-Caveat Lector- from:alt.conspiracy As, always, Caveat Lector Om K ----- Click Here: <A HREF="aol://5863:126/alt.conspiracy:644859">Drug Industry Shills</A> ----- Subject: Drug Industry Shills From: Alex Constantine <A HREF="mailto:[EMAIL PROTECTED]"> [EMAIL PROTECTED]</A> Date: Thu, Oct 5, 2000 10:05 AM Message-id: <[EMAIL PROTECTED]> NYT October 5, 2000 MEDICINE MERCHANTS Drug Industry Has Ties to Groups With Many Different Voices By JEFF GERTH and SHERYL GAY STOLBERG ------ WASHINGTON, Oct. 4 � Elizabeth Helms arrived on Capitol Hill on a warm Tuesday afternoon in July with a simple message for Congress: Drug stores, not drug makers, are to blame for the high cost of prescription medicines. Under the hot glare of television lights, Ms. Helms, a former hairdresser from Folsom, Calif., implored a panel of senators not to "kill the golden goose � the pharmaceutical industry." Then she presented her evidence: a survey of 80 pharmacies that showed consumers could cut their drug bills by more than half simply by shopping around. "The argument that the industry is gouging consumers with prices is completely unfounded," Ms. Helms declared. A consumer activist, Ms. Helms came to the Senate hearing representing three grass- roots organizations, including the patients' group that sponsored her survey and a consumer coalition, Citizens for the Right to Know. What her audience did not hear, however, was that she also works full time for a public relations company whose clients include the Pharmaceutical Research and Manufacturers of America, the drug industry's trade group. Six years ago, the industry trade group provided the seed money and public relations expertise to help create Citizens for the Right to Know; it still pays the group's telephone bills. And a spot check of Ms. Helms's survey found it overstated the differences in pharmacy prices. In an interview, Ms. Helms defended the survey and said working for the trade group is only a small part of her job. "I'm as grass roots as they come," she said. The story of how a woman schooled in cosmetology wound up offering testimony on drug prices to the United State Senate is a small, but telling, example of the pharmaceutical industry's broad and sometimes unseen reach into the debate about prescription drug prices. The industry is one of America's most lucrative and powerful businesses. And in this election year, with prescription drug prices at the center of the political debate, it has so far staved off what it fears most: a government-run prescription drug plan for the elderly, which drug makers say could lead to price controls. With drug companies concentrated in only a few states, they lack a broad constituency. And although they make life-saving products, they are not always warmly embraced by the patients who take them. So they have worked hard over the past 15 years to cultivate alliances with people like Ms. Helms. They have created large coalitions from scratch, and also financed hundreds of existing patient advocacy groups. They contribute to public policy groups of all political stripes, from state legislators' organizations to the Democratic Leadership Council, whose chairman is Senator Joseph I. Lieberman of Connecticut, the Democratic vice-presidential candidate. Today, the companies need allies more than ever. In the prescription drug benefits debate, they face well-financed opposition from labor and citizens' groups, notably the AARP, as well as the insurance industry, which typically runs neck-and-neck with the pharmaceutical industry as the business that spends the most money on lobbying. But after a decade of legislative successes, including valuable tax breaks, speedier approval of drugs and patent extensions, the drug makers are suffering some defeats. Members of Congress, anxious to show voters that they have taken action, are poised to enact a bill that would allow lower- priced medicines to be imported from foreign countries. Maine has adopted a law that gives the state authority to negotiate discounted prices on drugs, and the right to prosecute companies for profiteering. Helping elderly people pay for their medicine is a hot topic in presidential politics; in the debate on Tuesday, the candidates clashed repeatedly over how to accomplish that. The companies, fearing a government- run plan would lead to price controls, are siding squarely with Gov. George Bush of Texas and other Republicans who want to keep the government out of the drug insurance business. The drug makers' message is emotional and simple: don't interfere with our ability to save lives. To get it across, the top 15 pharmaceutical companies spent nearly $60 million last year, up from $45 million in 1998. They have hired the usual group of former government officials as lobbyists, have financed studies to advance their views, and run expensive advertising campaigns to soften their image. "We have refused to play only defense and serve as a punching bag for those who want to attack the industry as a means of pursuing their own political agendas," Gordon Binder, the president of Amgen, said in April, in his farewell address as chairman of the industry trade group. "We have succeeded in changing the substance and nature of the debate." But the companies' hand in the debate is not always readily apparent. Last spring, for example, a study by the Lewin Group, a consulting firm, helped persuade House Republicans to pass a prescription drug benefits bill the industry favored. The study examined the potential savings from private drug insurance. The trade group heavily advertised it � without mentioning it had paid for the study. And when the study's own author re-examined the data at the request of The New York Times, she determined it had overstated the potential savings. The drug companies