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The More Things Change

1,100 industry arm-twisters have spent over $1 billion since 1998

We've come a long way from the days of Warner's Safe Cure for Diabetes.

Warner's was an elixir peddled at the turn of the last century, typical of a generation of potions that were heavy on promotion and light on actual benefit. After decades of debate and a timely push from Teddy Roosevelt, Congress passed the Food and Drug Act of 1906. But like that law, every effort to regulate the industry since has faced stiff resistance from the drug industry. Granted, the pharmaceutical industry has helped make the nation healthier, kept us out of hospitals and nursing homes and extended our lives. As a nation, we depend on drugmakers' research skills and creativity. Still, the industry continues to mix a potent brew of financial largess and political influence that at times has stymied public officials and overwhelmed lawmakers.

Let's follow the money:

Approval money. The Food and Drug Administration expects $400 million from the drug industry to finance the approval process of brand-name drugs next year. That distorts the FDA's drug approval process by accelerating availability of high-cost drugs at the expense of a growing backlog of low-cost generics whose approval depends on scarce federal funds.

Campaign money. The drug and health products industry has directed $93 million to congressional and presidential candidates since 2000, according to the nonpartisan Center for Responsive Politics.

Lobbying money. An army of 1,100 lawyers and arm-twisters has spent over $1 billion since 1998, more than any other industry, to influence public officials and shape drug legislation.

These three financial trails converged with a new Congress this spring and deflected efforts to secure greater FDA scrutiny, to let the secretary of health and human services bargain for lower drug prices and to reduce drug costs by legalizing imports from Canada. Over the last four years, industry lobbyists effectively blocked at least six separate bills approving importation. In May they did it again. The Senate also rejected a partial advertising ban for new drugs and the addition of another step to the approval process that would have added an independent voice in post-market assessments.  . That amendment failed by one vote. 

The one constant in these debates was the pharmaceutical lobbying money and campaign contributions. This is not to suggest that the senators were bought off by campaign contributions. That's illegal, and it's not how the system works. But campaign contributions do provide special interests greater access to lawmakers.

And where does that leave consumers? Americans pay almost twice as much per capita for their medical care as people in other industrialized nations, yet our longevity rate is lower and our child mortality rate higher. The drugs we take are a major factor in those inflated numbers for medical care. A recent study by the management consulting firm McKinsey & Co. calculated that each American pays $728 a year for prescriptions, nearly twice the average cost for the industrial world. The pharmaceutical industry is fond of saying that as a share of the total health bill, Americans pay no more for their drugs than they did in 1960. That ignores the fact that the cost of health care today is three times what it was in 1960.

Warner's Safe Cure is long gone—except at antique shows. It was banned in the 1930s. In its wake are higher prices and a regulatory system that is vastly underfinanced and overwhelmed and remains too close to the pharmaceutical industry it is supposed to regulate.

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