Truly, The Guardian Is Written By The Insane

Or, perhaps, the Guardian is written by the ignorant, your call.

So, we’ve a screed from a GP about how appalling it would be if we replaced the National Health service with American style health care. OK, good so far, that American system is about the only one which is worse than the current NHS. After that it all rather falls apart though:

As a GP working in London, it is not uncommon for me to hear people say they can’t afford prescription charges, or that they don’t have the money to buy their medication until they get paid at the end of the month. Some drugs are so expensive they are wholly out of people’s reach. “But if this is such an effective treatment, why isn’t it available free on the NHS?”, patients ask me.

Well, drugs that are effective are on the NHS. And the maximum prescription cost for a year is £110. For all drugs, everything. The effectiveness is ensured by NICE, which won’t pay for a drug that is more expensive than the value gained from taking it. That is, drugs which aren’t either free or on prescription aren’t worth it – aren’t effective.

Even Polly Toynbee gets this so someone clever like a doctor should be able to grasp it.

But it doesn’t have to be this way. Progressive reform of the dysfunctional relationship between the state and the pharmaceutical industry is possible. But it requires the vision and political will to prioritise public health over private profit.

Labour recently announced plans to scrap prescription charges in England, bringing policy in line with Scotland, Wales and Northern Ireland. They have also announced plans to create a publicly owned drugs manufacturer, to supply cheaper medicines to the NHS. As a doctor, I welcome these plans that will put an end to difficult conversations with patients about whether they can afford to pay for their health.

And a publicly owned manufacturer isn’t going to make any difference. Because the problem isn’t with manufacturing cost. It’s with patents.

So, the whole thing is nonsense anyway. But then we come to this:

The US pharmaceutical industry is intent on making this happen. In the last two years alone they have collectively spent over half a billion dollars on lobbying ministers – and it appears to be working. In addition to the six official meetings between senior UK civil servants and their US counterparts, there have been five meetings behind closed doors with representatives of US pharmaceutical corporations to discuss drug pricing.

Half a billion bucks, eh? Truly, this is written by the insane or ignorant. Even, insanely ignorant. And, of course, it’s worse. At least two levels of editors at The Guardian have read through this and thought yup, that’s just fine.

Sure, we’re all proud of how money isn’t the only determinant in British politics but really. Half a billion – $500,000,000 – would buy the entire House of Commons let alone the Cabinet. Damn, the ex-Deputy Prime Minister is only costing Facebook a million a year.

Ameen Kamlana is a GP in east London and an NHS activist

You’d really look forward to checking the dose from a GP who can be out by three orders of magnitude, wouldn’t you?

As to where the half billion comes from:

Hence Mr Corbyn’s claim: “Remember Boris Johnson’s famous promise of £350 million a week for the NHS? Well his toxic Brexit trade deal with Trump could hand over £500 million a week of NHS money to big drugs corporations.”

Sure, it’s Jezza and making a claim in an election period and all that. But it’s lobbying for, not with, all the same.

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Rational Anarchist
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Rational Anarchist

500m a week needs sourcing. There’s a report I saw that said in 2017/18 the total NHS drug bill was £18bn (at cost price, not taking discounts into account). Why the hell would we do a deal that sees us spending £26bn just on drugs from America?

swannypol
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swannypol

Here’s a kings fund report substantiating your £18bn a year:
https://www.kingsfund.org.uk/publications/rising-cost-medicines-nhs
By the same token Corbyns “State Drug manufacturer” isn’t going to make very much difference to the overall NHS spend, even if run economically.

Jim
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Jim

Isn’t it the case the the US pharmaceutical companies are actually stiffing the US public, and selling their drugs at more competitive prices elsewhere? Mainly because they’ve got the US government bought and paid for, but pesky foreigners won’t play ball so they have to compete on price?

Mr Yan
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Mr Yan

Isn’t it the case that American’s are very rich (relatively) and so can pay more for medicine? Where countries aren’t as rich they charge less.

