‘It is normal for pharmaceutical companies to have profit margins of over 20%. This is relatively high compared to other sectors, and as high as the profit in the software industry. The profit can not be explained by the high risk of investment in specific related R & D processes ‘(COM Report SEO, 2014). The explanation is that pharmaceutical companies often abuse their monopoly position of a specific drug and thereby demand an irreplaceable high price for the drug. ‘To keep expensive drugs affordable, profit margins for pharmaceutical companies should be tied to a maximum. That says Wouter Bos, chairman of the VU medical center in Amsterdam. According to Bos, a profit standard of maximum 10% is necessary because the pharmaceutical industry itself only comes with nonsense solutions’ (FD, 2017). They save on providing cheap, commonly used drugs by the GP to pay new expensive cancer therapies, which cost between 50.00 and 150.000 euros per patient each year.
The drug market is not a market: all sales are done by the prescription pen of the doctor where the pharmaceutical industry targets its marketed to. This concerns mainly new, patented resources, whose price is unilaterally determined (Trouw, 2013). This market, which deals with tens of thousands of billions worldwide, is often based on a lack of test data, which makes deception easy and as a consequence doctors prescribe the new resources massively. The prescribing behavior of the doctor is strongly influenced by opinion leaders of universities. However, the universities are also influenced by their need of market support and to a large extent participate in the marketing of drugs. Over the last decades hundreds of thousands of patients worldwide have died of new drugs that were not yet in the test phase.
Three examples of abuse
‘Only by Avandia, an anti-diabetes drug, 47,000 people had a fatal heart attack, a US Senate Commission stated in 2010. Eighty percent of American sugar patients and eight percent of Dutch patients swallowed Avandia when it disappeared in that year’(Trouw, 2013). The drugs Januvia and Janumet have also been promoted with billions to GPs and universities, and further promoted by lobbying to politicians, health insurers, journalism, patient associations, etc. Thanks to these campaigns, 50,000 sugar patients now swallow the not yet well tested drugs Janvia and Janumet.
2) Cholestrol inhibitors
That all is about money is clear. Six Dutch professors advise Lipitor cholesterol inhibitors to a commercial DVD from producer Pfizer. Simvastatin works much better and is well researched, but we have spent two billion euros over the last ten years in the Netherlands on the much more expensive Lipitor. Based on the scarce effectiveness studies, Lipitor does not show any better score. It is clear that it has many more side effects, but the “moles” on the DVD are silent. Pfizer thanks them to the cover of the DVD warmly for their clear analyzes’ (Trouw, 2013).
3) AIDS inhibitors
The era in which pharmacists actively try to withhold people of poor countries of life-saving drugs is forever over, Leereveld thinks. At the beginning of this century, the industry sent pelotons of attorneys to Nelson Mandela when he wanted to make local factories for cheap AIDS inhibitors. More than they wanted to save lives of poor Africans, the pharmacists wanted to protect their own patents’ (Volkskrant, 2014). Now the pharmaceutical industry is increasingly making efforts to make drugs available to the poorest inhabitants of developing countries. The motive is again profit: two billion poor people have little or no drug access and the demand for drugs is growing in the Third World many times faster than in richer countries.