Trump health care is welfare for Big Pharma

by Tom Maertens, Vox Verax

The Trump administration continues trying to kill the Affordable Care Act, to cut Medicare (by $845 billion) and Medicaid (by $1.5 trillion) while Trump simultaneously proclaims the GOP is the party of health care.

Trump also promised lower drug prices; then he appointed Alex Azar as secretary of HHS and a dozen former Big Pharma lobbyists. While at Eli Lilly, Azar hiked the price of insulin from $21 to $255.

The results are predictable: Fortune recently reported that drug makers had raised the prices on 250 drugs in 2018; in addition, Trump’s renegotiated NAFTA (now USMCA) increases the patent rights of biologics to 12 years, insuring continued high drug prices.

Big Pharma frequently blames price increases on research costs, but most pharmaceutical companies don’t fund any research; the 210 drugs that were patented by the FDA between 2010 and 2016 were all developed with National Institutes of Health money, some $100 billion.

Big Pharma is notorious for manipulating data, physicians, and politicians — paying for conferences, presentations, ghost-written studies, endorsements, clinical trials, advisory boards, peer reviews, advocacy groups/charities that demand new treatments, and experts who regularly warn about the next epidemic.

Among their methods is a statistical deception called RELATIVE Risk Reduction, to promote drugs; reducing a trivial risk by half is hyped as a 50% risk reduction; the absolute risk reduction may be as low as 1%.

Some of the big medical journals have called them out for their practices. Dr. Marcia Angell, editor-in-chief of the New England Journal of Medicine for 20 years, has estimated that Big Pharma spent billions every year to corrupt the system. Angell has said that “It is simply no longer possible to believe much of the clinical research that is published....”

Richard Smith, who edited the British Medical Journal for many years, complained that much published work is misleading and of low quality, a view shared by Drummond Rennie, former deputy editor of the Journal of the AMA.

Richard Horton, editor of The Lancet, has characterized the peer review system as “biased, unjust, unacceptable, incomplete, easily fixed, often insulting, usually ignorant, occasionally foolish, and frequently wrong.”

Peter Gotzsche, a former drug salesman turned physician, has likened Big Pharma to the mob, paying off doctors, academics, journals, professional and patient organizations, journalists, regulators and politicians.

Such skepticism prompted the Physician Payments Sunshine Act of 2010 which mandated more transparency about doctor-industry relationships, and led to the Cochrane Collaboration, which doesn’t accept industry money.

Public Citizen has found that the pharmaceutical industry is the biggest defrauder of the federal government under the False Claims Act of any industry, worse than big tobacco. Pharmaceutical companies have paid billions in fines or settlements for fraud, false advertising, and kickbacks. (https://en.wikipedia.org/wiki/List_of_largest_pharmaceutical_settlements)

One of Big Pharma’s goals is to develop drugs intended to be taken in perpetuity such as antidepressants, statins, and asthma-control medications.

When the College of Cardiology lowered the threshold for stage 1 high blood pressure to 130/80 in 2017, it doubled the number of adult Americans with hypertension to about 46%. The chairman of the guidelines committee said that people over 55 with normal blood pressure have a 90% risk of developing high blood pressure down the road. Ka-Ching$$$$.

Statin manufacturers pay for repeated trials to show that high cholesterol causes Coronary Heart Disease and stroke. The reason is clear: lifetime sales of just one drug, Lipitor, exceed $140 billion.

In contrast, studies without industry funding, like the U.S. Government ALLHAT-LLT and another by the University of British Columbia, refute the cholesterol hypothesis.

Diamond and Ravnskof have observed “that high cholesterol is not a risk factor for CHD has been documented in many studies on a broad range of individuals, including women, Canadian men, Swedes, Maoris, elderly people and patients with CHD.“

There are several studies that show all-cause mortality is actually lower for people with high LDL (the ‘bad’) cholesterol (British Medical Journal, 9/7/17). In addition, “in no statin study done has there ever been an impact on overall mortality in women. None, ever.”(Dr. Malcolm Kendrick).

Big Pharma spent $280 million in both 2017 and 2018 lobbying the Trump administration to prevent regulation or price rollbacks.

Big Pharma also spent $62 million in 2016 to elect mostly Republican candidates; in return, Trump’s tax cuts saved the 10 largest pharmaceutical firms at least $76 billion. Some 60 of the biggest corporations in the country, including pharmaceutical companies, paid no taxes on billions of dollars in profits last year.

The real Trump program, it’s clear, is corporate welfare and socialism for plutocrats, capitalism for the schlubs.

Tom Maertens held several science and technology positions in the U.S. government, including minister-counselor for Environment, Science, and Technology at the U.S. Embassy in Moscow.

Also published in the Mankato Free Press, April 20, 2019.