E-drug: Pharma Lobby and US Bioterror Plan
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E-drug [Copied as fair use. HH]
New York Times, November 4, 2001
A Muscular Lobby Tries to Shape Nation's Bioterror Plan
By Leslie Wayne and Melody Petersen
With anthrax spores turning up all over Washington, plenty of
people are heading out of town.
Not those in the drug industry.
Executives of the major pharmaceutical companies have been
hopping trains and planes to the nation's capital, where they are
staging an enormous lobbying campaign, at the highest levels of
government, to help shape the nation's bioterrorist plan - and
beyond.
So far, they have had some remarkable victories. While the
government has struggled to make sure the nation will have enough
drugs to treat biological weapons that were largely hypothetical a
few months ago, drug companies have managed to stave off many
actions that would harm them, like violating patents or forcing them
to supply free drugs.
As that success shows, the pharmaceutical lobby, which represents
the nation's biggest drug makers, from Eli Lilly to Pfizer to Merck, is
both large and politically adroit and, if anything, more sophisticated
than when it gained fame in the early 1990's for helping to defeat
the Clinton administration health plan.
It has more lobbyists than there are members of Congress - 625
who are registered. It had a combined lobbying and campaign
contribution budget in 1999 and 2000 of $197 million, larger than
any other industry. Now it is harnessing those resources to
influence major policy decisions being made by the Bush
administration that may well influence public health issues and
industry profitability for years to come - much to the dismay of
many consumer groups and others.
"When you've got this access to high places, it will encourage
these guys to coordinate instead of compete," said Jack Calfee, a
health care expert at the American Enterprise Institute, the
conservative research group. "It's more likely to forestall getting
good products than to encourage it."
Because of the anthrax scare, and all the attention given to Cipro,
the anti-anthrax drug of choice, that access has been enormous. In
recent weeks, the chief executives and other top executives of
Merck, Bristol-Myers Squibb, Bayer, Pfizer, Eli Lilly and Johnson &
Johnson, along with trade association officials, have been meeting
regularly with Bush cabinet members. On one occasion, with
executives from other industries, pharmaceutical executives met
with President Bush in New York to discuss the administration's
response to terrorism. Drug company executives have offered to
send scores of industry scientists, now on their payrolls, to work in
government agencies in what the industry calls a gift to the nation,
but critics say it is both a conflict of interest and a way for the
industry to get a toehold in government.
In return, at these top-level meetings, industry executives and
lobbyists are seeking exemption from antitrust regulations,
reduction of the timetable for getting new drugs to market for
treating the ills of biological warfare, and immunity from lawsuits
for any vaccines they develop to combat bioterrorism. The
administration, those in the meeting say, has offered other help,
asking the pharmaceutical executives to identify the regulatory
barriers they would like to see eliminated for this fight.
Last Wednesday, for instance, a dozen industry lobbyists and
executives, among them Peter R. Dolan, chief executive of
Bristol-Myers, and Raymond V. Gilmartin, chief executive of Merck,
met for an hour and a half in the Roosevelt Room of the White
House with Tom Ridge, the director of homeland security.
According to one person at the meeting, Mr. Ridge was so
impressed with what the industry executives said that he
responded: "I'm grateful for your offers of assistance. I accept."
That , according to the meeting's participant, reflected "a true
partnership between the federal government and America's
pharmaceutical companies."
Industry executives say they are just trying to help. "We are part of
the nation's defense system," said Mr. Dolan, who has met with
President Bush in New York and with Tommy G. Thompson, the
secretary of health and human services, and Mr. Ridge in
Washington. "As an industry, there is a real opportunity for us to
give our resources in a time of great need."
But that partnership is troubling to some industry watchdog groups.
They say the cozy relationship threatens to compromise regulatory
standards on new applications of medicines at a time when millions
of Americans may be seeking new drugs and vaccines. They worry
that the industry's efforts to present its proposals as patriotic
gestures mask an effort to increase its power in Washington and to
improve its image while still protecting its financial interests. Critics
also say consumer groups and executives from generic drug
companies, which make cheaper copies of well-known drugs, have
been conspicuously absent from any administration meetings.
"I am concerned that the industry is trying to subvert the normal
regulatory process," said Dr. Sidney Wolfe, director of the health
research group of Public Citizen, a Washington research
organization. "These meetings have no transparency, no openness
nor any involvement of the public. It's a dangerous precedent."
The pharmaceutical industry, of course, has not always had its
way. Some of its efforts to speed federal drug approval have failed.
Federal regulators are actively investigating several companies'
attempts to keep generic drugs off the market and are taking a
harsh look at some marketing practices.
