News

Ban evergreening and restricting generics to reduce drug prices, says US academy

BMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j5624 (Published 04 December 2017) Cite this as: BMJ 2017;359:j5624

Could US academies deliberately blow in the wind? It takes two to tango!

Could US academies deliberately blow in the wind?
It takes two to tango!

The National Academies of Science, Engineering, and Medicine recommended among 27 points: a) reducing the number of drugs that can be prescribed through Medicare; b) restricting direct to consumer advertising; c) restricting “evergreening” drugs to extend their patents and “pay-to-delay”—where drug makers pay generics manufacturers not to enter the market.(1)

At first glance I felt that these academies had only just discovered warm water and that a lawyer (bachelor degree could have been enough) could have explained to them that “pay-to-delay” is an understatement for a serious breach of anti-trust/anti-competition laws which directly and seriously affect patients and national health systems. In the US, the main statutes are the Sherman Act 1890, the Clayton Act 1914 and the Federal Trade Commission Act 1914. In the European Union it is more recent (EC 1/2003 of 16 December 2002) and was used in cases concerning AstraZeneca and Lundbeck. (https://www.lexology.com/library/detail.aspx?g=5ea66772-4cdf-419c-9783-5... http://europa.eu/rapid/press-release_IP-13-563_en.htm)

However, everywhere fine levels are always far lower than the illegal profit, their aim seems not to prevent corruption but to be a smokescreen. Indeed, even serial and the highest fines never affected stock prices as with GlaxoSmithKline which agreed on $3bn to settle civil and criminal investigations into its sales practices for numerous drugs in 2011, its fourth case since April 2008.(2)

Can US academies ignore why the drug industry can be the biggest defrauder of US government?(2) Applying Gustave Le Bon’s theorem may provide a response: "The IQ of a mob is the IQ of its most stupid member divided by the number of mobsters." The National Academy of Sciences, Medicine and Engineering membership consists of approximately 6,500 members.

At least, this news may help to understand Trump’s election. US academies recommendation is one among too many examples of the soft diplomacy that has been nurturing Trump’s cynicism who can easily claim: “All talk, no action, sounds good, doesn't work, never going to happen.”(https://www.youtube.com/watch?v=Gmyv13Avmfs)

1 Roehr B. Ban evergreening and restricting generics to reduce drug prices, says US academy. BMJ 2017;359:j5624.

2 Braillon A. Drug industry is now biggest defrauder of US government. BMJ 2012;344:d8219.

Competing interests: No competing interests

06 December 2017
alain braillon
senior consultant
University Hospital
Avenue René Laënnec