Big Pharma Isn't in the Business of Saving Lives

• Medicines are now getting harder to come by — Yannis Natsis, a policy manager at European Public Health Alliance, said that despite the massive profits of Big Pharma, shortages are occurring:

“In the past, it was only a problem that had to do with southern Europe or Eastern Europe and now, it touches upon even the richest and wealthiest EU member states in the west. And this is why this issue has gained a bit more prominence.”

• Big Pharma always wins — While being bound by laws, drug manufacturers always seem to have an upper hand on governments and doctors because they’re too important. As one expert noted, “In the arm wrestling between the pharmaceutical industry and governments, the pharmaceutical industry invariably wins.”

• Priorities are always on the moneymakers — In Mexico, 1,600 have died due to medicine shortages. Yet, Viagra is always available, demonstrating how Big Pharma values its different consumer groups.

• Digging deeper into the supply issue — Globalization has allowed health institutions to purchase medicines from around the world, but this is causing pressure among buyers when faced with shortages. As one hospital pharmacist explains:

“We’ve stopped being supplied with numerous molecules and medicines. This concerns 69 products at the moment and we’ve been faced with 17 new ones over the last three weeks. If I take a list of molecules today, we have shortages of completely classic medicines.”

• Patents are held for a long time — The documentary explains how manufacturers control the prices once a new drug enters the market:

“The profitability of a drug evolves with time. At the beginning, the medication is protected by a patent. A high price is accorded to the maker who has the monopoly on sales for 10 to 20 years. This is the most profitable period when the price and volume of sales are at their highest. When the patent expires, the drug can be copied in generic form. It therefore becomes less profitable due to the reduction in price and the competition.”

• Big Pharma manipulates the market — Despite knowing the importance of certain medicines, Big Pharma willingly removes them to create scarcity. Natsis explains:

“We see a lot of products, a lot of medicines, which have been widely used. And long-established medicines being withdrawn from the market only to be reintroduced to the market with higher prices, for instance. Or, there is a push to say that ‘if you don’t want to have shortages then you need to pay the highest.'”

• Another example of Big Pharma’s lack of cooperation — In another interview, a teenager explains that she has allergies and needs an epinephrine pen to keep the symptoms at bay. However, ALK, the manufacturer that makes them, has discontinued production, despite hundreds of thousands relying on this life-saving drug:

“ALK laboratory produces them for 500,000 clients around the world. But in 2017, it stopped selling auto injectors in Spain. It refused a government-imposed price drop. For patients the product became difficult to obtain.”

• Big Pharma doesn’t want to be controlled — While manufacturers set the price, governments also do their best to lower it to ensure all citizens have immediate access. However, as the vice president for the epinephrine manufacturer justifies:

“When we launched the product, it was €34 back in 2011 in Spain. Then, there was a price decrease or a few, but at least it ended on €27. And then there was the last imposed price decrease in 2018, getting it down to less than €24. That was the last draw for me.

The €24 would be, by far, the lowest price in Europe, and this comes back to my point that in essence, you could say the one who pays the lowest price, eventually, it will be the price for everyone. This would kill then the entire business force. And this was why I said, ‘Sorry, dear Spanish government. We cannot honor this anymore. It’s impossible for us the price was already too low.’ We need to say, ‘no thank you.'”

• Cancer medication supply is being controlled — BCG-Medac “is experiencing severe supply difficulties,” explains a hospital pharmacist interviewed in the documentary.

• A quota system develops — According to the documentary, supply shortages give rise to a medical quota system. Here, medicines in short supply are only given to priority patients, making them unavailable to people who are also just as deserving in receiving treatment.

• Other labs are not interested in saving lives — A French patient explains that he needs BCG-Medac for his bladder cancer. However, his urologist told him that there are no treatments available:

“Since 2020, only the German laboratory Medac sells this treatment in France but it does not have the capacity to fill hospital demand. And none of the large laboratories are interested in this old medication resulting from a vaccine invented more than a century ago. The famous BCG [vaccine] given to children against tuberculosis.”