have also spent millions over the past decade to create seemingly independent groups that promote their agenda. Last year, the industry trade group created Citizens for Better Medicare, which has been waging a $50 million advertising campaign against a government-controlled prescription drug benefit. And lobbying records show that drug companies are major backers of Alliance for Better Medicare, which describes itself as "a coalition of nearly 30 organizations representing seniors, patients, medical researchers and innovators, doctors, hospitals, small businesses and others." "We advocate our positions in every way that we can," Alan Holmer, president of the trade group, said in an interview. "We do it directly and we do it indirectly and we seek allies in that effort." Mr. Holmer is passionate in his defense of the industry; his two children have cystic fibrosis, an incurable disease, and they have benefited from new medications. But while he is passionate, he is also guarded. He volunteered that the trade group is spending $22 million on advertisements this year, but declined to disclose its support for allies, arguing that industry critics would "misconstrue, misinterpret and twist" the information "to villify America's premier high technology industry." But some drug company executives say the industry has not been open enough, hurting their public image. "As an industry, we bear a great deal of the blame for the public anger aimed our way," Lodewijk De Vink, a former chairman of the board of the trade group, said to his colleagues in a speech in 1995."To too many people, our industry is like a tall building with no windows. Important, imposing, even inspiring � but also mysterious, secretive, frightening." The Argument Drug Makers Say Research Behind Costs For much of the 1900's, the officials of the "ethical pharmaceutical companies," as they were once called, to distinguish themselves from snake-oil salesmen, worried little about the image of their industry. "The companies dealt exclusively with doctors and pharmacies," said John Baruck, a former member of the trade group's board of directors. "They didn't have to worry about what people thought." That began to change in 1984, when Congress passed a bill to promote generic drugs. The trade group for the brand drug makers, then called the Pharmaceutical Manufacturers Association, responded by bringing in new management: Gerald Mossinghoff as president and Robert Allnutt as his deputy. The pair built an image campaign around a single word: research. Today, that word is at the center of the prescription drug benefits debate. The United States is the last free market for pharmaceuticals; other developed nations control either prices or profits. But the drug companies say price controls in the United States would lead to cutbacks in research. The argument resonates strongly on Capitol Hill. "Even the people that talk about the outrageous prices, the people opposed to the industry," Mr. Allnutt said, "they temper their statements by saying we don't want to hurt research." The message was so powerful that in 1994, on the advice of a focus group, the Pharmaceutical Manufacturers Association inserted the word research into its name, creating a new, if grammatically awkward, moniker: the Pharmaceutical Research and Manufacturers of America, or PhRMA. Mr. Mossinghoff and Mr. Allnutt also created an "ally development" plan, making friends with groups representing patients and doctors, minorities and associations representing businesses. "As you get further away from people who are hired to say things,' Mr. Allnutt said, "you have a much more believable spokesman." The effort paid "rich dividends," Mr. Mossinghoff said. In 1993 the Clinton administration proposed saving money on Medicaid by restricting coverage of certain medications. The trade group responded by hiring Apco Associates, a Washington public relations firm, to organize its allies into a new group, the Coalition for Equal Access to Medicines. The plan was defeated. Last year, again with Apco's help, Mr. Holmer assigned the industry trade group's advertising director, Tim Ryan, to pull together allies in the drug benefits debate. The result was Citizens for Better Medicare. Financed mostly by drug makers, the group is run by Mr. Ryan and leases spaces in Apco's Washington office. Most of the coalition's members are small organizations with a relatively narrow mission; many receive pharmaceutical company contributions. But coalition members say concern for the future of pharmaceutical research, and not money, drives their alliance with the pharmaceutical industry. "If you mean, `Does Alan Holmer get on the phone and call me and say, 'Go to Maine,' the answer is no," said Carl F. Dixon, executive director of the Kidney Cancer Association, a coalition member. "I'm more likely to call over there and say, `What are you doing in Maine?' " For the trade group, these are valuable relationships, and forging them has taken years of hard work. "It's very labor-intensive," Mr. Mossinghoff said. "You have to help them with their fund-raising dinners." Mr. Allnutt left the trade group in 1995 but still acts as a consultant to it. The Advocate >From a Jaw Ailment, A Lobbying Force Elizabeth Helms was just the kind of friend Mr. Allnutt envisioned: an articulate and strong-minded consumer advocate who commanded attention from California's politicians and press. Her activism began in 1993, when Ms. Helms owned a hair salon in northern California. Ms. Helms's managed care company had refused to pay for surgery to correct a jaw condition, temporomandibular joint disorder; she founded a support group, the TMJ Society, for other people with the condition, and soon became acquainted with more experienced patient advocates. At