Celebrex. Vioxx. Bextra. Celecoxib.
These so-called cox-2 drugs became household names because of the fortune our pharmaceutical companies spent selling their wares to America’s households on primetime TV. Now they are even more in the public eye, but certainly not in the way intended. Instead of pain relief and relaxation, they are now associated with heart attacks. Only Celebrex remains on the shelves, although with the precautions issued daily by its manufacturer, sales are plummeting.
The dangerous cox-2 saga highlights the trees in the forest. The trees are the individual medications. The forest is the for-profit pharmaceutical industry, a part of what passes for health care in this country, still the world’s only developed nation without comprehensive, universal health care.
The problems go well beyond the obvious doctor visits and acute hospital care. The failure to provide everyone with full coverage for needed medications is a huge gap. You only have to get a cramp, cough or some minor crisis that calls for drug relief and cure. The bill that comes at the end of your trip to the corner pharmacy will be a shocker.
No matter what your insurance status, you are a part of society that gets little allowance for prescription drugs. If you depend on Medicaid and Medicare, your budget will never allow for the expense of vital medications and preventative drug care.
U.S. pharmaceuticals enjoy a profit margin at least 10 times greater than any other U.S. industry. They tell us out-of-this-world drug prices are needed to cover research and development of new drugs (R&D). But over three-fourths (admitted to) of the support for R&D is from the National Institutes of Health and other federally funded agencies (read: taxpayers).
It gets worse. When successful research produces a valuable medication, the results are turned over to the drug maker — completely. All proceeds from eventual sales are company-owned! Worse yet, rival firms will undertake their own R&D, not for a new medication, but for a “me-too” drug. They will perhaps change a single, meaningless chemical and promote the result as a startling innovation. Then, when the original pharmaceutical company’s patent is no longer protected from generic versions of the drug, it will do the same, for still more profits. And so the cycle goes.
We know now that as few as 1,000 human studies were used for acceptance of the cox-2s for marketing. That is few by any measure, but more glaring when you recall the RU-486 history. It took several years and tens of thousands of cases for approval of this agent for pregnancy termination, despite its already well-known medical success and safety. We all know that delay was based on the staunch “moral majority” objection (read: friends of George W. Bush).
Since our health care industry has made care a for-profit commodity, we should not be surprised that we get dangerous medications peddled on TV sitcoms and the World Series between innings. And those promos are very successful. Drug company bottom lines are soaring.
The solution? It’s simple, although not easy to achieve. We make health care a right, not a privilege; establish a 28th amendment to the Constitution to assure us of that right; and finally, create a federally-administered, truly universal, single-payer health care program to implement that right. We can accept no less.
Don Sloan (donsloan@nyc.rr.com) is an ob-gyn physician and author of “Choice: A Doctor’s Experience with the Abortion Dilemma.”
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