• Triage is now commonplace — The practice of prioritizing which patients to treat comes from wartime experiences. To distribute BCG-Medac, a French professor was forced to apply a triage scheme:

“It’s always difficult to tell a patient they can’t have access to treatment. But if this has to be the case, it’s better that medical reasons be used to select or — to use a word that mustn’t be abused — sort patients. By which I mean in terms of gravity of the illness.

It was above all to ensure equity of medical access across the country, so that a patient in a remote region wouldn’t have less chance of access to treatment than somebody in a large city. It was also to make sure there was no financial influence, that a wealthy patient would not have more chance of receiving treatment.”

• A committee is formed — Representatives from the government and drug manufacturers discuss via committees. Philippe Bouyoux, president of the Economic Committee for Health Products, explains that “for every medicine, we examine the proposition made by a laboratory, and the committee reacts accordingly.” Going deeper into this:

“Each week, the committee brings together representatives from the health and finance ministries behind closed doors. This is where the arm wrestling between the state and the laboratories takes place.

For each drug, we look at the medical service which it provides, then we consider it for this particular health objective … It’s quite a challenge to satisfy the expectations and needs of patients without putting in danger the sustainability of the public purse.”

• Supply prices and distribution are abused by Big Pharma — The documentary also interviewed a Belgian mother whose child has spinal muscular atrophy (SMA), a rare genetic illness affecting 1 in 10,000 children. However Zolgensma, a gene therapy available for this disease, was priced at a whopping $2.125 million by Novartis — impossible for ordinary citizens.

Furthermore, the gene therapy was only released in the U.S. “In Europe, it was neither reimbursable nor even approved by the European Medicines Agency,” the documentary explains. Fortunately, the mother was able to help her daughter through a fundraising campaign.

• Big Pharma will give you the cold shoulder — If you can’t pay the price set by manufacturers, they will ignore you. The mother shares her experience:

“Novartis contacted us saying that they sympathized. That they were deeply touched by our story, but that they couldn’t give us a reduction. In fact, what they said was if you don’t have the $2 million, she can’t have the treatment.”

• Prices are pulled out of thin air sometimes — How does a single drug cost millions of dollars? While companies’ base prices on manufacturing costs, certain products are priced arbitrarily. As noted by the documentary:

“Novartis did not calculate the price in terms of production costs, but instead, according to what society is prepared to pay to have access to the treatment.”

• Monopolies are hurting citizens — Manufacturers can set high prices for special medications because of its rarity. While problematic, it is still legal, and no one can challenge Big Pharma, as they’re too powerful. If a patient was able to purchase the medication they need, they’re now drowning in medical debt. Wilbert Bannenberg, president of the Pharmaceutical Accountability Foundation, explains:

“Pharmaceutical companies have the right to do this. It isn’t forbidden. They have the monopoly. They ask the price which they consider right, but it’s like throwing a life belt to somebody who’s drowning. Then, when the person asks, ‘How much do I owe you?’ You reply, ‘I saved your life. You’ll live for another 20 years, so that’s 20 times €80,000 which makes €1.6 million.'”

• A systematic reset is needed — In a press conference, Obrador explains, “The whole system was defective. Production, distribution, and the buying of medicaments. It was just another business. But we are talking about medicaments. And there was so much corruption as well.”

• Exposing the drawbacks of corruption — The government of Mexico singled out PiSA Farmaceutica, which is responsible for half of the anticancer drugs sold in the country. Here’s what authorities found afterward:

“The drug agency inspected their factory and realized that it wasn’t up to standard. Bacteria had spread through the laboratory when the production line was halted. What did PiSA do? PiSA met with the directors of the agency and tried to pressure them into production to continue without carrying out improvements.”

• Big Pharma isn’t afraid to fight back — When the government of Mexico closed down several factories due to poor conditions, PiSA refused to supply the market. Consequently, this showed how drug manufacturers are able to influence public health simply because they don’t want to be held accountable.

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