I have taken heat from people in certain sectors on presenting on my old blog one of the most persuasive arguments for intellectual property rights enforcement, public health.
You all know the arguments, those evil multinational drug companies deny drugs to poor people because of exorbitant prices, therefore we should just strip them of their patent rights. Granted this presentation is rather stripped down, but such is being done world wide with Thailand being the latest.
Now while I can understand, or rather sympathize, with the premise of the argument, Korea’s situation should give a pause to those asserting the conclusion. Korea has a de facto generics market due to the complications in patent law, KFDA approval, and to a lesser extent what is allowed in the “oriental medicine” field. One reason the pharma pricing issue is such a big deal as part of the KORUS FTA talks is the fact that it will lead to trade barrier to authentic foreign made and developed drugs.
So what has all this lead to. Lower prices for sure, however are you really getting what you are paying for? An article today in the Joongang today points out the dangers of allowing generics to take over your market:
The medical group said its test showed that the anti-fungal mediation was only 5-35 percent as effective as the original drug, which they said was essentially ineffective. They assessed the effectively of the cholesterol medication at 63-86 percent of the original.
The drug to treat hypertension, the group said, was rated 102-131 percent more effective than the original, a difference that they said could cause side effects in treatment regimes.
…
Last year, the government inspected 35 domestic pharmaceutical laboratories and found that clinical test data for 115 of 647 drugs had been forged. Those approvals were canceled
Now to be fair, there is nothing in the article that these generics are the patent busters I mention. However it does show some of the problems that can develop if you rely on producers of a drug who do not hold the patent. As I keep on telling people about this drug patent issue, there is more here than perceived greed.
I wish I could identify these drugs but there is this troubling little piece from the Korean Medical Association that did the generic testing:
Mr. Yang told the JoongAng Daily that the group did not identify the specific drugs because there was a 10-percent chance that the results of its studies were statistically inaccurate.
Let me get this straight. In a worst case scenario you are 90 percent right that a generic anti-fungal agent is only 5 percent effective, or basically medically worthless, and you are keeping that from the public? Or what about that hyper-tension medication, you have 90 percent chance that said generic is delivering almost a third more than the required dose, and such can cause “complications” (a euphemism if I ever seen one), yet you are keeping the knowledge from the public… disturbing.
43 Comments
Generic drugs can be safe and effective. Like any other product, it depends who produces it, really.
This really hit home with me in the last month. I was going to the Itaewon International Clinic. The doctor, who seems to be more interested in pushing his viatamins, put me on blood pressure medication last March. They had no effect for 6 months. He then put me on an additional medication (in conjunction with the first) and, again, they did not work.
I went to Soonchunghyang University hospital in Hanam-dong where they have an international clinic. The doctor asked to see my about the meds and told me they were generic and not very effective.
I was quite surprised because I assumed that generic drugs were just as effective as brand name drugs. Lest I assume.
Sure enough, he put me on the brand name drugs and I’m now enjoying the benefits of 120/70. I read the article on Thursday and was rather surprised to say the least.
PS. I know a few people, including my brother, that have been misdiagnosed by the ‘horse doctor’ at the Itaewon Internation Clinic’. Buyer beware, indeed.
That guy is a quack. He used to overprescribe meds when he sold them there. Now that he can’t, he flogs his expensive vitamins (this from a buddy who I had advised against going there).
Actually, this is Korean generics. Anyone have a clue on generics manufactured in, ahem, more regulated environments?
Wedge..I’ve been prescribed generic versions in the U.S. only. In the U.S. i’ve never heard of generic drugs not being on-par with brand name versions. I was waiting for someone to call him a quack. Thanks!
http://www.hc-sc.gc.ca/iyh-vsv/med/med-gen_e.html
SomeguyinKorea…..thanks for the information.
I’ve always chosen the generic version when given the choice.
I’ve just assumed that if the pharmacist offered a choice then the generic one was equal to the original.
