Reports have surfaced that pop superstar Michael Jackson was spending as much as $48,000 per month on prescription drugs, including Demerol and Diprivan.

A sidelight of this story is the pharmacy that news reports say filled and delivered many of those orders: Mickey Fine Pharmacy & Grill in Beverly Hills.

Mickey Fine is a pretty snazzy-looking place. It was originally one of those legendary Schwab Pharmacies where starlets were discovered while drinking milkshakes. As recently as March, it was a featured location in the Starz comedy series “Head Case.”

It’s not the kind of place you would normally associate with supplying a prescription drug habit.

Let me be clear: there is absolutely no evidence that Mickey Fine has done anything wrong here. But I hope it’s involvement in the Michael Jackson case will help us to think twice about preconceptions and stereotypes when it comes to prescription drug abuse.

Opponents of American citizens buying drugs from Canada have worked hard to associate online pharmacies with the increase in prescription drug abuse — although there is absolutely not one shred of statistical evidence to support this claim.

The fact is, while it’s certainly possible to use online pharmacies to feed a drug habit, it’s just as easy to borrow medications from friends, sneak them out of your parents’ medicine cabinet — or to get prescriptions from multiple doctors and fill them at a place like Mickey Fine.

Dean Baker, co-director of the Center for Economic and Policy Research, has written an excellent piece for Truthout that explains why a public option for health insurance is so vital to true healthcare reform.

Here are some choice excerpts from Dean’s article, which I’ve organized in a Q&A format:

Why is healthcare so expensive in the United States today?

The basic story is simple. The insurance, pharmaceutical and medical supply industries, along with the hospitals and the American Medical Association, have rigged the deck so that they get rich at the public’s expense. They have structured our health care system so that we pay more than twice as much per person as people in other wealthy countries, even though we get worse care by many measures. The bloat in the health care sector is projected to grow rapidly over the next decade as health care consumes an ever larger share of the economy.

Who benefits from high prices?

The Centers for Medicare and Medicaid Services (CMS) reports that just the increase in health care spending share of the economy over the next decade will cost us $4.3 trillion. That is equal to a health care tax of $57,000 for an average family of four … CMS projects that $1.4 trillion, or $18,500 per family will go to the hospitals. Doctors and the pharmaceutical companies are each expected to score about $550 billion, costing families $7,300. And the insurance industry’s share of GDP is projected to rise by $360 billion, or $4,800 for an average family.

What are some examples of the current system’s inefficiencies?

The government grants the pharmaceutical industry patent monopolies that prevent normal competition in the prescription drug market. Unlike every other country in the world, the United States lets the drug companies use their government-granted monopolies to charge whatever they want. As a result, we pay nearly twice as much for our prescription drugs as people in countries like Canada and Germany.

Of course, the insurance industry is a total mess. They pocket more than 15 cents for every dollar they pay out to providers. By comparison, the administrative costs of Medicare are less than 2 percent of its revenue.

Why don’t private insurers want consumers to have a public option?

If the insurers ever had to compete with a publicly run insurance plan on a level playing field, they would be blown out of the water. We know that private insurers can’t compete because we already had this experiment with the Medicare program. When private insurers had to compete on a level playing field with the traditional government-run plan they were almost driven from the market. That is why they got their friends in Congress to pass Medicare Advantage. This program spreads the wealth around by giving the private insurers a subsidy of more than 11 percent per patient.

As Congress debates health care reform, we should be very clear what is going on. It is easy to devise reforms that will reduce costs without jeopardizing the quality of care. That is not the fight. The fight is over whether Congress will leave in place structures that will siphon an ever-larger amount of money out of taxpayers’ pockets and put this money in the hands of the insurance industry, the hospitals, the drug companies and the doctors.

What will happen if the public option fails?

Unless Congress creates a serious public plan, you can expect to be hit with the largest tax increase in the history of the world — all of it going into the pockets of the health care industry.

