Questor Behavior Begs for Controls

Charles Ornstein’s article in Upshot   http://www.nytimes.com/2014/08/05/upshot/the-obscure-drug-with-a-growing-medicare-tab.html discusses one more example of the unethical dealings of the pharmaceutical industry.   An old drug (ACTH) with a newer brand name (Acthar)  is reaping profits with no evidence that it gives any better results than inexpensive cortisone-type pills and injections.

When I started medical practice in 1964 a common treatment for arthritis and other inflammatory conditions was the ACTH shot. ACTH is adrenocorticotropic hormone, a hormone which we all have in our bodies. It is made by our pituitary gland and is responsible for the feedback mechanism that regulates the cortisone output by our own adrenal glands. ACTH causes us to increase our own output of cortisone. That reduces swelling and makes inflamed tissue feel better. In 1964 that was the rationale for using it.  But then came along the oral cortisone preparations such as prednisone (which costs about 1 cent a pill to make) and ACTH was no longer used (I think it used to cost about $5.00 for a shot that worked for 1-2 weeks).

But Questor came along in 2001 and bought the drug and began marketing it without any proof of benefit or effectiveness over prednisone. They have now worked the price up to $32,000 for a 5 dose vial. This story is just an example of  a pharmaceutical world of lying, greed, cheating, fraud, graft, bribery, and corruption.* These are not things that can be controlled by the “free market”. Like it or not; this industry has to be put under strong government control. We need not be hood-winked by the old clichés about stifling research and innovation. Very little of that goes on in the pharmaceutical industry which spends 19 times as much on promotion as they do on research. And a lot of basic research is paid for by the NIH. The high costs of drugs in general could be reined in by restructuring and empowering the Federal Drug Administration and allowing Medicare and health exchange plans to negotiate drug prices. These could be two more steps in creating an improved Medicare for all.

The drug companies have a license to steal…and they use it.

*For additional information on the corruption involved read Andrew Pollack’s article: http://www.nytimes.com/2012/12/30/business/questcor-finds-profit-for-acthar-drug-at-28000-a-vial.html?pagewanted=all&_r=0

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