Pharmaceutical Drugs: who decides how much they cost?

Why does the NHS (the customer) feel they have to pay more for drugs? It is usually the company who decides on the price they charge - but apparently not when industrial investments are involved!

The UK's science minister, Patrick Vallance, has said that "The price the NHS pays for medicines will need to rise to stop a wave of pharmaceutical investment leaving the UK".

This was reported last week in a BBC article. Lord Vallance continues by saying that “low prices for new drugs, a lack of government investment, and tariff pressure from US President Donald Trump, have been pushing firms away from the UK”. As a result he told the BBC that “price increases are going to be a necessary part” of solving that problem - even though he did not know where the additional money, for a cash-strapped government, and a ‘broken’ NHS, would come from to pay for higher prices. That, he said, was something the Department of Health would have to work out alongside the Treasury!

So raising the price of pharmaceutical drugs is not a health issue. It is purely a financial matter because industrial investment in Britain by drug companies is at stake.

“According to the government, Moderna is investing more than a £1bn in UK research and development as part of a 10-year partnership to create new treatments jobs and boost pandemic resilience”.

But Merck has recently decided scrap a £1bn investment in the UK; AstraZeneca is ‘pausing’ a £200m investment in Cambridge; and Novartis has warned that NHS patients will lose access to “new cutting-edge treatments because of skyrocketing costs” so it was not considering the UK for any major new investments in manufacturing, research, or advanced technology because of “systemic barriers”. In addition the article states that Eli Lilly has told the Financial Times that the UK was “probably the worst country in Europe” for drug prices.

So a rise in drug prices is not necessary because of the industry’s rising costs; or an increased demand for the industry’s products; or their value and worth to patients. They are the result of industry threats to withdraw pharmaceutical investment! In terms of the principles of capitalism this is not how the pricing mechanism should work (except, perhaps, that every industry is supposed to seek to maximise its profits).

What the Science Minister seems to have forgotten, it would appear, is that there are other factors involved in the investment decisions of the pharmaceutical companies at this moment in time - facctors that have never been raised by the BBC, or as far as I am aware, any other mainstream media platform.

Why would any industry invest, in the UK or anywhere else, when its business prospects face such a very serious threat?

Since the debacle of the Covid-19 pandemic there has been growing cynicism about the efficacy of pharmaceutical drugs, especially “safe and effective” vaccines. More patients are becoming “drug-hesitant“. Apparently the NHS budget for drugs has gone from 14% to 9% of its total spending. Even doctors are now extolling the virtue of ‘social’ or ‘environmental’ prescribing. Drugs, even vaccines, are not as ‘fashionable’ as they were.

So even Big Pharma’s biggest customer in Britain, by far, the NHS, is questioning the safety of effectiveness of its drugs and vaccines. The investment withdrawal decisions mentioned in the BBC article were taken by pharmaceutical companies at a time when they had every right to believe that demand for their drugs and vaccines would make any new investment less profitable than they previously thought.

The situation is likely to get worse. The USA government is now forcefully questioning the safety of pharmaceutical drugs and vaccines. It is removing vaccine mandates. It is questioning whether all vaccines are necessary. It is stating that any new drugs and vaccines will be approved by the Drug Regulator only if and when their safety and effectiveness can be proven by honest medical science.

And Big Pharma must know that it is going to be extremely hard for them to provide this proof, following decades of ‘buying’ and ‘owning’ the science, manipulating the raw data so that it can reach conclusions that the data does not support, denying independent statisticians from examining the raw data, and then getting the ‘science’ rubber stamped by a Federal Drug Regulator (the FDA), and organisation that has been infiltrated by pharmaceutical place men and women.

Potentially this can undermine the entire business plan of the pharmaceutical industry. Future prospects for drug and vaccine sales must have plummeted. So might this not be why drug companies are withdrawing their UK investments?

Donald Trump, with all his many faults, appears to realise this. It is reported that he has made a drug price agreement with Pfizer - which both lowers drug prices and gains a $70 billion investment in the USA. Perhaps he is a politician who understands economics better than Lord Vallance; or perhaps they justnhave different vested interests.