If you follow political coverage, you’ve no doubt heard about the AARP lobby. The AARP’s opponents like to paint the organization’s lobby as one of the most powerful back-room forces in Washington. While this charge is open to question, it’s a narrative that many reporters have bought into — lock, stock and barrel.

The most recent example of this narrative in action is this story by Politico’s Chris Frates, in which he says the AARP is “threatening” legislators on healthcare reform and quotes a pharmaceutical industry representative trashing the organization and saying its real motives are financial (even though it is a non-profit organization).

What a bunch of nonsense.

Yes, as lobbies of non-profit organizations representing real people go, the AARP is a powerful one. That’s to the organization’s credit, and thank God for it. Because without the AARP as a buffer to Big Pharma, we would be in big trouble.

The AARP draws its strength from its members — tens of millions of seniors who are concerned about issues like Social Security, Medicare and — yes — prescription drug costs. It fights hard on Capitol Hill to make sure the voices of its members are heard.

That’s why the organization expressed concern to Senate officials last week that Congress is considering giving Big Pharma pricing monopolies of 12-14 years on generic biologics. Generic biologics are drugs such as insulin that are made by living organisms. Big Pharma is trying to slip this windfall provision into broader healthcare reform legislation.

The AARP would like a shorter monopoly window — meaning generic competition, and lower prices for consumers, sooner. The organization’s “threat” was simply to tell the Senate that it might not be able to support reform legislation if Big Pharma is allowed to sneak in such a lengthy window of monopoly profit-taking.

Sounds pretty reasonable to me.

And you know what? I’m pretty sure about 90 percent of the American public would agree — if anyone cared for our opinion on the matter.

And yet, Frates presents this as just another example of the AARP, the supposed 800 pound gorilla, throwing its weight around.

So, who’s the real 800 pound gorilla?

According to public data, the AARP has spent a little more than $4 million on lobbying so far in 2009. Big Pharma, by contrast, spent more than $25 million in the first quarter alone.

Frates even allows a pharmaceutical industry representative to charge the AARP, a non-profit, with having a profit motive for its lobbying efforts.

Nowhere is it mentioned in Frates’ story that pharmaceutical industry lobbying is motivated entirely and unashamedly by profits. Or is that just too obvious to mention?

Chris, I’m afraid you’ve gotten too absorbed in the hand-to-hand combat in Washington to see the difference between the good guys and the bad guys. It’s a common malady among the Washington press corps.

Michael Jackson could be the latest star to have died from an accidental overdose of prescription medications. According to Life & Style, Jackson was “taking a cocktail of up to seven prescription drugs in the months before his death,” including the anti-anxiety drugs Xanax and Zoloft and the painkiller Demerol. The Jackson family attorney compared the King of Pop’s death to that of Anna Nicole Smith.

While most celebrity drug deaths have been the result of either suicide or the use of illegal drugs, a surprising number of stars have died by accident — from medications you can purchase at the corner pharmacy. Here are 13 of the most famous:

1. MARILYN MONROE. Elton John’s “Candle in the Wind” died from an overdose of sleeping pills — specifically, Nembutal and chloral hydrate [pictured]. Although Monroe’s death was officially listed as a suicide in 1962, many forensic experts and investigators now say the overdose was more likely to have been accidental.

2. ELVIS PRESLEY. Perhaps the most famous prescription-drug abuser of all time, Elvis died in 1977 from an overdose of medications while on the toilet in his Graceland mansion. Presley’s ex-wife wrote: “Presley was taking Placidyls [pictured] to combat severe insomnia in ever increasing doses and later took Dexedrine to counter the sleeping pills’ after effects.” Presley’s personal physician, Dr. George C. Nichopoulos, concluded: “Elvis’s problem was that he didn’t see the wrong in it. He felt that by getting [pills] from a doctor, he wasn’t the common everyday junkie…”

3. JUDY GARLAND. The Wizard of Oz star was found dead in her London bathroom by her husband in 1969. Coroner Gavin Thursdon said the cause of death was an accidental overdose of Seconal [pictured].

