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Archives | (July 2002)
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THE RISING TIDE OF PRESCRIPTION DRUG COSTS:
A CORPORATE CON JOB (cont.)
------------------------------------------------------------------ Page 3 of 6 The trouble is that most of the panels that establish standards of care for each specialty are comprised of physicians who have ties to the pharmaceutical industry. They rely on the industry for research grants, honoraria, consulting contracts and other substantial financial benefits. As a result, the influence of “Big Pharma” on these panels is pervasive. A telling example of how these panels can manipulate standards of care to benefit their pharmaceutical company patrons is found in the recent change in standards of care for managing cholesterol. CHANGING THE RULES TO BENEFIT THE BOTTOM LINEIn 1993, federal guidelines were established for managing cholesterol. A key element of these guidelines was the determination that patients with cholesterol levels above 200 should make dietary and lifestyle changes to reduce their cholesterol level below that figure. These included reducing the overall level of fat in their diet to no more than 30% and reducing the level of saturated fat to no more than 10%. It also recommended increasing the intake of soluble fats. If a patient’s cholesterol was above 300, the guidelines recommended placing them on cholesterol-lowering drugs. Even these guidelines, however, were flawed. In focusing on the total cholesterol level, the guidelines ignored the fact that the ratio of LDL, or so-called “bad” cholesterol to HDL, or “good” cholesterol was the real measure of a healthy cholesterol level. In fact if the HDL level was too low, even if overall cholesterol levels were low as well, the patient still faced an increased risk of heart disease. Under the 1993 guidelines, 52 million Americans would fall under the category that required dietary changes and 13 million would require cholesterol-lowering drugs. Last year, however, the National Institutes of Health issued recommendation that the guidelines for management of cholesterol be revised. The panel recommended changing the dietary guidelines for patients with elevated cholesterol by reducing the permissible amount of saturated fat in the diet to 7% while raising the overall permissible level of fat to 35%. Most important, however, the panel recommended that cholesterol-lowering drugs be administered to patients with levels above 200 rather than 300. The impact of this change was stunning. Under the new guidelines rather than 13 million Americans being candidates for cholesterol-lowering drugs, 36 million – three times as many – would now require drug therapy. The windfall “Big Pharma” will reap from the change is almost beyond imagining. On average a prescription for a cholesterol-lowering drug cost $88 in 2001. This comes to $1,046 per year. That means that if all 23 million candidates are put on these products, sales will jump by roughly $24.3 billion annually! |
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