The answer for people who need medicines is coverage, not price controls.

With all due respect, you are dead wrong when you cite the myth that the pharmaceutical industry “is significantly subsidized by taxpayers” (Jan. 22).

The National Institutes of Health, the federal government’s premier biomedical research agency, found in a July 2001 report that only four of 47 drugs with U.S. sales of $500 million a year or more had been developed in part with technologies created with NIH funding. The U.S. pharmaceutical industry spent about $30 billion on research and development alone in 2001. The NIH budget that year was $20.3 billion, and only a part of that sum was actually devoted to pharmaceutical research.

Regarding taxes, a PricewaterhouseCoopers analysis found that, according to 1997 data from the Internal Revenue Service, “the pharmaceutical industry paid more tax than 97 percent of all industries (ranking sixth out of 180 industries).”

Since 1980, our industry has spent about $248.2 billion on research and development and developed dozens of medicines for HIV/AIDS, leading to a dramatic reduction in U.S. AIDS deaths over the last seven years. The industry has developed more effective drugs that are largely responsible for reducing heart disease deaths by more than half since 1950, including a one percent drop in 1999 alone, and medicines that have helped cut emphysema deaths by 57 percent and ulcer deaths by 72 percent since 1965.

Ten years ago, there were no medicines available for Alzheimer’s disease. Today, there are four, with 17 others in clinical testing. Cases of bacterial meningitis among young children dropped nearly 80 percent over 11 years after the introduction of a vaccine, saving $135 million a year in avoided hospital costs. Cancer deaths were reduced between 1990 and 1997 as a result of better treatments and earlier detection. Today’s new medicines help many patients avoid the higher cost of surgery and institutionalized care.

Despite an increase in the over-65 population in the 1990s, the nursing home population declined by about 400,000 patients between 1994 and 1999, for a projected savings of about $18.9 billion. The decline is, in part, the result of effective medicines for depression, blood pressure, cholesterol and arthritis.

By violating federal Medicaid law, the Pharmaceutical Research and Manufacturers of America believes Maine Rx hurts the state’s poorest, most vulnerable patients to ensure that everyone else in the state, including the wealthy, receive at least the federally-established Medicaid rebate, and eventually an even larger rebate.

It is a bad law that is not in the interests of Medicaid patients or other citizens who have limited access to prescription drugs. Many, if not most, of the patients with access problems are elderly and disabled and the answer for them is clear: they desperately need a Medicare drug benefit.

A Medicare drug benefit could relieve Medicaid programs of the responsibility of providing drug coverage to poor patients over 65, thus providing a significant savings in state Medicaid funds. We also need federal Medicare drug coverage because the last thing we need is a confusing patchwork of different state laws with uneven records of serving financially strapped older patients.

While we are waiting for Congress to act, there are interim ways to help the millions of senior citizens and 8 million disabled patients who would benefit from a Medicare drug benefit.

Pharmaceutical companies have voluntarily offered discounts to Maine’s Elderly Low Cost Drug Program, a state assistance program in existence long before Maine Rx was enacted. A number of large pharmaceutical firms also offer discounts to elderly patients through discount cards. All PhRMA member companies, meanwhile, have patient assistance programs that provide free medications to patients who can’t afford their medicines. In 2001, more than 20,000 Maine residents received free medicines from these programs. Nationwide, in 2002, these patient assistance programs provided free medicines to about 5.5 million patients.

Patients can receive free copies of a PhRMA directory that summarizes each patient assistance program and provides directions on how to get in touch with each.

The answer for people who need medicines is coverage, not price controls. In Canada, prices are artificially low because of strict government-mandated price controls. The Canadian system hurts patients by stifling pharmaceutical innovation and rationing care. In some Canadian provinces, the delay for getting new drugs can be up to two to three years.

Jeff Trewhitt is the spokesman for the Pharmaceutical Research and Manufacturers of America in Washington, D.C.,

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