4. HEATH LEDGER. Found dead in a Manhattan apartment he had been renting on Jan. 22, 2008, the 28-year-old actor died of an accidental overdose of prescription drugs that included the painkillers OxyContin and Vicodin, the anti-anxiety drugs Xanax and Valium, and the sleep aid Restoril [pictured], according to the New York Times. Upon learning the findings of the New York City medical examiner, Ledger’s father stated: “While no medications were taken in excess, we learned today the combination of doctor-prescribed drugs proved lethal for our boy. Heath’s accidental death serves as a caution to the hidden dangers of combining prescription medication, even at low dosage.”

5. HOWARD HUGHES. The germophobic genius and subject of Martin Scorcese’s The Aviator died in 1976 in route to a Houston hospital from his Acapulco estate. Although the official cause of death was liver failure, his autopsy showed lethal amounts of codeine and valium [pictured] in his system.

6. ANNA NICOLE SMITH. According to Wikipedia, “Ultimately her death [in 2007] was ruled an accidental drug overdose of the sedative chloral hydrate that became increasingly lethal when combined with other prescription drugs in her system, specifically 4 benzodiazepines: Klonopin (Clonazepam), Ativan (Lorazepam), Serax (Oxazepam), and Valium (Diazepam). Furthermore, she had taken Benadryl (Diphenhydramine) and Topamax (Toprimate), an anticonvulsant GABA agonist, which likely contributed to the sedative effect of chloral hydrate and the benzodiazepines.”

7. DOROTHY DANDRIDGE. The first African-American actress to be nominated for an Academy Award, Dandridge was found dead in West Hollywood in 1965 from an overdose of Imipramine [pictured], a tricyclic antidepressant. It’s believed she improperly combined the medication — which she took for her bipolar disorder — with pain medication she received after breaking an ankle.

8. DANA PLATO. The long-troubled Diff’rent Strokes star died from an accidental overdose of Vanadom [pictured] and Vicodin at her mother-in-law’s Oklahoma home in 1999.

9. KEITH MOON. The Who drummer died in 1978 from an accidental overdose of Heminevrin [pictured], a medication taken as part of a program to wean him off alcohol.

10. ROB PILATUS. The Milli Vanilli star, disgraced after the public learned the music duo did not actually sing on its hit records, died in 1998 of an accidental overdose of a medication (reportedly methadone [pictured]) designed to help him with drug withdrawal symptons.

11. ROBERT WALKER. Perhaps the most bizarre accidental prescription-drug death. The star of Hitchcock’s Strangers on a Train died mysteriously in 1951 after being given an injection of the “truth serum” sodium amytal [pictured] by psychiatrists at his home.

12. NICK DRAKE. The influential singer-songwriter died at his childhood home in the U.K. in 1974 from an accidental overdose of the antidepressant amitriptyline [pictured].

13. PAIGE SUMMERS. The 1998 Penthouse Pet of the Year was found dead in her fiance’s home in 2003 from a combination of the painkillers codeine and oxycodone. Her death may or may not have been an accident; some have pointed a finger at fiance Bracey Bobbitt — who was a pharmacist.

[Note: This is an update of a 2008 post.]

Can I make a suggestion to you? When some political blowhard on TV or the radio tells you something, don’t automatically believe it. Do your research to learn the facts for yourself, OK?

You see, pundits and politicians lie. And they hope you’ll be so accepting of their carefully crafted talking points that you won’t bother to investigate an issue for yourself.

A great example is high drug prices. America has — by far — the highest prescription drug prices in the world. But the pharmaceutical industry, aided by various demagogic pundits and alleged “think tanks,” has done a masterful job of convincing a sizable minority of Americans that these high prices are not the pharmaceutical industry’s fault, or our government’s fault — but instead, the fault of other countries.

