The Truth About the Drug Companies Marcia Angell, M'D'

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The Truth About the Drug Companies Marcia
Angell, M.D.
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WORLDS TOP 10 DRUG COMPANIES AND SALES 2005

• Total 6 American, 4 European, 248 billion
• Source Pharmaceutical Executive May 2006

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FORTUNE 500 U.S. DRUG COMPANIES 2005 SALES AND
EXPENSES
Billions
Median drug company profits 16 v. 5.9 for all
Fortune 500 industries Pfizer, JohnsonJohnson,
Abbott, Merck, Bristol-Myers Squibb, Wyeth,
Lilly, Amgen, Schering-Plough Source Fortune
4/17/06 company annual reports
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New Drug Approvals 2000-2005 (6 years)
506 new drug approvals Only 62 (12) were both
NMEs and improvements
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New Drug Approvals 2005
79 total
4 of 13 from big pharma (Wyeth, Bristol-Myers
Squibb, GlaxoSmithKline, Novartis)
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InnovationPublished Research Leading to Drugs
Sources Internal NIH document available from
Public Citizen also Zinner, Health Affairs,
Sept-Oct 2001 also Boston Globe 4/5/98
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Nine Fortune 500 U.S. Drug Companies Marketing
and Administration

• 71 billion total (32 of sales)

• Estimate 60 billion marketing
• and 11 billion administration

Estimates based on Novartis figures
Source Novartis annual report, 2005 company
annual reports
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Top U.S. Drug Companies Marketing Where Does
60 Billion Go?

• Assume 15 billion of this spent on
• Free samples
• Sales Reps
• Direct-to-Consumer ads
• Journal ads
• These are the only marketing activities the
  pharmaceutical industry acknowledges (claims
  entire industry spent 25 billion on these four
  activities in 2003)
• 60 billion - 15 billion
• approximately 45 billion . . .
  unaccounted for.

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45 BILLION
Source of picture Cover of An Elephant in The
Living Room The Childrens Book by Jill M.
Hastings, M.S. and Marion H. Typpo, Ph.D.
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Whats The Elephant Up To?

• Education of doctors
• CME
• Professional societies
• Medical conferences
• Educational materials
• Gifts, meals, and junkets
• What doctors learn
• Drug-intensive style of medicine
• Expensive new drugs better
• Expanded indications

• Lobbying
• Political contributions
• Front groups (patient advocacy and policy
  organizations)
• Gifts to institutions (medical schools, community
  and cultural organizations)

Patients pay 20 mark-up on drug prices.
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