Government, Big Pharma, and The People A Century of Dis-Ease, 1E

Συγγραφείς: Mickey C. Smith
ISBN: 9780367432447
Εκδότης: Productivity Press
Σελίδες: 502
Έτος Έκδοσης: 2020

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Pharmaceuticals constitute a relatively small share of the total Health Care expenditure in most developed economies, and yet they play a critical role in the ongoing debate over how best to advance, improve, and afford Health Care. Despite this, and perhaps because of this, the industry has had, for many years, an outsized claim to fame and controversy, praise and criticisms, and support and condemnation. Unfortunately, many participants in the debate do not fully understand the complexities of the industry and its role in the overall Health Care system.

The analytical tools of economics provide a strong foundation for a better understanding of the dynamics of the pharmaceutical industry, its contribution to Health and Health Care, and its dual and often conflicting priorities of affordability and innovation, as well as the various Private and Public Policy initiatives directed at the sector. Everyone is affected by Big Pharma and the products they produce. At the Drug store, the physician’s office, in front of the television, in everyday conversations, Drugs are a part of our lives. Society shapes our values toward Drugs and Drugs shape society. ("The Pill" and minor tranquilizers are good examples.) And, of course, the way Congress deliberates and Big Pharma responds has a huge impact on how Drugs affect our lives.

This book is well-researched on the subject of the pharmaceutical industry, its struggles with Government, and its relationship to the consumer from the early twentieth century until the present. The Dynamic Tension between the three participants – Government, Big Pharma, and the People – is described and explained to lead to an understanding of the controversies that rage today. The author describes how the Government, its many investigatory efforts, and the ultimate legislative results affect the industry and the consequences of their activities are explored in light of their effects on other players, including the patients and consumers who rely on both Government and Big Pharma for their well-being and who find sometimes unexpected consequences while giving special attention to the attitudes, beliefs, and misadventures of less-than-optimal Drug use. Stakeholders are identified with physicians as a major focus, as well as describing the significance of prescriptions as social objects and the processes by which physicians make choices on behalf of their patients. The author ties it all together with how Big Pharma affects and is affected by each of these groups.

The author utilizes his 50-plus years’ experience as an academic, practicing pharmacist, and Big Pharma employee to describe the scope of the pharmaceutical industry and how it affects us on a daily basis, concluding with an inside look at Big Pharma and how regulations, marketing, and the press have affected their business, both good and bad.

Dedication

Acknowledgements

Preface

about the author

Chapter One – Introductions

Health

Woman as a Biological and Social Entity

A Different Paradigm

Health Care and Rights

Drugs and Their Role in Society

Drug Policy

Big Pharma

Drug-Related Problems

The People

What’s Ahead

Conclusion

Chapter Two – The Four "P’s"

Introduction

Marketing as an Actualizing Process

The Marketing Mix/The Four "P’s"

Government and the Four "P’s"

Conclusion

Chapter Three – Investigators and Investigations

Introduction

The Hearings

The Grand Inquisitor

Gaylord Nelson – Son of Torquemada

The Fountain Hearings

Senator Kennedy Joins the Fray

Small Business Problems – Dingell

Drug Efficacy Problems – Fountain

Moss on Drug Abuse

Fountain Redux

Congressman Rogers on Transition

Senator Humphrey and the Literature

A Newcomer – Congressman Van Deerlin

Senator Fountain – "One More Time"

Senator Kennedy Returns

FDA Under the Microscope Again

Kennedy – Not Too Tranquil

Gore on Pharmaceutical R & D

Senator Fountain Again

Claude Pepper for the Old Folks

Zomax in the Spotlight

A Pryor Engatement

The Task Force on Prescription Drugs

Research Findings and Recommendations

Conclusion

Chapter Four – Legislators and Legislation

Introduction

Laws and Policy

Bills and Sponsors

The Process

Conclusion

Chapter Five – Regulators and Regulations

Introduction

The Food and Drug Administration

Other Regulators and Regulations

Federal Trade Commission

Federal Communications Commission

Drug Enforcement Administration

Centers for Medicare and Medicaid Services

Patents and Trademarks

State Regulations

Drug Names

Conclusion

Chapter Six – Non-Government Influence

Introduction

Self-Regulation

Third Parties – Managed Care Controls

Formularies and Prescription Limitations

Lawyers

Advocates and Adversaries

Mail Order Pharmacy

Pharmacy Benefit Managers and Outcomes Management

Conclusion

Chapter Seven – The People and Their Drugs

Introduction

The People as Patients

Health Belief Model

Case – Health Belief Model

Attitudes and Evaluation of Drugs

The Sickness Career

The Sick Role

The Sick Role in Acute and Chronic Illness

Compliance with Medication Regimens

Other Influences on Medication Use

What to Do

Death or Maybe Not

Conclusion

Chapter Eight – Response of Big Pharma

Introduction

Response to Government

Big Pharma Speaks

Response of Big Pharma to the People

Some Ideas for Big Pharma

PMA Monographs

Statesmanship

Conclusion

Chapter Nine – Little Pharma and Friends

Introduction

Generic Pharma – Not So Little

Big Bio

What is Special about Specialty Drugs?

Little Boutiques

Back to the Future – Compounding Pharmacists

Friends

Conclusion

Chapter Ten – Greedy Big Pharma

Introduction

Two Parts of Greedy

AARP and Greedy Big Pharma

Congress and Greedy Big Pharma

Risk vs. Reward

Greedy Big Tech

Conclusion

Chapter Eleven – Whence the Drugs?

Introduction

Origins of Drugs

Drug Product Development

Marketing in the Last Century

Invention, Discovery, Development

Curiosities and Surprises

Government, Big Pharma, and The People A Century of Dis-Ease, 1E

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