Specifically, they argue that drug prices in Canada and Europe are too low, because those countries are “socialist” and put price controls on medications. That leaves the poor pharmaceutical industry to recoup all its enormous R&D costs by charging your grandma $100 for a bottle of pills that everyone else on the planet pays $40 or less for.

You see, America believes in the “free market.” America believes in “competition.” And that’s why America’s drug prices are correct — because they’re set by the “free market,” not by “socialist” price controls.

What a load of rubbish.

When it comes to prescription drugs, America is anything but a “free market.” In a free market, if a company developed a new drug, its competitors could develop competing drugs, and prices would quickly come down to a price set by the market.

That doesn’t happen in America. In America, we do have a form of socialism; it’s called “corporate welfare.”

When a new drug is developed, our government gives the drug company so-called “patent protections.” This means other companies are not allowed to compete with the drug developer for a period of several years.

Then, we allow these same drug companies to game the system, enabling them to extend their patents indefinitely by creating “new and improved” versions of the same drugs ad nauseum.

Finally — and this might be the most “ad nauseating” thing of all — once a drug company’s patent expires, our government allows drug companies to pay off generic suppliers to NOT make low-cost competing drugs.

Does ANY of this sound like a “free market” to you?

You can thank our lawmakers in Washington — and their friends, the pharmaceutical lobbyists with briefcases full of campaign contributions — for creating this system. It’s not a “free market” because Big Pharma has bought and paid for it.

All of this is to preface telling you that your outrage as consumers — despite the best efforts of Big Pharma and its water carriers to tamp it down — is finally having an impact.

President Obama is working with Congress to make it illegal for drug companies to pay off generic drugmakers. As U.S. News & World Report explains:

The administration wants to ban makers of brand-name drugs from shelling out “pay-for-delay” settlements to generic drugmakers, a practice that creates a financial incentive for generic drug companies to keep their much cheaper drugs off the market.

“If it’s legal for a brand to pay a generic to sit out, why wouldn’t it?” Federal Trade Commission Chairman Jon Leibowitz explained today at a Center for American Progress event. “And if a generic drug company is allowed to make more money by not competing than by going to market, isn’t that a good business deal for the company and its shareholders? The answer is, of course it is.”

Brand-name drugmakers have exclusive rights to their drugs only for a limited time. Generic drug companies can enter the market once the original patent is expired, “invented around,” or invalidated. This is when the elbows come out, as brand-name drug companies in recent years have spent millions paying their generic rivals to drop patent challenges. It’s often better business for the generic drug company to take the money than to continue the challenge and then put the drug out there. “Clearly these are win-win deals for the companies, but they leave consumers footing the bill,” says Leibowitz.

The administration is solidly behind stopping this, and there are bills making their way through the House and Senate that would do just that. If the practice ends, American consumers could save $35 billion over a 10-year period, according to Leibowitz. The government’s savings could be $12 billion over 10 years since it pays such a hefty chunk of the nation’s prescription drug bill. “And these assumptions are quite conservative,” adds Leibowitz.

Someone once told me during an argument that I was entitled to my own opinions — but not to my own facts.

You can say “yes” to high drug prices if you want to. But don’t ever say that high drug prices are set by the “free market.” That’s a load of hooey.

Image source

We’ve received a lot of questions from the eDrugSearch.com community about the Pharmaceutical Market Access and Drug Safety Act of 2009, the proposed legislation that would enable Americans, once and for all, to legally purchase prescription drugs from Canada.

Here some common questions about the bill, along with answers provided by the bill’s sponsors:

Q: Why is this bill necessary?

A: American consumers are charged the highest prices in the world for the same medicines that are available in other major, industrialized nations at a fraction of the cost. The Congressional Budget Office estimates this legislation will save U.S. consumers more than $50 billion over the next decade. The legislation will allow American consumers to import FDA–approved prescription drugs at the substantially lower prices available on the world market.

Q: How will it work?

