Carrying Water for Big Pharma

Carrying water for big Pharma is the metaphor used by many, including Robert F. Kennedy, Jr., to describe how Big Pharma gets government favors from the Federal Drug Administration (FDA) and Drug Enforcement Agency (DEA) to receive favorable decisions regarding their drugs. The favors that the Federal Government grants to Big Pharma are unfortunately neither new nor singular, and those favors have been around for 80 years, since 1940.

The original favors were quiet and subtle, and were therefore hard to recognize as favors, but they were nonetheless, favors. For years Wyeth, which had moved Premarin from Canada to the U.S., did their own studies and those studies were endorsed by the DEA as valid.  Whatever the motivation, the results of those Wyeth controlled studies led the DEA to recommend to doctors and menopausal women that pregnant mare’s urine was wonderful.

The Fox in the Henhouse

These hormones were promoted as preserving bone health, cardiovascular health, mental health, and yes, protecting against Alzheimer’s, as well as preserving bladder and vaginal health. The hormones were supposed to prolong life. The risks of cancer were downplayed. The studies had what researchers call endpoint problems. The goal of the study is called the endpoint which answers the question, “What are we trying to prove?”

With the Wyeth studies, Premarin increased blood levels of good cholesterol and decreased blood levels of bad cholesterol. This didn’t have anything to do with the question they set out to prove, but because of these results, it was extrapolated that Premarin offered increased life expectancy. But guess again.

If you want to actually study life expectancy, then you need as your end point to measure actual life expectancy, that is, age at the time of death, not cholesterol levels. But for years the people doing the studies preferred the extrapolation to doing actual research with an end point demonstrating that life expectancy was increased.

Eventually those life expectancy studies were actually performed. It was discovered that the previously inferred increase in life expectancy did not exist. As a matter of fact, increasing good and decreasing bad cholesterol were meaningless. What matters then, is choosing the correct endpoint. With the correct endpoint, it was discovered that what was assumed would add years to life-expectancy actually decreased it.

When the Women’s Health Initiative (WHI) study came out in 2002, much of what we thought were advantages as a result of the Wyeth testing, approved by the DEA, was found to be false. So, for 60 years we had the DEA “carrying water” for Wyeth. Although the damage to the consumer population is immeasurable, neither Wyeth nor the DEA was held accountable in any way. I doubt that there have even been any laws made to curb such water-carrying relationships.

We have failed to recognize the subtleties of the past transgressions and have moved on, with the help of the Big Pharma water carriers, to much more blatant transgressions. What exactly are the future dangers for consumers? After the last few years, we can expect increased water carried by agencies such as the National Institutes of Health (NIH), the Center for Disease Control and Prevention (CDC), Food and Drug Administration (FDA), Federal Bureau of Investigation (FBI), Office of the Inspector General (OIG), and the Department of Justice (DOJ). Sadly, when we discover these agencies “carrying water” for Big Pharma, we are no longer surprised or offended.

In November of 2018, CVS Health Corporation (owner of CVS Pharmacy) bought Aetna, which included Aetna’s Pharmacy Benefits Manager (PBM). As a result of this so called “merger,” not only was the DOJ carrying water for Big Pharma CVS Health, but also the PBM is carrying water for CVS Health, exactly the organization the PBM is supposed to be watching. Why did the DOJ, which is supposed to prevent this kind of destructive merger actually grace it with their approval?  Here is the reason the DOJ by bought hook, line and sinker. CVS asserted that this move was “innovative” and healthcare required this kind of innovation. Both the DOJ and the PBM are supposed to protect the public by controlling and managing the cost of pharmaceuticals. The job of the DOJ is to protect the public from being fleeced by Big Pharma. Clothing the wolf in “innovative” fur may fool Little Red Riding Hood, but it shouldn’t fool the DOJ.

Why this particular merger? This merger makes sense on several levels. First CVS was flush and obviously had more money than they needed. Although CVS had raised their average employee salaries from $29,000 a year to $55,000 a year, the CEO of CVS still made about $22 million a year. Life insurance companies such as Aetna had suffered severe losses during the pandemic. Deaths among the 18 to 62 age group had increased markedly during the pandemic. Aetna had gone from being very flush to being very cash poor as a result of the increased deaths in this age group, which was the average age of the working population. So, Aetna was broke and CVS was flush.

How much did CVS pay for Aetna? The answer is $75 billion. Yes, billion. The questions we should be asking is where did CVS get the $75 billion dollars. Traditionally the PBM was designed to interface between insurance companies and Big Pharma. The PBMs of insurance companies are supposed to be representing consumers by keeping the costs of consumer medications down.

By now most readers are probably asking, where did CVS got an extra $75 billion?
CVS’s money comes from the increased cost of health insurance for all consumers.

The Generics Game

         Big Pharma is well known for requiring the use of a generic medications instead of brand name medications. The generics often do not work as well as brand medications because generics are similar to, but not 100 percent comparable, to brand name medications. Furthermore, generics are made in India, Israel and China to name a few. We are unable to control how these generics are produced or hold the production process to safety standards in this country.

In my experience, Big Pharma will offer a generic which doesn’t work very well before they will pay for a medication that actually works. The average consumer should also know that the most profitable medication for any pharmaceutical company is the generic. Big Pharma makes more profit on generics made in other countries than on name brand medications produced in this country. The forced use of generic medications by Big Pharma should not be determined by how much money Big Pharm can wring from generic sales to patients.    

This DOJ decision to allow CVS to buy Aetna could not have been any more destructive for consumers and their healthcare. The problems associated with this so-called merger will reverberate for decades throughout Medicare, Medicaid, insurances and federal agencies. The DOJ and other federal agencies should not be allowing corporate mergers to set up business structures under the guise of being “innovative” when the merger is clearly not in the best interest of healthcare consumers. We don’t need more water carriers for Big Pharma. We need the water carriers gone. When the DOJ can’t recognize mergers and procedures harmful to the public, we are all in trouble.