The Price of Medicine in America

This is ____________. And this is _____________with the VOA Special English program EXPLORATIONS. Today we tell about the issue of how drug companies sell their products in the United States.

Drug companies sold about one-hundred-fifty-thousand-million dollars worth of their products in the United States last year. This represents an increase of about nineteen percent over Nineteen-Ninety-Nine. The prices of the drugs rose on average almost four percent last year from the year before.

Economic experts say Americans are spending more on drugs because the population is getting older. One report says the prices of fifty drugs most often ordered by doctors for older people rose more than the rate of inflation.

The drug companies say the money paid for the drugs helps support research and development. An organization representing drug manufacturers says companies produced new treatments for thirty diseases in Two-Thousand. They included drugs for heart disease, cancer and AIDS.

Critics say prices for drugs are too high partly because the drug industry spends too much money selling its products.

People in the United States buy medicine in two ways. They can buy some medicines in a store without an order from a doctor. These are called over-the-counter drugs. They usually are mild, like aspirin. Over-the-counter drugs generally do not create unwanted effects on the body.

Other medicines require the written or telephoned permission of a doctor for a person to buy them. These prescription medicines are usually more powerful than over-the-counter drugs. Under some conditions they can cause unpleasant or dangerous effects. Prescription drugs usually cost more than over-the-counter drugs.

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For many years, drug companies have used sales messages aimed at the public to help sell their over-the-counter products. They advertised their prescription drugs mainly in publications for doctors.

In the last few years, the companies have increasingly tried to sell prescription drugs directly to the public. They spent thousands of millions of dollars on advertising the drugs last year. Some experts say that is why American doctors prescribed six-percent more drugs during Two-Thousand than the year before.

Some companies buy advertising messages, known as ads, in newspapers and magazines, and on the Internet. A number of companies also buy ads on television.

One such television ad shows people of different sexes, ages and races. They look tense and sad. An announcer says they are suffering from severe depression. He asks if people watching the ad have this problem, too. If so, he says, they should talk to their doctors about getting the drug.

Drug-industry critics say such ads sometimes cause people to ask doctors for medicine they do not need. Or, people may ask for a costly medicine when a less costly one would be equally good.

Drug companies say advertising is helpful. They say ads help people recognize health problems. They say advertising also increases public knowledge and choice of treatments.

The Federal Food and Drug Administration began supervising ads for prescription drugs in Nineteen-Ninety-Seven. This spring, the agency criticized eight manufacturers for their ads about drugs for HIV. The virus causes the deadly disease, AIDS. The government said the ads gave people wrong ideas. Officials told the companies to change the message.

For example, one ad for an HIV drug shows a group of young people. They are climbing on a mountain. They look healthy and full of energy. But Food and Drug Administration officials and other health officials objected. They say the ad misled people. They say it communicated the false message that AIDS patients can live totally normal lives.

The prescription drug Celebrex treats arthritis. This disease causes joint pain and difficulty moving. It affects the neck, back, knees and other parts of the body.

A recent ad for Celebrex showed people doing demanding physical activities. At the same time, energetic music played. The people moved their bodies easily. They appeared to have no pain.

The Food and Drug Administration said the ad promised too much improvement from taking the drug.

Celebrex changed the ad.

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Drug companies also pay millions of dollars to place ads in publications for doctors. In addition, the companies send sales representatives to doctors' offices. They tell the doctors more details about their products. The representatives also provide examples their products.

Many companies offer doctors more than free samples.

A half-century ago, drug manufacturers gave doctors small gifts like pens and writing paper. Today, some companies are paying for costly meals and holiday trips for doctors. In return, they hope the doctors will prescribe their drugs.

Drug companies also ask doctors to take part in focus groups. These discussion groups meet to gather expert opinions on health issues. The companies sometimes pay as much as several thousand dollars to people taking part in the focus groups. Some doctors suspect the main purpose of these groups is to increase support for the companies' products.

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Millions of people in the United States belong to health-insurance plans. These plans help pay for services by doctors and hospitals. Many insurance companies also pay part of the cost of prescription medicines. Yet insurance officials say increased prices may force them to stop doing this.

One of America's largest health-insurance companies is proposing a way to cut prices. It has asked the Food and Drug Administration to permit three prescription drugs to be sold without prescription. These allergy medicines treat bad reactions to materials such as dust, trees and food. The insurance company says the drugs are safer than most over-the-counter products. It says people do not need a doctor's permission to take them.

Experts for the drug companies, however, say these medicines might harm people if used without medical advice.

Almost five-thousand-million dollars worth of the three allergy medicines were sold in the United States during Two-Thousand. One of the prescription drugs costs more than two dollars for each pill in the United States. The same drug sells over-the-counter in Canada. There, it costs seventy cents for each pill without tax.

Legal experts say it does not appear that the drugs will be sold over the counter in the United States any time soon. They say no one is sure the Food and Drug Administration has the right to make such a decision.

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Drug companies hold patents which give them the legal right to be the only seller of some of their drugs. These patents protect against competitors producing less costly copies of the drugs. The copies are called generic drugs.

Protection against generics is not permanent. When the time limit for a patent ends, a competing company can sell its generic version of the drug. The more costly drug often loses about half its business within months after the generic drug is first sold.

Some companies are trying to use legal action to delay producers of generics from introducing competing products. For example, the Schering-Plough Corporation now holds the patent to sell the allergy drug Claritin. But its patent ends in about seventeen months. So the corporation is bringing legal action against ten manufacturers of generics.

Schering-Plough says people taking Claritin produce a substance in their livers called a metabolite. The corporation holds a separate patent for the metabolite. This patent does not end until Two-Thousand-Four. The corporation claims generics cannot be sold until its rights to the metabolite also end.

This kind of argument has never won in court. But such legal action does delay introduction less costly generic drugs.

Widespread concern about drug prices has caused President George W. Bush to propose a solution. The president proposes that drug companies help older people pay lower prices for drugs. Five big health-care companies have promised to co-operate with the plan.

Many members of the opposition Democratic Party oppose the plan. They say the measure does not provide nearly enough help.

There is only one agreement about the debate over the price of drugs and how they are sold in the United States. Everyone agrees that there are no easy answers.

This Special English program was written by Jerilyn Watson and produced by ___________. This is _______________. And this is ______________. Join us again next week for another EXPLORATIONS program on the Voice of America.