A: Individual consumers will be able to purchase prescription medicines from registered Canadian pharmacies for their personal use or the personal use of a family member, via mail–order or the Internet. The FDA will be required to make available on its Web site a list of the Canadian pharmacies that are approved to ship prescription drugs to Americans. Drugs imported by American consumers would have to be in a 90–day supply or less, accompanied by a valid prescription.

Q: From what countries can prescription drugs be purchased under the act?

A: Individual Americans can purchase medicines from Canada via mail–order or the Internet from Canadian pharmacies registered with the FDA. In addition, the bill allows U.S.–licensed pharmacies and drug wholesalers to import FDA–approved medications from Europe, Australia, New Zealand, and Japan and pass along the savings to their American customers.

Q: Won’t Big Pharma just shut off supplies to Canadian pharmacies that sell to Americans?

A: For some time, Pfizer, Glaxo Smith Kline, Eli Lilly and others have worked to shut off the supply of drugs to those in Canada that export drugs to American consumers. Under the proposed legislation, such tactics are deemed an unfair and discriminatory trade practice and will not be permitted.

Q: What about Big Pharma’s claims that the proposed legislation would reduce their profits, and that research and development of new drugs would suffer as a result?

A: Drug companies spend a significant (and increasing) portion of their budgets on product promotion. In fact, Fortune 500 pharmaceutical companies on average spend nearly three times more on marketing, advertising, and administration than they do on R&D. And yet, the pharmaceutical industry never talks about needing to cut back on drug advertising. In addition, American taxpayers heavily subsidize pharmaceutical research both through the tax code and research at the National Institutes of Health.

Q: How much will American consumers save as a result of the Pharmaceutical Market Access and Drug Safety Act of 2009?

A: The Congressional Budget Office (CBO) estimates the legislation would reduce total drug spending by $50 billion over 10 years, with $10 billion of that in savings to the federal government. It’s important to note that the CBO found these significant savings even after adjusting for the weakening of the U.S. dollar and assuming that the dollar would remain at the same weak level over the course of its estimate. If the value of the dollar were to strengthen, the actual savings could increase substantially.

This needed legislation is currently in committee, where it could easily stall without your support. Please call your Congressman and Senator and ask them to bring the Pharmaceutical Market Access and Drug Safety Act to a vote.

The eDrugSearch.com e-book “99 Ways to Save Money on Your Prescription Drugs, 2009 Edition” is now available on Scribd, where you can see a preview of the book’s first 10 pages before purchasing.

Check it out and start saving on your prescription drugs now!

As readers of this blog know, we have been following the proposed Pharmaceutical Market Access and Drug Safety Act carefully as it wends its way through Congress. So far, neither the House nor Senate versions of the bill have gotten very far since their introduction in early March, although there has been some talk that the Senate bill may be put to a vote within a matter of weeks.

For those of you who would like to learn more about this proposed legislation, which would allow American consumers to legally purchase prescription drugs from Canada and other Tier One countries, you can read the full text of the House bill here, and a summary here.

Why do we need this legislation passed? The bill makes the case in seven points:

And what would passage of the bill achieve? Here’s a summary:

Pharmaceutical Market Access and Drug Safety Act of 2009 - Amends the Federal Food, Drug, and Cosmetic Act (FFDCA) to revise provisions governing the importation of prescription drugs. Waives the limitation on importation of prescription drugs that have been exported from the United States.

Prohibits the importation of a qualifying drug unless such drug is imported by: (1) a registered importer; or (2) an individual for personal use.

Establishes registration conditions for importers and exporters. Requires the Secretary of Health and Human Services to inspect places of business, verify chains of custody, inspect facilities, and determine compliance with registration conditions.

Sets forth provisions governing the importation of qualifying drugs that are different from U.S. label drugs, including standards for judging such differences.

Prohibits manufacturers from: (1) discriminating against registered exporters or importers; (2) causing there to be a difference in a prescription drug distributed in the United States and one distributed in a permitted country; (3) engaging in actions to restrict, prohibit, or delay the importation of a qualifying drug; or (4) engaging in any action that the Federal Trade Commission (FTC) determines discriminates against a person that engages or attempts to engage in the importation of a qualifying drug.