I can’t believe the crux of this story has been missed. The Thais have just ripped us off and it seems ok to this audience. The reason we live so long is because of better drugs. The opposite phenomenon is true here in Korea. The U.S based pharmaceutical companies play hell playing in one of the most hypochondriacally markets in the world?
railwaycharm,
Not really. Regardless of whether the Thai manufacturers were crooks, I can’t imagine why there wouldn’t be regulations forcing the importers have these drugs tested independently.
S.G.
Look at the excuse that states its ok to pirate if you have a national epidemic…
‘Look at the excuse that states its ok to pirate if you have a national epidemic.’
yep, it’s the western way to put profits before human life. and these are the people lecturing koreans.
i don’t think the South Koreans even want to experiment with changing the system. They tried a little portion of it, and I think the results were more costs and not much difference in benefits for the patients. Keep in mind that South Korea is trying to keep at least maintenance health care (didn’t count big surgeries or chemo in the early 90’s I think) for all South Korean citizens at a nominal cost.
Who are you to talk? US health care demands a lot of private money to be shelled out, and many can’t even afford generic drugs, so they wait till either they’re truly dirt poor or over age 65.
i reference you to the pdf that I linked a long time ago, that apparently no one read. Perhaps because it wasn’t a newpaper article.
wjk> I have no bone to pick with you about the cost. At least not in this forum.
Rather my fear is if you lift the regulatory environment around drugs, and the patent system is definitely one of those mechanisms, you can create a host of free-rider problems.
To put it another way. If a company has put the time and energy to research and develop, and in turn patent, a drug, they have a strong incentive to make sure the drugs are effective and safe as possible. If they do not, the loose their investment in that drug, if not jeopardize the entire company (e.g. the Vioxx situation).
On the other hand, a generic manufacturer has no extra incentive make sure their product is effective, in fact especially since most drug regulations revolve around safety not effectiveness. However all this does have an impact on safety when such are marketed as an alternative to such (when you take it you assume its going to have the expected effect).
Thus I submit that so casually removing IP protections for drugs for “public health” reasons can actually have an detrimental effect on public health.
Could be the offending governments’ way of doing the same.
It’s those same companies who are distributing drugs for free or low cost throughout the third world.
I know you’re not all there, but how do you suppose pharmaceutical companies can be persuaded to spend billions of dollars to develop drugs (a Western skill, BTW) without a profit incentive?
Oh, and speaking of no regard for human life, how about your relatives the North Koreans, nulji? They don’t even have the excuse of seeking profit — they are just happy to kill their own.
So yes, Koreans can be lectured to. Now, sit down and STFU, you worthless hypocrite.
Or, just keep spouting crap and continue to tarnish the reputation of Korean Americans. That would be fine, too.
Yeah, selling cheap but worthless generics, that’s really going to benefit the average Korean. What a choice, generics that don’t work (but at least it’s cheap) or expensive drugs that (probably) work. You get what you pay for.
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pawikirogi
Posted February 6, 2007 at 5:23 am | Permalink
‘Look at the excuse that states its ok to pirate if you have a national epidemic.’
yep, it’s the western way to put profits before human life. and these are the people lecturing koreans.
That’s right Pawi, there is no free lunch, you have to earn it! Sorry that is not in your little red book!
dogbertt says,
“I know you’re not all there, but how do you suppose pharmaceutical companies can be persuaded to spend billions of dollars to develop drugs (a Western skill, BTW) without a profit incentive?”
/another time dogbertt attempts to assert white superiority over mankind. The others were California and the US had better times without those other kind of people immigrating. Now, it’s drug development is a western skill. Drug development is active in Japan, South Korea, Taiwan, China, and the US. All the named countries have a ton of people with yellow skin participating as key scientists. Far East Asia got behind due to Chinese influence over the region and the closed door policy and mindset, but drug development with billons of dollars involved is a scientific process, not a western one.
…railwaycharm says,
“That’s right Pawi, there is no free lunch, you have to earn it! Sorry that is not in your little red book!”
/Medicine tries to set itself a little different from pure business. Whenever possible, benefiting human lives should be respected over profits alone. That is something all these drug companies will say, even if it’s just lip service. And in some cases, drug co’s will make drugs widely accessible and cheap, although limited, and with considerable social and political pressure.
can somebody kindly share some html codes on quotes and links?