There is no lobby in Washington as large, as powerful or as
well-financed as the pharmaceutical lobby. Battle-honed over a
number of health care initiatives that began with the creation of the
Medicare program in the 1960's, the industry spent $177 million on
lobbying in 1999 and 2000 - a good $50 million more than its
nearest rivals, the insurance and telecommunications industries.
Thanks to Washington's well-oiled revolving door between
government and business, the industry is able to claim friends in
especially high places. Defense Secretary Donald Rumsfeld is the
former chief executive of the drug maker G. D. Searle, for example,
and Mitchell E. Daniels Jr., the White House budget director, is a
former Eli Lilly executive.
Even more important, more than half the drug industry's 625
registered lobbyists are either former members of Congress or
former Congressional staff members and government employees,
according to a report from Public Citizen. Former members of
Congress who now work for the industry include Beryl F. Anthony
Jr., Birch Bayh, Dennis DeConcini, Vic Fazio, Norman F. Lent,
Robert L. Livingston, Bill Paxon, Robert S. Walker and Vin Weber.
While in Congress, many of them led key legislative committees,
and they still have close ties to those now in power.
Along the city's fabled K Street corridor, 134 lobbying firms are on
the industry's payroll. One company, Bristol-Myers Squibb, has
hired 15 lobbying firms with 57 lobbyists, including such superstars
as Haley Barbour, a former chairman of the Republican National
Committee, and Thomas H. Boggs Jr., the city's legendary
Democratic lobbyist and son of the former Louisiana representative
Lindy Boggs (and the late Hale Boggs, a former Democratic House
majority leader).
The industry has also hired such up-and-coming lobbying
rainmakers as Deborah Steelman, a powerful Republican insider,
and Anthony Podesta, brother of President Bill Clinton's former
chief of staff.
On top of that, the industry makes generous campaign
contributions - giving much more to Republican politicians than to
Democrats. Of the $26 million that the industry donated in the
presidential election cycle, nearly 70 percent went to Republican
candidates. Last January, the industry wrote a $625,000 check -
one of the biggest - to the Bush-Cheney inaugural committee.
One of the industry's staunchest critics, James Love, the director of
the Consumer Project on Technology, who works to get low-priced
AIDS drugs to poor countries, called the industry's drive for
government contracts for medicines against bioterrorism "a feeding
frenzy."
"They are putting together another gravy train to cash in on some
big government contracts," Mr. Love said.
With Americans spending more than $100 billion on drugs last year
- double the amount of 1990 - and with public pressure increasing
for pharmaceutical companies to lower their prices, the companies
concluded quickly that they had to become an active participant in
the resolution of the nation's crisis. Executives have gone to great
lengths to say that they are not going to profit from it. They point
to the fact that Bayer, under pressure from the government,
reduced the price for government purchases of its anti-anthrax
antibiotic, Cipro.
At every opportunity, they have also noted that they plan to give
away additional drugs and vaccines to the government fight
bioterrorism - albeit with some important strings attached. The
medications would be made available only if the government agreed
to speed the process that would allow existing drugs to treat
anthrax and only if there was a national emergency.
"It's very unusual for our industry to get a large number of chief
executives to come to Washington on short notice," said Alan F.
Holmer, chief executive of Pharmaceutical Research and
Manufacturers of American, the industry's trade group. "But it
reflects our overwhelming desire to do whatever we can to address
these issues. This is not about profits. It is not about patents. It is
about making sure we have an adequate supply of medicines
available to the American people."
Not so fast, critics say. They say the drug industry is trying to
stockpile good will at a time when it badly needs to improve its
image in Washington. For years, the industry has been roundly
criticized for putting profits ahead of people when, for example, it
has blocked or stalled the production of cheaper, generic drugs.
Criticism comes most loudly from senior citizens and health care
providers.
The drug industry needs this political capital both now and the
future - especially when it comes to patents. For the industry, the
protection of patents - which give companies monopoly control over
the drugs they bring to market for a number of years - is basic to
their existence. For them, any threats to that protection, even at a
time of national crisis, is a clarion call to action.
"This is a huge issue to them," said William Nixon, chief executive
of the Generic Pharmaceutical Association, which battles the large
drug companies with a budget of about $2 million a year. "They will
do everything in their power to maintain their monopoly. There is no
question of that. And that's what made Bayer and Cipro so
important to them. It could be perceived by them as the crack in
the dike that they have been trying to put a finger in. They didn't
want this to escalate."
Companies are fighting so hard to protect their patent rights in part
because they have so few drugs with large potential that will move
from development to the market over the next several years.
By 2011, brand-name drugs with more than $40 billion in annual
sales are expected to go off patent; they can then be sold by
generic drug makers at prices of, say, 70 percent less. Last year,
the Food and Drug Administration approved just 27 new drugs,
down from 35 the year before and about half the number approved
in 1996. To prevent huge drops in revenue, drug makers need to
hold on to their patent protections for as long as possible - or even
extend them further.
