Expenses for medicine at Danish public hospitals have doubled in only seven years. Prognoses say that in 2015 health authorities will have to allocate 1.1. billion Euro for this purpose.

Of course this provokes debate among hospital professionals, politicians, journalists and academics in the field. Unfortunately, it is the wrong discussion: Can society afford very expensive medicine that may only prolong the life time of serious ill persons with few months or a maybe a year?

In a recent newspaper article these medicines are mentioned as examples of expensive medicine:

− Zytica for the treatment of prostate cancer

− Yervoy for the treatment of birthmark cancer

− Gileneya for the treatment of sclerosis

If the reporter had taken the time for a little research, she would have learned that these three drugs are produced by Janssen Biotech (formerly Johnson & Johnson), Bristol-Myers Squibb and Novartis.

This might have given her a hint of what the real problem is. All three of these pharmaceutical firms are mentioned among the villains in a book that was published last year in Denmark with the title “Deadly medicine and organised crime”. The book is written by a renowned Danish professor, Peter C. Gøtzsche. It is a 450 pages long and well documented indictment against pharmaceutical industry (Big Pharma) for fraud, corruption, extreme super profits and distributing deadly drugs *.

Among his points are:

• An unreasonable high number of people die because of medicine

• Big Pharma markets medicine that has no positive effect on patients in relation to their illness – and industry knows

• The industry deliberately withholds data and manipulate data in order to cover up serious side effects

• The industry pay (bribe) researchers to praise their products, and they pay doctors to market and distribute the products among their patients

• Big Pharma are regularly sentenced to pay millions of Euros in fines for marketing dangerous medicine or medicine without any effect, but more often they accept out-of-court deals in order to avoid the brand-damaging court decisions and to avoid being forced to publish the data behind the case.

• Research academics and public authorities assist the industry in replacing relatively non-expensive medicine with new more expensive medicine with the same effect

• The industry allocates more funds for marketing than for research while at the same time they try to legitimize their monopoly patents with high research costs.
This is all based on documentation from the global pharmaceutical industry. Several of the examples include Bristol Myers Squibb and Novartis.

Among the conclusions of Gøtzsche is this: “In 2012 the 50 largest firms sold for 610 billion dollars in prescription drugs. I am absolutely convinced that this could be reduced by 95 %, equal to 580 billion dollars, because our most common drugs are 20 times as expensive as the alternatives with the same effect, and because our citizens are “over-treated”.

So maybe the solution for the Danish public health system is not to deny patients the necessary treatment, but to look into the methods and profits of private pharmaceutical industry and to start to curb their power and their profitmaking. Even for this purpose professor Gøtzsche offers his assistance. One whole chapter deals with political solutions to the problem..

On the most basic level is the suggestion that the authorities should prosecute the criminality of Big Pharma with the same energy that they use for ordinary crime, and that they should protect whistle blowers from within the industry and compensate them for their loss of job.

Going more radical step by step Gøtzsche offers these kinds of proposals:

–  To make it obligatory for firms to publish research data and all other knowledge about their drugs

–  To make it obligatory for firms to publish all contracts

–  To make it illegal for private medical firms to make their own clinical research; instead they should pay a special tax to fund public medical research.

Finally he looks at the core of the problem and the real solutions. The first one is to de-medicalise society. The second one is to prohibit privately owned medical firms and to replace them with state owned production units or non-profit companies. He writes. “To let the forces of the market rule medical praxis does not favour the needs of the patients, and it is incompatible with an ethical based profession. Profitmaking does not produce social benefits,” he writes.

Michael Voss

* English language version of the book: Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Healthcare, Radcliff, 2013