about that time, the drug industry's trade group hired a firm in Northern California to "initiate an education and empowerment campaign for consumers regarding managed care and disclosure," said Kassy Perry, a Sacramento public relations woman who now has the trade group's account. That campaign led to Citizens for the Right to Know, with Ms. Helms and the other advocates as its steering committee. Their agenda eventually expanded to include pressing insurance companies to cover most prescription drugs, a goal shared by the drug industry. Ms. Perry, a former adviser to two Republican California governors, took over the trade group's account, and with it, Citizens for the Right to Know, about five years ago. Her firm, the Perry Communications Group, specializes in health care, and it has represented an impressive list of clients, including drug makers and nonprofit groups. With Ms. Perry's help, Citizens for the Right to Know has grown to include 80 organizations, from AIDS advocacy groups to a clinic for poor pregnant women. But it is Ms. Helms, and not Ms. Perry, who has been the public face of Citizens for the Right to Know. A few years ago, she joined the Perry Group to work full-time as director of advocacy and patient outreach. Among the fellow advocates Ms. Helms teamed up with was Lenny Van Pelt, a lawyer in Bellevue, Wash., who suffers a rare hereditary disorder. Like Ms. Helms, Mr. Van Pelt founded a patients group, the International Patient Advocacy Association. Mr. Van Pelt's health depends on a drug made by the Genzyme Corporation. The medication grew out of an invention by federal scientists at the National Institutes of Health, which licensed the idea to Genzyme. The drug is extremely costly � $170,000 a year, on average �and so both Genzyme and Mr. Van Pelt work to persuade insurance companies to cover it. And Mr. Van Pelt is active in managed care issues, with Citizens for the Right to Know. In California, Citizens for the Right to Know takes credit for managed care legislation and a state investigation into accusations that managed care companies unfairly restricted access to certain medications. The group operates out of Ms. Perry's office; Ms. Perry said the group's bills are covered by a medical association, biotech companies, a pharmacists association and the drug industry's trade group, which she said provides $2,000 a year for the telephone and fax. Mr. Van Pelt said his group's backers included drug and biotech companies, among them Genzyme. But he declined to disclose further details, saying, "It's none of your business." In the States Price Relief Along the Border Perhaps nowhere is the drug manufacturers' need for allies as strong as in the states along the Canadian border. In Maine, Vermont and Mr. Van Pelt's home state of Washington, residents do not just look enviously at Canadian pharmacies, with their low drug prices, they drive across the border to shop there. Politicians, mostly Democrats, organize some of the trips. One industry critic is Chellie Pingree, majority leader of the Maine Senate. Ms. Pingree, a Democrat, sponsored Maine's new prescription drug pricing law that permits the state to negotiate with drug manufacturers for lower prices for the uninsured. The drug makers' trade group has sued in an attempt to block the law from taking effect. Over the years, Ms. Pingree had been befriended by drug lobbyists � relationships that, she said, have been as difficult to give up as the campaign contributions from the industry she no longer receives. "They take you out to dinner, they make friends with you, invite you to parties," she said. They also donate money. In Washington, the drug makers donate overwhelmingly to Republicans. That holds true in Maine; in July, drug makers gave $10,000 to Maine Republican leaders, their biggest source of money, records show. In the past, Maine Democrats have also received contributions from the pharmaceutical industry. But in a recent note to Maine Democratic leaders, provided by Ms. Pingree, a Pfizer lobbyist complained that he had seen her and Maine's Democratic speaker of the House "attack our companies" and so could "no longer be a supporter." A Pfizer spokesman, Andrew B. McCormick, said the company donated to both political parties, but withdrew financing from the Maine Democratic leadership committee due to "misleading attacks." But Ms. Pingree's idea is spreading. In Vermont, Peter Shumlin, the Senate president, pushed for similar legislation, and organized a caucus of New England state legislators to work for lower drug prices. The companies are working hard to oppose Mr. Shumlin, whom they view as an advocate of price controls. When Mr. Shumlin was to moderate a panel on drug pricing at a meeting of the National Conference of State Legislatures, in June, the drug maker's trade group complained, sending a letter that noted each drug company's financial support to the conference's foundation. The panel was reorganized. Industry lobbyists say the drug companies are outmanned in northern states, particularly Maine, where labor unions promote bus trips to Canada and where there are no drug manufacturing facilities. In Maine and elsewhere, the drug industry and its opponents are waging a daily battle to sway public opinion. Allies of the industry trade group, people like Mr. Van Pelt, and Mr. Dixon of the Kidney Cancer Association, are especially important in this fight. In Maine, they joined to urge the governor to veto Ms. Pingree's bill. In Vermont, the Kidney Cancer Association paid for a poll to demonstrate opposition to controls on drug prices. Mr. Van Pelt, meanwhile, turned his attention to his home state of Washington, where Senator Slade Gorton, a Republican, broke party ranks in April and introduced a bill that would bar drug