The industry is also hoping that its effort will build political capital
for legislation pending before Congress and later as well. At the
moment, industry lobbyists, among them Mr. Boggs, the Democrat,
and Mr. Barbour, the Republican, are swarming through the halls of
Congress because the House is about to consider a Senate-passed
bill to extend the industry's monopoly patents by six months on
many existing drugs - a measure that could reap billions for the
industry but cost consumers. Also on the horizon are trade talks in
Qatar that will deal with patent rights and a battle over prescription
drug benefits in Medicare.
"The industry has been under the gun and losing the public relations
war," said Ira S. Loss, a drug industry analyst for Washington
Analysis, which provides research for institutional investors. "The
drug industry has been pointed to as a major reason for the rise in
health care costs. They are trying to position themselves for the
future and to be able to say: `We are not the bad guys. When the
country was in a crisis, we stepped in and were willing to donate
our products.' "
But Mr. Loss says, there is less than meets the eye to the industry's
offer of free medications. Johnson & Johnson, GlaxoSmithKline,
Bristol- Myers Squibb and Abbott Laboratories have all made offers
of free medications to fight bioterrorism - should the government
speed these drugs through the approval process.
"It's a very contingent offer," Mr. Loss said. "If they get the
approval and if there is a national crisis, they will provide it for
nothing. You have to have two ifs for it to work."
And there may have been another motive for the corporate offers.
Drug makers depend on patents to help them recoup their research
and testing costs, but once those costs are recovered, the high
prices they charge for patented drugs give them operating margins
that are among the highest in corporate America.
Several of the offers of assistance came a day or two after Mr.
Thompson, the health secretary, threatened to seek Congressional
approval to break Bayer's patent for the anthrax drug Cipro if Bayer
did not lower its price for the drug. A few days earlier in Canada,
the government had momentarily overridden Bayer's patent by
ordering a generic version of Cipro from another company.
The drug companies say their offers of free drugs had no
connection to Mr. Thompson's comments on Cipro's patent. "We
only wanted to be as helpful as we can," said Jeffrey J. Leebaw, a
spokesman for Johnson & Johnson.
In the end, Bayer backed down and agreed to reduce the price of
Cipro tablets to the government to 95 cents a pill from $1.77 for
the first 100 million, to 85 cents for the second 100 million and to
75 cents after that. It also agreed to increase production. Still,
while these price reductions will dent Bayer's profits, they pale next
to the $800 million the company could have lost, according to
analyst estimates, if the Cipro patent had been overridden. Sales of
Cipro, Bayer's best-selling prescription drug, were $1.6 billion last
year out of total pharmaceutical sales of $5.8 billion for the
company, which is based in Germany. Stewart Adkins, a Lehman
Brothers analyst in London, said the cut in price for Cipro would
reduce Bayer's profit margin on the drug to 65 percent from 95
percent.
"Bayer will still be doing O.K. on it," Mr. Adkins said. "If Bayer lost
the patent protection and the drug could be sold in the U.S. at
generic prices, it would have been devastating for the company." In
the last few days, as Congress has debated a patents measure, the
industry has been pulling out the stops to renew a law that provides
the pharmaceutical industry with a six-month extension on patents
in return for the drug makers' agreement to do more testing of
drugs for pediatric use.
Consumer groups say the bill would require the drug companies to
do little new research but would cost consumers $14 billion over
what generic equivalents would cost. On Cipro alone, for instance,
Public Citizen, the consumer group, estimates that Bayer would get
an additional $357 million in business that it could have otherwise
lost to cheaper generic drugs.
Fighting the hardest is Bristol-Myers, which is also seeking a three-
year extension on the use of Glucophage, a diabetes medicine,
based on studies of the drugs on children. Analysts estimate that
the company could reap an additional $1 billion in sales for every
six months the patent is extended.
Eli Lilly, meanwhile, is lobbying Congress to overturn guidelines that
limit the use of its antipsychotic drug in Veterans Administration
hospitals - over the strong objections of some government doctors
in those hospitals. They contend that it would be a "dangerous
precedent" for Congress to start telling them which drugs to
prescribe.
"This is a great time to buy some good will," said Jake Hansen, a
lobbyist for Barr Laboratories, which wants to make a generic
version of Glucophage, the Bristol-Myers diabetic drug. Under
"normal times," Mr. Hansen said, "the press would be having a field
day" over the patent- extension issue now in play.
But, with the attention on anthrax, big pharmaceutical companies
"know they are not under as much scrutiny," he said, adding "and
they are taking advantage of that."
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