Gavin Longmuir
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Gavin Longmuir

Jim — remember Economics 101, the difference between marginal cost and full cost? The full cost of a drug includes all the research and (staggering) regulatory costs to bring it to market (and also the costs of all the dead-end research which never results in a marketable drug), along with all the investment to manufacture the finally approved drug at a commercial scale. The marginal cost is simply the additional time & materials to pop a few more pills out of the end of an existing production line. Historically, Europe has got a free ride off of the US citizen… Read more »

Quentin Vole
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Quentin Vole

The way it works. BigPharm invents new wonder dug (of proven efficacy). It sells it for $1,000 a packet. NICE say “nope, that’s too expensive for the Qualys it gains, we’re not buying.” Five years later, BigPharm have recouped some of their costs and the price has been reduced to $200 a pack, and the NHS will now buy it.

How is this a ‘free ride’? It’s like deciding not to buy the new iPhone that’s just announced, and waiting 12 months when it will be available at a lower price.

Gavin Longmuir
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Gavin Longmuir

Quenton V: “Five years later, BigPharm have recouped some of their costs and the price has been reduced … How is this a ‘free ride’?” You have already explained that Someone Else has paid for most of the Research & Development Costs. If Someone Else has already paid most of the cost of a medication, and now we get to buy it at closer to the marginal cost than the full cost, we are dependent upon the kindness of those strangers who are willing to pay the full cost. Otherwise, there would be no R&D and no medication for the… Read more »

Bishop Brennan
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Bishop Brennan

That’s propaganda – R&D costs are grossly exaggerated by Big Pharma, which has a productivity problem: instead of addressing that, it spends vast amounts of money lobbying the US government and advertising drugs patients don’t need to bump up profits. I’m all for capitalism, but many of these companies represent crony capitalism at its worst, along with the Defence and farming sectors, which follow the same lobbying model.

John B
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John B

In some European Countries that dysfunctional relationship between State and Pharmaceutical companies underwent progressive reform years ago and the price that a Pharma may charge is decided by the State. This explains why nearly all new drugs are developed in the UK, USA or Switzerland. Elsewhere instead of cash going to research, the money is spent on incentives for doctors to prescribe so low margins are compensated for in volume. ‘… so someone clever like a doctor…’ I laughed for two minutes when I read this, having spent a 25 year working life dealing with this breed. Clever, they ain’t.… Read more »

Mr Yan
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Mr Yan

How exactly does a free trade deal mean we have to pay more to US pharma companies for medicine anyway?

Spike
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Spike

NAFTA had little to do with Free Trade (hence the 1000 pages) and USMCA won’t either. One of the US’s hot buttons is that, in some countries, government negotiates the price for a medicine, and the maker (unwilling to abandon sales there entirely) agrees not to bundle in its R&D costs. Trump calls this “foreigners stealing from us!” and a typical Trump Free Trade treaty would prohibit it.

Jim
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Jim

How can a free trade deal force the buyer to pay a price he doesn’t want to? Or indeed force the seller to charge a higher price than he wants to? Nothing is stopping the US pharmaceutical companies bundling their R&D costs into their non-US pricing right now, except that they then won’t get the sales they get now, because the non-US customers will tell them to take a hike. So the market dynamic post free trade deal will be exactly the same as before it – the manufacturers want to sell extra product at marginal price + profit and… Read more »

Bloke in North Dorset
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Bloke in North Dorset

As a GP working in London, it is not uncommon for me to hear people say they can’t afford prescription charges, or that they don’t have the money to buy their medication until they get paid at the end of the month. This is utter bollocks. If they are that poor they are likely to be on benefits and prescriptions will be free anyway. These numbers are 5 years out of date but they won’t have changed much. The proposals are contained in a report looking widely at how health and social care systems can be brought together in a… Read more »

jgh
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jgh

She and the Grun truely are insane. If I was an NHS purchasing manager being faced with the choice of bandages from Smith & Nephew in ‘ull for ten quid, or bandages from duPont in America for twenty quid, in what insane world am I going to buy the American stuff?

Paul Devenish
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Paul Devenish

The US public are ripped off by Pharma companies claiming they need high reimbursement for R&D. In fact, as a number of studies have shown, they hugely inflate the costs of R&D – much of which are actually incurred by publicly funded researchers. On top of that, the mega mergers of big pharma in the 1990s / 2000s have destroyed productivity, with centralised research proving less successful than dispersed models. As the patents create a monopoly, prices need regulating on a utility model – the UK model does this, but fails because it’s cost-plus rather than insisting on productivity gains… Read more »