companies from charging different prices to wholesalers in different countries. Soon afterward, Ms. Perry and Mr. Van Pelt conducted a survey to examine the variation in domestic drug prices � the survey that Ms. Helms eventually took to the nation's capital. The telephone poll, which Ms. Perry said was conducted by her employees, canvassed 80 Washington State pharmacies. It reported that prices varied an average of 101 percent. The 101 percent variation was based on extremely high prices from one pharmacy. In an interview on the day Ms. Helms presented her survey, the pharmacy's owner said those prices were incorrect. Using the lower figures he provided, the actual variation dropped to 59 percent. Asked about the survey, Ms. Perry said she stood by the original numbers. On July 18, Ms. Helms, appearing on behalf of Mr. Van Pelt, presented the survey to the Senate. On July 20, Mr. Van Pelt released it at a crowded news conference in Seattle. The survey made the local newspapers and was broadcast on the evening news. That same day, as part of a campaign to defeat another prescription drug bill, the drug makers' trade group began running advertising critical of Senator Gorton. In a recent interview, Mr. Gorton said that such attacks are inhibiting his fellow senators. "They are extremely reluctant to step out as I have," Mr. Gorton said, "because they don't want to be trashed." The Capital Fight Standing Behind Questionable Figures In April, the nation's pharmaceutical executives gathered at the Ritz-Carlton in Laguna Niguel, Calif., for their annual meeting. The issue of drug coverage for the elderly was high on the agenda. "One year ago, most in Washington said we could never achieve expanded drug coverage for seniors through the private sector," Mr. Binder, the trade group chairman, said then. "And now, that is exactly what key members of Congress are proposing." Around that time, to give its allies in Congress some ammunition, the trade group commissioned the Lewin Group, the consulting company, to examine the potential savings from private drug plans. Published in April, the study found that discounts from private plans would average at least 30 percent and as much as 39 percent. On June 13, Mr. Holmer of the trade group testified in the Senate and cited the Lewin group study, without mentioning who paid for it. That same day, the manufacturers' association featured the study in an advertisement in The Washington Post, again without mentioning its own role. When asked about this, an official of the trade group said that the group's use of the study "implicitly makes clear" that it paid for it. The Lewin study came in handy for Republicans when, on June 28, they passed an industry-backed bill that calls for the government to pay subsidies to insurance companies that offer drug coverage for the elderly. "This played into our hand," said Greg Maurer, health aide to Representative Cass Ballenger, a North Carolina Republican who cited the study in support of the bill. "It just gave us some numbers, the numbers we were kind of looking for anyway. It worked well." But when a reporter later asked the study's author, Katharine Harrington, a Lewin Group vice president, for a further analysis, she lowered her estimates for potential savings to 23 to 33 percent for brand and generic drugs, and to 20 to 30 percent for brand-name drugs only. Robert J. Rubin, president of The Lewin Group, said his firm stood by the study. "The point of substantial discounting is still valid," he said. The Studies Independent Research Is Hard to Find Dirksen Lehman spends a considerable amount of time sorting out conflicting information in the pharmaceutical pricing debate. As the health counsel to the Senate Committee on Health, Education, Labor and Pensions, it was up to Mr. Lehman to find witnesses for the July 18 hearing that brought Elizabeth Helms to Washington. Mr. Lehman knows the pharmaceutical industry well; he once worked for a law firm that lobbied for its trade group, a job that he says helps him in his current position. Mr. Lehman knew that the companies were trying to explain medicine prices by pointing to variations in pharmacies. He wanted someone to present a study on the topic. But he did not want one paid for by the drug industry. That is a tall order, said Dr. Stanley S. Wallack, executive director of Brandeis University's health policy institute. At the July 18 hearing, Dr. Wallack complained that it was difficult to find independent research on pharmaceutical pricing. "Almost all the studies are being conducted by the pharmaceutical companies," he said. Mr. Lehman's search led him to Ms. Helms. Her connection to the drug makers' trade group did not entirely surprise him. "You can find folks all over the place to come out and criticize the industry," Mr. Lehman said. "But to find people who are pro-industry on some of these positions, and completely independent of the industry, is difficult." ------------ ----- Aloha, He'Ping, Om, Shalom, Salaam. Em Hotep, Peace Be, All My Relations. Omnia Bona Bonis, Adieu, Adios, Aloha. Amen. Roads End <A HREF="http://www.ctrl.org/">www.ctrl.org</A> DECLARATION & DISCLAIMER ========== CTRL is a discussion & informational exchange list. Proselytizing propagandic screeds are unwelcomed. Substance�not soap-boxing�please! These are sordid matters and 'conspiracy theory'�with its many half-truths, mis- directions and outright frauds�is used politically by different groups with major and minor effects spread throughout the spectrum of time and thought. That being said, CTRLgives no endorsement to the validity of posts, and always suggests to readers; be wary of what you read. CTRL gives no credence to Holocaust denial and nazi's need not apply. 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