obama’s plan will allow the pharmaceutical companies to gouge us for $220 billion in excess charges over the next ten years.

Even that figure is too low. We’re just scratching the surface here. The truth is, we are an insanely overmedicated nation.

In this era of specialization, the General Practitioner has gone the way of the hand-cranked telephone. All too often, there is no one to look out for the patient as a whole person, and as patients go from one specialist to another, layer upon layer of prescriptions build up, like plaque in Rush Limbaugh’s coronary arteries. Half of our senior citizens take five or more prescription drugs or supplements on a regular basis. Is all of this drugging of our elderly population really doing them any net good?

This is a question that deserves careful examination.

The pharmaceutical companies are always blabbering that they need to charge the outrageous prices they charge so they can afford to develop new medicines. And heaven knows, we are all fragile creatures who would fall over dead if it weren’t for this constant infusion of new medicines.

Or, maybe not.

Let’s leave aside for the moment the point that, for the most part, it’s not the drug companies who develop new medicines. That’s a subject for another essay, another day. In the book Our Daily Meds, author Melody Peterson points out the dirty little secret of the pharmaceutical companies, one that most people probably never dream of: many of these new “medicines” do NOTHING for MOST of the people who take them.

Consider a drug like Pravachol, a statin prescribed to lower blood cholesterol. The West of Scotland Study showed that out of every 100 men taking this drug, there were two fewer non-fatal heart attacks and one fewer death. In plain English, out of every 100 men who took the drug, ninety-seven received no benefits whatsoever. Lowering cholesterol is not, in and of itself, a benefit. It’s a benefit only if it helps you to avoid death or heart attack or some other hard clinical outcome.

Why don’t they mention this in their ads? “Pravachol may help you to avoid a heart attack or premature death – but it probably won’t.”

And all this begs the question of whether these men wouldn’t have been better off with lifestyle changes. The men in this study were judged to be in the subset of the male population most at risk for a first heart attack. It’s a pretty safe bet they didn’t get there by exercising and eating sensibly.

So in plain English, many of these new “medicines” have been approved on the basis of barely measurable effects. Add to that the fact this business of the FDA approving drugs on the basis of “surrogate outcomes,” such as lowering cholesterol, without requiring any evidence that they actually save lives. Consider a drug such as Zetia, one of the two active ingredients in the cholesterol-lowering drug Vytorin. Clinical trials have shown no evidence that Zetia reduces the risk of heart attack or death, while it may actually increase the risk of developing cancer.

Add to this the fact that while many of these new medicines are intended mainly for elderly patients, there is no requirement that they be tested in elderly patients. For a variety of reasons, elderly people often metabolize drugs differently than younger patients do.

Add to this the fact that the pharmaceutical companies routinely bury negative results, and the fact that a study published in BMJ found that half of US internists and rheumatologists admit to prescribing placebos to their patients. Finally, consider that there are few studies that asses the affect of taking more than one medication at a time, and none that assess the effect of taking five different medications simultaneously, and I submit to you that there is no reason to believe this cocktail of drugs we have our senior citizens swallowing is doing them any net good.

We do know that between 1980 and 2003, per capita spending on drugs, adjusted for inflation, increased by a factor of seventeen times. Not seventeen percent more -- SEVENTEEN TIMES more. And during this time, life expectancy at 65 has barely budged -- and I’d be willing to bet that most of the increase – maybe all of it –is because fewer people are smoking.

We still grow old and die. That hasn’t changed.

I've been wondering, as of late, why our senior citizens so jealously guard their right to overmedication. I believe the author Ivan Illich said it best, more than thirty years ago, when he wrote, "The transformation of old age into a condition calling for professional services has cast the elderly in the role of a minority who will feel painfully deprived at any relative level of tax-supported privilege."

It is my view that a hallmark of a healthy society is that is cherishes its senior citizens. I also believe the best way to do that is to take the time to listen to them, to allow them to share the accumulated wisdom of a lifetime – not to ply them with as many expensive “medicines” and invasive treatments as they will stand for.

This deal President Obama cut with the slippery Billy Tauzin is a colossal windfall for the drug companies – and a colossal ripoff of everybody else.

All photos via Wikimedia Commons