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Health Letter Archive
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Health Letter Cumulative Alphabetical Subject index
View a comprehensive list of subjects covered in Health Letter from its first issue in 1985 through the present.
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Read our outrages
- Doctors in the Death Chamber — Participants Should Lose Their Licenses, June 2014
- Revolving Door at FDA Undermines Public Confidence, May 2014
- Auto Safety Regulators Ignore Danger Signal, Fail to Protect Consumers From Life-Threatening Defect, April 2014
- Dangerous New Opioid Pain Drug Scheduled to Hit U.S. Market in March, March 2014
- FDA’s Reckless Inaction Regarding Over-the-Counter Acetaminophen, February 2014
- Secrecy in Health Care Pricing, January 2014
- False and Misleading TV Drug Ads, December 2013
- Addicting Children to Nicotine with E-cigarettes, November 2013
- Preventable Death and Lack of Insurance, October 2013
- Exploiting The Desire for Younger-Looking Skin, September 2013
- Pay for Delay, August 2013
- Avandia, July 2013
- Medicare Advantage — Whose Advantage?, June 2013
- Unethical Studies on Premature Babies, May 2013
- Republican Politics, Medicaid Expansion and Hypocrisy, April 2013
- Modeling For Ads Promoting a Diabetes Pill, March 2013
- More About Drug Industry Lawlessness, February 2013
- Court Allows Big Tobacco to Hide the Graphic Dangers of Smoking, January 2013
- Top Five Examples of Overdiagnosis and Unnecessary Treatment, December 2012
- Evidence of the Damaging, Expensive Results of Privatizing Medicare, November 2012
- Deficiencies of the Texas Medical Board, October 2012
- Substandard Doctors Should Not Treat Louisiana Prisoners, September 2012
- Profiting from Obamacare, August 2012
- Medical Center Shares Patient Information With Fundraiser, July 2012
- The Personal Face of Inadequate Doctor Discipline, June 2012
- FDA Helps Companies Exploit Patients With Alzheimer’s Disease, May 2012
- Treating Sick Rich Folks, April 2012
- Dangers of Overdiagnosis and Overtreatment, March 2012
- American Red Cross Violations, February 2012
- 50 Million Uninsured in the U.S. Equals 50,000+ Avoidable Deaths a Year, January 2012
- More Despicable Drug-Industry Behavior, December 2011
- For Big Pharma, Crime Pays, November 2011
- Having 50 Million Uninsured Americans Is Bad Enough, But…,
- Profiting from Disasters, September 2011
- Further Arguments for Eliminating the Private U.S. Health Insurance Industry, August 2011
- Hope for Delaware Emerges After Disaster for Its Children, July 2011
- Remove Dangerous Alzheimer’s Drug — Aricept 23 — from the Market Immediately, June 2011
- Unreliable Alzheimer’s Diagnoses, May 2011
- Patient Advocacy Groups and Drug Company Funding, April 2011
- Atomic (Nuclear) Power, March 2011
- War’s Adverse Impacts, February 2011
- Governor Scott of Florida, January 2011
- Pharmaceutical Industry Is Biggest Defrauder of the Federal Government under the False Claims Act, New Public Citizen Study Finds, December 2010
- U.S. Troops: More Deaths Related to Prescription Drugs, October 2010
- The Health Insurance Industry, September 2010
- Don't Get Sick in July, August 2010
- They Said What?!, July 2010
- Crime in the Pharma Suites, June 2010
- The Continuing Saga of Avandia: Paid Cheerleaders for the Drug, May 2010
- FDA Cautious on Food Safety, Reckless on Drug Safety, April 2010
- “Botox Injections Helpful for Depression?”, March 2010
- Everybody In, Nobody Out (That Means Immigrants Too!), February 2010
- Tamiflu? More Like Scamiflu!, January 2010
- The Case of Neurontin: Skewed Research in the Service of Selling, December 2009
- AHIP’s Actuarial Acrobatics, November 2009
- Drug Company Inducements to Doctors: Not Par for the Course, October 2009
- Ghostly Prescriptions, September 2009
- Medical Publisher Offers Bribes for Writing Favorable Book Reviews, August 2009
- Language Matters: Poor Communication Can Mean Poor Health Care, July 2009
- A Coalition of the Scared, June 2009
- Psychoprostitution, May 2009
- High Deductibles for Limited Eligibles, April 2009
- Ending the Insanity of Failed State Health Insurance Reforms, March 2009
- “Morning After” Contraception: Too Difficult to Get, February 2009
- Full Body Scams: Not Your Source for Peace of Mind, January 2009
If you're not outraged,
you're not paying attention!
Read what Public Citizen has to say about the biggest blunders and outrageous offenses in the world of public health, published monthly in Health Letter.
Pay for Delay
Sidney M. Wolfe, M.D.
The more we learn about the lucrative scheme of “pay for delay,” in which brand-name drug companies pay generic companies to delay marketing of a drug, the more outrageous it becomes. In the scheme, generic companies profit by agreeing to delay the introduction of their lower-priced version, and brand-name companies profit by having an artificially prolonged time to maintain their market exclusivity, at much higher prices. But what is lucrative for these companies is extremely costly, even unaffordable, for patients who must pay higher prices for an extended time.
A new report by the nonprofit advocacy organizations California Public Interest Group and Community Catalyst examines the consequences for patients of 20 widely used drugs for which pay-for-delay schemes were employed. Among the drugs studied were Cipro (ciprofloxacin), Lipitor (atorvastatin) and Nexium (esomeprazole). For the 15 medications studied for which the delay is now over, the price disparity after the delay period shows the extent of savings that are unavailable while the delay period is in place. For example, a prescription for brand-name antibiotic Cipro costs $346, but generic ciprofloxacin costs only $23, and a prescription for Lipitor costs $205, while generic atorvastatin is only $18. The brand-name drugs studied cost an average of 10 times more than their generic equivalents, but as much as 33 times more, and the payouts on these drugs have delayed the introduction of generic versions for an average of five years, but for as long as nine years. Since 2005, generic versions of 142 drugs have been delayed this way.
Although many federal bills banning pay for delay have been proposed since 2006, none of them have succeeded, largely due to drug industry opposition. But a vital ray of sunshine comes via the recent Supreme Court decision in Federal Trade Commission v. Actavis. This ruling upheld the Federal Trade Commission’s right to challenge patent settlements that would result in pay-for-delay deals because of the significant anticompetitive effects these schemes can have. In this case, the payment from the brand-name company to the generic company was said to be between $19 million and $30 million annually until 2015. The decision did not flatly ban any such payment by brand-name companies, but it implied that much smaller payments might be allowed.
The decision stopped short of an outright ban but is likely to significantly reduce the size and occurrence of pay-for-delay deals and thereby hasten the time for less-expensive generic drugs to reach the millions of patients who will be much more able to afford them.