Drug companies have been hugely profitable throughout the last 100 years. They have used their accumulated wealth to lobby (bribe?) politicians and governments; and they have invested heavily in the mainstream media to ensure that they (and their products) receive a good press (and free advertising). All this ‘influence’ is now in serious danger - at least in the USA. The pharmaceutical industry has been largely unchallenged since the Thalidomide debacle of the 1960’s and 1970’s, which resulted in the establishment of stronger drug regulation (that is, a regulatory system, designed to protect patients from dangerous drugs), but one that Big Pharma has successfully undermined in the last 20-30 years).

For all these reasons, the future of pharmaceuticals must now be in serious doubt - to the extent that current investment plans will need to be revised in line with reduced profit expectations.

Lord Vallance, and perhaps the entire UK government, may not yet understand how events in the USA may affect the pharmaceutical industry. So it is seeking to persuade drug companies to continue their investment decisions by voluntarily offering and increase in what they are prepared to pay for their failing drugs and vaccines. Dare I suggest that it seems that drug companies are using their investment decisions as a blackmail strategy; and that faced with this powerful blackmailer the government is willing to pay ransom money?

Why should this be? Perhaps the BBC article provides a clue.

“The science minister is most widely known for his regular appearances in pandemic news conferences in his role as the government’s chief scientific adviser, and was also previously the president of research and development for global pharmaceutical company GSK”.

Vallance is a pharmaceutical man! He has the interests of the drug industry at heart. He spent years promoting the Covid-19 vaccines of AstraZeneca (a vaccine that had to be withdrawn because of the patient harm it caused). Now he is encouraging drug companies to invest in the UK - at the taxpayers expence.

• Damn the patients who are being harmed by pharmaceutical drugs and vaccines!

• Damn the taxpayer who will have to pay for his generous largesse!

It’s the industry, and its future in Britain that seems to be important, and it’s ability to invest heavily in the country must be maintained, literally at any cost.

Recently, and in the same vein, I reported that Eli Lily was to increase the price of Mounjaro (its weight-loss drug) by 170%. I asked whether any industry, other than Big Pharma, would get away with doing this? To date there appears to have been little resistance to this extortionate price-hyke, and this raises similar questions about who determines the price of pharmaceutical drugs.

The questions Lord Vallance, and the UK government, should be asking is this:

• Are the big drug companies likely to be investing anywhere?

• And therefore is it really necessary to pay higher prices for drugs?

This article was first published on Substack 

Pharmaceutical Drug "Side Effects:differentiating between symptoms of an illness and 'side effects' caused by drugs taken to treat illness.

The term “side effects” seems such an innocuous one, something quite minor, unimportant, nothing to worry about, a mere inconvenience. An alternative term “adverse drug effects” is little better at describing the seriousness of drug ‘side effects’.

So why do so many patients not realise that they suffer from drug ‘side effects’? Or that they can be serious? There are many reasons.

First, the medical profession does not tell patients about the ‘side effects’ of drugs they prescribe, certainly not the full extent of the harm they are known to cause, or the serious impact they can have on our health. Patient Information Leaflets usually stay, unread, within the packaging. Usually doctors tell their patients little more than that side effects are ‘minor’ or ‘rare’ or are ‘well-tolerated’.

Second, when patients develop ‘side effects’ they tend to dismiss them as just another sign of their original illness; the fact that they are unwell, and that any new health issue is merely another manifestation of being sick.

A third reason, perhaps not so well known, is that drug ‘side effects’ are often so similar to the illness for which were prescribed that it is difficult to differentiate the two. If so, an assumption is usually made that new symptoms are just an extension of the original illness which is getting worse. After all, they have been told that ‘side effects; are ‘minor’, ‘rare’ and ‘well tolerated’ and too often an assumption is made that their doctor would not give them anything that might be harmful.

So let’s see how this third factor works by looking at ADHD and the known ‘side effects’ of ADHD drugs.

