The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #62992

Antonio Ugalde, PhD, Department of Sociology, University of Texas-Austin, 1802 Westridge, Austin, TX 78704, 512-471-1122, augalde@mail.la.utexas.edu and Nuria Homedes, MD, DrPH, University of Texas at El Paso, 632 Skydale, El Paso, TX 79912.

A very large percentage of the poor can not access needed pharmaceuticals because of their high cost. Some drugs are not available in the market because they are not profitable for the industry and therefore they are not produced (orphan drugs).

After examining critically the industry’s reasons for the high cost, authors question if medicines should be produced under capitalist principles. Competitive capitalist behaviors lead to production of me-too-drugs, irrational combinations, lifestyle drugs; costly marketing practices often including misleading information and hiding important information on adverse reactions and interactions; and a reduction of needed expenditures to ensure safety. These practices result in iatrogenia, inappropriate prescription and use of pharmaceuticals, and in wasteful use of scarce public and private resources.

The paper discusses the behavior of big-PhRMA in developing nations (lack of transparency, price fixing, oligopolistic/monopolistic behaviors, legal suits, and trade threats), the efforts made by governments to control prices (use of generic drugs, local production and/or parallel importing, and centralized purchasing) and the loopholes used by the industry to bypass them. The paper also examines other strategies adopted by the industry to void developing-countries’ efforts to make drugs available to their populations through regional trade agreements and the international conference of harmonization of technical requirements (ICH). Cases studies of several countries are presented (Argentina, Colombia, Brazil, Costa Rica).

The paper concludes with a discussion of alternatives to the capitalist system of production of medicines, including the exemption of patents from TRIPS, the socialization of research and the regulation of production.

Learning Objectives:

• Acquire the skills to analyze critically the reasons for lack of access to pharmaceuticals in developing nations.

Keywords: International Systems, Drug Use

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Big-PhRMA
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.