Thanks.
also, drugs are known to make comebacks to the market, every now and then. Vioxx may be a good drug for a certain group of patients. Rumor is don’t be surprised to see it comeback sometime down the line.
All is not lost. Research and development is written off in the books as expense, but drug co’s usually make up for it pretty well by charging more on popular drugs that do work pretty darn well.
In 2005, advisory panels in both the U.S. and Canada encouraged the return of rofecoxib (Vioxx) to the market, stating that rofecoxib’s benefits outweighed the risks for some patients. The FDA advisory panel voted 17-15 to allow the drug to return to the market despite being found to increase heart risk. The vote in Canada was 12-1, and the Canadian panel noted that the cardiovascular risks from rofecoxib seemed to be no worse than those from ibuprofen[11] — though the panel recommended that further study was needed for all NSAIDs to fully understand their risk profiles. Notwithstanding these recommendations, Merck has not returned rofecoxib to the market.
http://en.wikipedia.org/wiki/Vioxx
you know what’s interesting? There are no vaccines or drugs to treat certain parasites or diseases that only concern certain poor regions of the world. I guess there’s no money to be made in it, so no one cares to study for one. But if that particular illness concerned a rich country, they study that disease day and night and come up with a remedy within a decade. Very interesting.
wjk,
No profit, no R&D, no pills, dead people. Simple enough for you?
wjk> First I note you have yet to respond to the argument disclosed above.
I think I could find a gaggle of analysts who would disagree with you on the financal health of Merck on the wake of hte Vioxx problem. Regardsless this is a tangent.
As for the “write off of R&D”, that is rather misleading since such is required under GAAP. The accounting industry, for better or worse in a seperate debate, accounts for such spend in such a way. It is rather erronous, or intellectualy dishonest, to assert that because of an accoutning rule such expenses do not matter to Pharma Cos.
As for your “interesting…no research for parasites” it first must be pointed out the argument is a bit of a post hoc ergo hoc prompter fallacy. The fact is cures and prevention methods have been developed, and are off patent,for quite a few of these problems. For instance proper sanitation, use of mosquito nets, and adminstration of vitamins. Why should drug companies research awnsers that already exist.
“you know what’s interesting? There are no vaccines or drugs to treat certain parasites or diseases that only concern certain poor regions of the world. I guess there’s no money to be made in it, so no one cares to study for one. But if that particular illness concerned a rich country, they study that disease day and night and come up with a remedy within a decade. Very interesting.”
Nobody ever pretended that the pharmaceutical business isn’t a business. Besides, there are government and non-government organisations that try to find treatements for these illnesses.
“As for your “interesting…no research for parasites” it first must be pointed out the argument is a bit of a post hoc ergo hoc prompter fallacy. The fact is cures and prevention methods have been developed, and are off patent,for quite a few of these problems. For instance proper sanitation, use of mosquito nets, and adminstration of vitamins. Why should drug companies research awnsers that already exist.”
/ Sorry, you are wrong on this. I’d like to offer some detailed examples, but I won’t. You’re just looking at this from a legal or finance background. Thus, arriving to a false impression or false conclusion. Also, sanitation isn’t as easy to achieve at all. I agree with someguyinkorea that they’re companies and they’ll only do it to make money.
Despite what you read in the Korean press, “kimchi” is not medicine.
Dram_man wrote:
“The fact is cures and prevention methods have been developed, and are off patent,for quite a few of these problems. For instance proper sanitation, use of mosquito nets, and adminstration of vitamins. Why should drug companies research awnsers that already exist.”
Most cardiovascular disease and many cancers could be prevented or postponed through a healthy lifestyle that includes a nutritious diet, regular exercise, and the avoidance of tobacco. Answers to diseases of modern life already exist, but modern people don’t like the answers and turn to conventional medicine to fix the bodies they didn’t take very good care of and then complain about rising health care costs.
SomeguyinKorea,
Do we want to save people who screw Green Monkeys?
“dogbertt
Posted February 9, 2007 at 10:49 am | Permalink
Drug development is active in Japan, South Korea, Taiwan, China, and the US.
Despite what you read in the Korean press, “kimchi” is not medicine.
