The Business of health

Watching the 7.30 report the other night I was interested to see a segment on Human Growth Hormone. The pharmaceutical benefits advisory committee (PBAC) has restricted subsidy to children, thus causing anyone over 14 that reckons they need the drug to pay full price if they want to continue using it. Full price is about $25,000 per year.

In a book entitled “Alternatives in Cancer Therapy” I’m reading at the moment, the author says, “One argument, an offshoot of the Big Business theory, has it that: “Newspapers and broadcasters very often depend on corporate press releases as unacknowledged sources for their ‘news stories,’ meaning that the PR spindoctors can clean up and slant adverse findings, and promote fictitious ‘good news’ discoveries. The media abrogate … [their] responsibility because competitive pressures have left them without specialist staff who [can] bring knowledge and cynicism to their reporting, and sometimes because they need to mollify corporate advertisers. Often their … owners will also have investments in the corporations or products .The scuttlebutt here is that the old boys’ network of media, advertisers, and big business ensures that breakthroughs within the establishment research community are reported with frenzied excitement and a distinct loss of perspective.”

It’s disturbing to think that the ABC simply scans the media releases (Eli Lilly pushing to expand growth-hormone use) to come up with a news story.

Even though Penelope Williams is promoting alternative treatments in general and Immuno-Augmentative Therapy in particular, she makes some very telling points in her book. If one substitutes the word ‘health’ for ‘cancer’, she could be writing about trends in the Australian health industry.

“In the debate about cancer treatments, you will certainly hear about cancer as Big Business. The current lingo underlines view that cancer is not a disease but a commodity; sick people are not patients but “health consumers.” People who need treatment, who need their health insurance to cover those treatments, who are persuaded into clinical trials, are not patients but “clients.” If cancer were on the stock market, it would be a good buy.

You hear the argument that freedom of medical choice is restricted not to protect citizens, but to protect the almighty dollar. It goes like this: Cancer is just another industry, with the market determining the direction of treatment and research. Since the production of cancer treatment drugs – chemotherapies – is such a lucrative enterprise, their producers block other therapies that are cheaper to produce, unpatentable and which could threaten the profits or market share of what are sometimes called “ethical” pharmaceuticals.

The economic argument is certainly compelling. The cancer industry, indeed the entire health industry, is a tangle of vested interests including the pharmaceutical companies, the health insurance agencies, the regulatory agencies, governments, lobbyists, and professional medical associations. It would be more surprising if these organizations did not fight to protect their market, given that, for example, the chemotherapy industry alone generates about $12 to $14 billion a year in the United States alone. But to what length and whose cost?

For you, a cancer patient, these choices are not intellectual exercises or an opportunity for debate but issues of life and death. Your own. You must decide for yourself who is telling the truth; if you opt for an alternative therapy, you must deal with the fear that you might lose access to it at any time, because a distant agency says so; you must wrestle with the planted nag that maybe the therapy is useless because the authorities imply or outright say so. You must deal with shaken faith, fading hope, and energy dissipated not so much in your fight against cancer as in your fight against the politics of cancer.”

And probably the scariest thing of all is that Eli Lilly, the manufacturers of synthetic human growth hormone, may be lobbying to have the drug included for adults in the PBAC list because the engine of it’s phenomenal financial success, Prozac, is losing it’s place as drug of choice because of adverse side affects.

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Geoff Honnor
Geoff Honnor
2022 years ago

Yeah it’s interesting. I caught the 7.30 Report segment and, I guess, saw it as fairly standard pressure tactics for PBS listing. I spent two years as the Ministerial Appointee in “the consumer interest” on the Pharmaceutical Benefits Pricing Authority (PBPA). PBPA is the less glamorous of the two Pharmaceutical benefits committees. It gets to try and negotiate a mutually acceptable price out of Industry once the PBAC has decided to list a specific product.

I don’t know PBAC’s reasons for declining listing but I’m picking that it would be a combo of:

– absence of study data pointing to longterm efficacy in adult treatment of the specific condition;

– cost effectiveness

– The potential for leakage – HGH is black market gold

BTW, Eli Lilly has the ability to offer a Special Access Scheme through the TGA, for these patients.
It would be interesting to know why they aren’t….

You’ve hit the nail on the head Wayne: when it comes to health reporting in Oz, nothing is as it seems…..

2022 years ago

You’ll see from the ABC transcript that Lloyd Sansom uses the “they haven’t done clinical trials” excuse. BTW the same Lloyd Sansom was a lecturer in Pharmacy when my wife and I studied at Adelaide Uni in the late 60’s – he was a prig then and little seems to have changed. And you’re correct, athletes and bodybuilders love the stuff so there would be a thriving black market, however I think it behooves somebody to tell real patients that Special Access schemes exist. But that would be expecting too much of the ABC reorters wouldn’t it ?

Geoff Honnor
Geoff Honnor
2022 years ago

Yes it would Wayne. I could tell you about the hours I spent being interviewed by Four Corners a couple of years back about Wooldridge’s sacking of the then PBAC. When I wouldn’t feed them the preferred line – the doc’s were paragons of moral virture and government was in bed with big pharma to dismantle the PBS, (cackling maniacally all thee while type of thing)- they finally had to dump me.

I kept insisting that the deal was a little more complex than they would prefer – and that there was maybe a public interest thingo in going there – but hey: that’s entertainment ;-)