ADHD, or Attention-Deficit/Hyperactivity Disorder has been described by the NHS Inform website as “a group of behavioural symptoms that include difficulty concentrating and paying attention, hyperactivity and impulsiveness”. It describes the main symptoms of ADHD in children and teenagers as:

Inattentiveness: having a short attention span, being easily distracted, making careless mistakes, appearing forgetful, losing things, being unable to stick at tedious or time-consuming tasks, appearing to be unable to listen to or carry out instructions, constantly changing activity or task, having difficulty organising tasks

Hyperactivity and Impulsiveness: being unable to sit still, especially in quiet surroundings, constantly fidgeting, being unable to concentrate on tasks, excessive physical movement, excessive talking, being unable to wait their turn, acting without thinking, interrupting conversations, little or no sense of danger.

NHS Inform goes on to say that symptoms of ADHD “tend to be noticed at an early age” and that “they may become more noticeable when a child’s circumstances change, like when they start school”. Indeed, I (and many other people sceptical of conventional medicine) would say that sometimes many children who diagnosed with ADHD who are little more that normal, but active, inquisitive, perhaps mischievous youngsters (who often have a bad diet that contributes to the problem).

But then they are given ADHD drugs……

There has been an ever-increasing number of children who have been prescribed ADHD drugs, like Ritalin, Adderral, Concerta, Vyvanse, Strattera, Focalin (and many others). These drugs can, and often do, have serious ‘side effects’. (For a full list of the known/accepted ‘side effects’ of each of these ADHD drugs click on each of them above (although they all have ‘side effects’ that are remarkably similar).

Going through the horrendous ‘side effects’ of Ritalin, perhaps the best known and most used of all ADHD drugs, the following can be picked out as conditions quite similar to ADHD itself. The NHS website mentions side effects such as “struggling to get to sleep”, and “becoming irritable, aggressive, tearful, and depressed”.

• agitation

• talking or acting with excitement you cannot control

• uncontrolled vocal outbursts or tics (uncontrolled and repeated body movements)

• anxiety

• confusion as to time, place, or person

• false or unusual sense of well-being

• inability to speak

• loss of consciousness

• nervousness

• overactive reflexes

• seeing, hearing, or feeling things that are not there

• talking or acting with excitement you cannot control

• unusual excitement, nervousness, or restlessness

• Anger

• Fear

• Aggression

These ‘side effects’ can be confused with ADHD itself. In other words, Ritalin and other ADHD drugs are known to cause the same, or similar ‘side effects’ to the symptoms of the (so called) illness. But the ‘side effects’ are not recognised because nothing has changed, except that their condition has got gradually worse. So they need more of the drug, or the drug in a stronger potency.

But what is important to note is that ‘side effects’ such as anger, fear and aggression are not normally present in children who have been diagnosed with ADHD!

Vernon Coleman, a highly cynical (but honest) former doctor-GP, tells this apocryphal story that I fear many people could tell, if only they realised what was happening to them as the result of taking pharmaceutical drugs.

“I take the red pill to stop the indigestion,’ says a man. ‘I get the indigestion from the blue bill and I take the blue pill for the headaches I get with the green pill and I take the green pill to stop the itching the red pill causes’”

This is not an uncommon situation. In another place Coleman outlines his “1st Law of Medicine” which is as follows:

“If you are receiving treatment for an existing disease and you develop new symptoms then, until proved otherwise, you should assume that the new symptoms are caused by the treatment you are receiving”.

Good advice, perhaps, but most people would not be able to take it as they would not be inclined to differentiate between symptoms of the illness, and other symptoms that have contracted since taking the drugs they have been given for the original or first illness!

As a homeopath I have spoken to many patients where it was difficult to differentiate between the symptoms of an illness and a drug ‘side effect’. And if anyone asks their doctor, the message most patients would receive is that the new symptoms are not drug ‘side effects’ because the drug does not have ‘side effects’!

But when the patient decided to stop taking the offending drug, regardless of the condition, their health would invariably improve, and for many it was the start of them getting entirely well. The best medicine, sometimes, is no medicine - especially if it is pharmaceutical medicine!