Drugs: How Regulations Kill

Posted by: on Dec 15, 2004 | No Comments

The year 2004 has been a bad one for the big drug companies of this world. It has been a particularly trying year for Merck, one of the world’s biggest drug manufacturers. Merck share price dropped from its peak of $95 in November 2001 to US$27 in November, 2004. This means that the company is worth US$60 billion vs US$200 billion it was worth just three years ago.

The reason for Merck’s pain is its blockbuster arthritis drug Vioxx. Merck has had to pull it off the market. Worse, Merck faces liability potentially running into tens of billions of dollars which it would have to pay to the users of Vioxx.

In a study conducted by Merck, it appeared that users of Vioxx faced a slight increase in risk of getting a heart attack. Merck decided to make the study public and, in keeping with its high ethical standards, also recalled Vioxx. Stores have sent the medicine back to the company and so have consumers. They are entitled to a full refund.

There is do doubt that Merck is seriously wounded. Swarms of lawyers in the US smelling blood have sprung into action. They have begun the process of collecting names of all Vioxx users. Cases will be filed on their behalf against Merck. It is possible that every user will be entitled to damages whether or not he has been harmed.

Those who have suffered heart attacks will probably be awarded damages in tens of millions of dollars. If someone has died while taking Vioxx, it is conceivable that Merck may be liable for a 100 million dollars in damages. It is now certain that Merck will end up paying billions of dollars to settle claims against it.

Persons investing in Merck have seen the value of their holdings vaporize. Its shareholders have lost a substantial portion of their wealth. If you bought Merck shares at its peak, you would have witnessed your holdings decline by over 70% in value.

This example illustrates why drug companies in the US have to charge high prices. The risk involved in developing a new drug is just too great. The approval process is time consuming, tortuous, full of pitfalls, and costs a fortune. In the US, the Food and Drug Administration (FDA) which has to approve all drugs takes upto ten years to do so. The company seeking approval may need to spend a billion dollars before it is ready to market its new molecule.

And even this rigorous approval process does not protect a company from liability. It still remains fully liable to users for any untoward effects which may come to light years later. The fact that Vioxx was approved by FDA does not protect Merck from liability in the least bit.

Vioxx has shown to not only Merck shareholders but also to investors in other drug companies as to how severe the liabilities can be. The share prices of other drug companies like Pfizer, Roche, and Bristol Myers have also fallen. In recent years a mere whiff of legal trouble is enough to cause share prices to plunge.

When we complain of mega profits and high prices drug companies charge, we have to take into account the enormous risks they face. Drug prices in the US and worldwide can come down only if the FDA is disbanded and legal liability is limited to actual damages.

For a user of Vioxx to be awarded a million dollars in damages without having to prove actual harm is not reasonable. If he has suffered a heart attack or died, yes a million dollar or even several million dollars may be reasonable compensation.

Reform liability and compensation norms, eliminate regulations to extent possible and we will see cheaper drugs. Will we be sacrificing safety? As we have seen with Vioxx, government approvals by no means guarantee safety, they in fact enhance the danger by providing an illusion of safety when we all know that you should take drugs only if you must. There is hardly any drug which does not have any side-effects.

There are dangers stemming from regulation and limitless liabilities. FDA is going to be even more careful in approving new drugs. New life saving drugs may not be available to the world for decades.

“I think this is really blown out of proportion,” said Dr. Carl Lavie, medical director of preventive cardiology at Ochsner Clinic Foundation, in New Orleans. “I don’t think it’s easy at all to get a new drug approved, and if you start being extremely conservative you stand the risk of taking good medicines from people.

Fewer companies can now afford to develop new drugs. Companies will not market drugs which harm a few even if they substantially help a 100 times more people, since the potential liability for damages far exceeds potential profits. No one is looking at how many have benefited from Vioxx, every lawyer is concentrating on those harmed. Regulations cost far more lives than they save.

It appears that Merck will have to pay damages even if Vioxx users reside outside the US. Are you a user? If you can prove usage you too may become a millionaire. Good luck.

The Boss

Plan or Prosper

Posted by: on Mar 10, 2004 | No Comments

Most people believe that governments must plan. Communist and socialist regimes made planning the centerpiece of their development agenda. India had its five year plans, copied on the basis of central planning by its ally the Soviet Union. Nepal too has its planning commission.

Government it seemed – and still seems to most – is required to plan everything. Government has to plan the savings rate. Government has to plan the growth in population, and family size. Government has to channel investments according to its plan. Government has to plan the food grain output. Government has to plan, plan, and plan – for four decades after independence the government of India planned the production of cement, iron, scooters, cars, fertilizers, electricity, wheat…

Nothing in India could be produced without a license. The government decided that it alone must allocate scarce resources in a planned manner for its people’s benefit.

Government also intervened directly to mandate that no private investment would be permitted in TV, airlines, railways, telephones, power stations … and that government would exclusively run and plan the production of these goods and services.

The private sector and markets were subjugated. Indira Gandhi referred sarcastically to those who advocated free markets as ‘marketwallahs’. In interest of planning India’s progress she nationalized the insurance companies and banks.

How successful were these plans? Indian industry was chained and crippled by its planners. Shortages became endemic. People could – at least some people could – satisfy their urgent requirements by buying in the black market. Smugglers satisfied the requirement of goods demanded from abroad.

Government planned the use of foreign exchange. “Perish the thought of private importing”, the people were told, “we hardly have enough dollars to buy petrol”.

Government of India planned. The economy stagnated. The sub 2% growth rate achieved during that period was dubbed, “the Hindu rate”. There was a problem with Hindus, thought the people of India. Inspite of such extensive government planning, if we still can’t progress, the reason must lie in our nature and our religion that advocates a belief that life is pre-destined and beyond our control.

All this changed in the early 1990’s. Industrial licensing was abolished in one fell swoop by the Narasimha Rao government. What could not be achieved by bureaucrats in over four decades of planning was accomplished by businessmen in a few years when planning became their job.

Shortages of steel, cement, telephones, scooters, and cars vanished. Today, not only do these industries fund their own expansion, they pay huge taxes as well. Foreign exchange reserves have grown from zero to $110 billion and the problem now is how to effectively use all the dollars coming in.

Similar failures of planning became even more apparent in the former Soviet Bloc. Planning by the state doomed the ‘evil’ Russian Empire. It collapsed overnight. The Berlin wall came down and East Germany disappeared in its rubble.

What is required is not planning by the state, but a complete separation between government and the economy. The role of the government must be minimized, that of the market maximized.

It is not the job of bureaucrats to allocate resources, it is for the consumer guided market to do so. Bureaucrats have no incentive to take correct decisions. If they allocate too few resources for the manufacture of cement, so what, they can always shift the blame to greedy hoarders. If government buys wheat at a price leading to overflowing granaries that serve as food stores for rats, so what, the loss gets to be borne by the taxpayers.

If private companies make mistakes – and they often do – it is they who lose out, not the taxpayer. Businessmen, therefore, have all the incentive to rectify mistakes fast or risk bankruptcy. If they produce too little they leave room for a competitor to come in and bridge the gap. If they produce too much, they run into a loss. They will thus continually struggle to get things right. There is no taxpayer and no currency printing presses supporting their mistakes.

Government, if it is serious about economic progress must shut down its planning office, and leave planning and implementation where it belongs – in the hands of businessmen.

The Himalyan Times