”
/ I hope you’re just joking, dogbertt. There’s more than enough non-white faces in drug development. You’re seriously being racist in saying drug development is a “western” skill. Do you also contend that yellow people are just copy catting “western” inventions and mass producing them by cheap labor? Because that’s also something I’ve heard from people like you. Feel free to defend yourself or hide.
besides, labor isn’t cheap anymore in South Korea, Taiwan and Japan.
my uncle has a PhD from Seoul National University and he was involved in drug development and published some papers, too.
“/ Sorry, you are wrong on this. I’d like to offer some detailed examples, but I won’t. You’re just looking at this from a legal or finance background. Thus, arriving to a false impression or false conclusion. Also, sanitation isn’t as easy to achieve at all. I agree with someguyinkorea that they’re companies and they’ll only do it to make money.”
So since these ‘greedy’ companies don’t want to give away all their money to develop medicines for poor people, maybe you and other socialists will step into the breach and hand over your own cash to get the ball rolling?
And no, you are wrong about drug companies in their approach to third world situations. Many are playing important roles in helping third world countries by donating drugs, offering drugs at cost and setting up hospitals and foundations in poor countries. Not all of them do this, but a good number are and more are coming on-stream with helping out. The drug companies are not charitable organizations (they do give away alot) so any claims that they should be forced to help out poor people should be backed up with cash. Get ready to fork over your own to help out sick poor people.
snow, I just said it was interesting. If it’s not interesting, then, that’s your taste. Anyway, you’re putting words into my mouth.
I think you’re wrong, snow.
Do you know what Leishmania is? How about Paromomycin? What about the term, orphan drug?
You know, concerning AIDs drugs, these were only made more available to Africa after historically documentable heavy political and social pressure. Whatever.
HIV emerged in the 60’s. Doing anything about it late 80’s. When it became a “home” problem.
I don’t think I said anything besides interesting.
wjk, the drug companies are doing a hell of a lot more than they used to and they are upping their efforts. This is a fact.
And all this political and social pressure? Yeah, socialists are always willing to spend someone else’s money to accomplish their own goals.
Of course I’m joking. No doubt Korean science has come a long way in recent years.
But there’s certainly no question that the modern pharmacopeia is based upon Western concepts of disease and its treatment. Most of what Dr. Reddy and his ilk are doing is reverse engineering/copying.
It’s not racist to point that out.
And of course, scientists of many different Asian ethnicities do such research in the U.S. and Europe. You may even become one of them, if you can get over your Gundam/Jpn porn obsession.
Do we really want to save people (from) the Green monkey? Is that better marmot?
To inject a little practicality: Pfizer, Merck, AstraZeneca, and Abbott are each worth between 80 and 200 billion USD. Korea’s largest pharm companies, Yuhan, Hanmi, LG Life Sciencees, Dong-A and Daewoong, are each worth between 500 mil and 1.4 billion USD. Yuhan makes 65% of its income from an antacid. Daewoong the same proportion from an antidiuretic. Dong-A makes half from an antibiotic, another 25% from Bacchus, and its major R&D effort is a Viagra clone. Virtually all the of other 30 or so smaller “pharm” companies just make health drinks or traditional tonics.
In America it takes 800 million USD and about 7 years to get a drug to market. Fewer than one in 1000 that enter the pipeline ever get past animal testing. It’s a high hurdle, but when a drug makes it it’s recognized worldwide as a “sure thing”. Korean firms just aren’t capitalized enough to make that leap, which is why LG is the only real research firm in the country, and it’s moving Sloooowly. Drug firms everywhere, including the Korean ones mentioned above, have enough R&D power to make incremental improvements to existing drugs, come up with new delivery systems, etc, but they don’t have the money to risk on major drug development.
My view: it is good and right that major US and EU drug companies get paid well for undertaking the massive and risky task of new drug development. It is also good and right that research efforts and resources be directed toward the afflictions of poor people and poor countries and the development of drug industries in smaller countries like Korea. But I can’t agree that the latter effort must necessarily be done while stripping big Western pharma companies of the rights that other businesses take for granted.
Well said, Linkd.