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Michael White: Pharma market abuse isn't picked up fast enough

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Doctors have been protesting for years about pharma companies sidestepping the price regime Whitehall negotiates with the industry. I’m all for having a regulator check for market abuse, but it doesn’t happen quickly enough or often enough

Did I ever share my qualms about the aspirin I get each day, courtesy of the NHS?

Together with a beta blocker, a diuretic and an ACE inhibitor, it’s part of a package that has extended my shelf life far longer than my parents managed with their undiagnosed or poorly medicated high blood pressure.

None of them is the kind of £20-plus drug that Jeremy Hunt plans to slap a price tag on next year (”funded by the UK taxpayer”). Wikipedia suggests my wholsesale cost to the taxpayer could be about £1 a day - a lot cheaper than the kind of stroke which recently killed my near-contemporary Cilla Black.

‘Buying my own aspirin might be a false economy’

It will be more, of course, since the supply chain needs its cut. But it was the 75 mg dissolvable aspirin which troubled me because I knew I could buy it off the shelf and probably save Mr Hunt (when I started it was probably Alan Milburn) a few bob.

There again, I reasoned: when they scrape me off the pavement and rush me to accident and emergency, it may be important that the paramedics discover why I’m bleeding so profusely because the script in my wallet includes aspirin. Buying my own might be a false economy.

Be aware of the cost of care

All right, I’m not a typical patient and am of an age to remember when “austerity” bit harder than it does now for most people. But I can’t see the harm in Jeremy - we could soon have two Jeremys to juggle - trying to make patients more aware of the cost of their care. The Daily Mirror and sections of the pharma business think otherwise.

But will it really make patients value the more expensive pill over the cheaper one? Will old people be too frugal to take ones that cost a lot?

‘Most of us benefit from knowing what things cost’

A few perhaps, but most of us benefit from knowing what things cost - “go easy with that wine bottle/cheese/smoked salmon/it’s the good stuff” etc).

The sums to be saved may be “modest” (is £150m a year modest? And is the sum actually nearer to £300m?), but that’s not to be sniffed at in an age of budget cuts, the “grey tsunami” and rising consumer expectations. It’s what Hunt has taken to calling the NHS’s “triple whammy”.

Notwithstanding Jeremy Corbyn’s surge in the Labour leadership contest, my sense of the public mood (as distinct from Labour activist mood) is that they still dislike public waste, especially when connected with fraud - doubly so when “foreigners” can be blamed. It may be deplorable to good liberals, but it helped cost Ed Miliband the big job.

Market abuse

So the pharmaceutical crowd in the shape of Pfizer (US) and Flynn Pharma (UK) got a deserved kicking as August arrived.

The Competition and Markets Authority, a much merged regulator like Monitor, found the pair had charged “excessive and unfair” prices (up to 27 times the original price between them) for phenytoin sodium capsules which 50,000 Britons use to control or prevent epilepsy seizures.

It’s only a provisional judgment (the firms will be allowed to respond). But it’s a lot of pills “funded by the UK taxpayer” and raised the NHS bill for the pill from £2.3m to £50m a year (equivalent to 2,000 nurses?). Exploitation of a market dominant position, says the CMA.

‘The pharmaceutical crowd got a deserved kicking’

Pfizer - already in the doghouse for trying to buy Britain’s AstraZeneca as a tax dodge last year - says new profitability has ensured the drug’s continued availability. Flynn Pharma bought the rights to the drug, then known as Epanutin, and rebranded it as a generic, thereby sidestepping the price regime which Whitehall negotiates with the industry.

In theory, competition keeps such prices low, but there isn’t much on this one whatever Flynn says about the price of rival products.

Some doctors have been protesting this particular abuse for years. But UK regulators are pretty cautious so don’t expect it to fine Pfizer the maximum 10 per cent of its worldwide sales ($32bn) if the CMA upholds its ruling on market abuse.

Put to better use

A market abuse eventually checked by the regulator? It sounds good to me, though it doesn’t happen fast enough or often enough.

Short of new wonder drugs, the pharmaceutical industry is going through hard times - of which mergers are a symptom - but rascals who scalp the taxpayer deserve to lose ill-gotten profits.

By the same test foreign individuals who shake down the NHS - “funded by the UK taxpayer” - by charging medical treatment in their own country to a UK issued European Health Insurance Card should also be pursued for fraud.

‘Just because an expose is in the Mail doesn’t mean it’s untrue or morally wrong’

It may be a small problem, but doctors popped up on the airwaves to confirm the loophole exists after the Daily Mail excitedly exposed it.

As I never tire of explaining to student audiences and Twitter trolls: “Just because an expose is in the Mail doesn’t mean it’s untrue or morally wrong.”

It’s all money we can put to better use.

Michael White writes about politics for The Guardian

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