States that the resale in the United States of prescription drugs that were properly sold abroad is not patent infringement.

Requires the Secretary to educate consumers regarding prescription drug importation.

Sets forth provisions governing the sale of prescription drugs through an Internet site. Includes the dispensing or selling of a prescription drug in violation of this Act as a prohibited act under FFDCA.

Prohibits the introduction of restricted transactions with unregistered foreign pharmacies into a payment system or the completion of such transactions using a payment system.

We wholeheartedly support the Pharmaceutical Market Access and Drug Safety Act, and we encourage you to contact your Congressman and Senator to show your support as well.

A new U.K. report, “Prospects for Legalizing Drug (Re-)Importation to the United States”, has been released on the topic of U.S. citizens buying drugs from Canada and other Tier One countries, such as the U.K., Australia and Japan. The report promises insight and analysis on these key questions:

• Will the drug reimportation bill pass?
• Where would supplies come from?
• What would be the risks and savings for consumers?
• What would be the risks and opportunities for industry players?

The report, issued by London-based Report Buyer, presents itself this way:

With public and private payers across the country seeking to save every healthcare dollar to get through the economic recession, [Sen. Byron] Dorgan senses a ‘bit of a tailwind’ behind his proposal this time. His supporters are tackling their critics head on with claims that rather than it being dangerous the measure will actually improve drug safety…

Whether you want to protect your business in the US, assess the potential for becoming a player in what could be a new channel or a supplier to it, or are concerned about the knock-on effects in the 20 countries initially named as potential sources (inc. Australia, Canada, France, Germany, Italy, Japan, Spain and the UK) this report is essential reading.

Unfortunately, the report is a pricey $1,600, so unless you have a specific business interest in this legislation, you’re probably better off waiting to see how things unfold rather breaking the piggy bank for this one.

Or you can just keep reading the eDrugSearch Blog. After all, we’re free.

Anne Dunev at The Huffington Post recently called attention to a thought-provoking article published at the peer-reviewed journal of the Public Library of Science. Titled “The Cost of Pushing Pills: A New Estimate of Pharmaceutical Promotion Expenditures in the United States,” the 2008 article by Canadian academics Marc-André Gagnon and Joel Lexchin concludes:

From this new estimate, it appears that pharmaceutical companies spend almost twice as much on promotion as they do on R&D. These numbers clearly show how promotion predominates over R&D in the pharmaceutical industry, contrary to the industry’s claim … (I)t confirms the public image of a marketing-driven industry and provides an important argument to petition in favor of transforming the workings of the industry in the direction of more research and less promotion.

Dunev elaborates on the way the pharmaceutical industry’s drive for growth has distorted public perceptions of diseases and how to treat them. She writes:

You don’t have to be a financial pundit to know that any public company is responsible first and foremost to their stockholders. As a public company how do you meet your fiduciary responsibility? You ensure the price of your stock by increasing your bottom-line.

Does that require that you make up new “diseases” as you go? (Restless Leg Syndrome, for example.) Do you bend the rules of science in how you determine what constitutes disease so you can repackage old drugs that have lost their patent? Do you push dangerous new drugs on the market knowing that a little collateral damage is the price of making money, just as it is the price of making war?

According to USA Today in 2005, there were 1,274 registered pharmaceutical lobbyists in Washington, D.C. — more than two for every member of Congress. In 2003, $143 million was spent on lobbying activities by the Pharmaceutical industry. There are more lobbyists from pharmaceutical than any other industry trying to bend legislators’ ears.

This is big business, and that means that your health care is not in the hands of people who really want to help you, but in the hands of people who view you as a market. Caveat emptor.

Clearly, whatever healthcare reform the government enacts must include some control over pharmaceutical marketing. Remember, less than 20 years ago, direct-to-consumer advertising by pharmaceutical companies was not permitted by the FDA. That would seem to be a good start as we try to get drug costs back under control.