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Getting Feverish Over Drug Prices

Opportunities exist to slow drug- price increases, but they are all too frequently avoided ("Drug prices: What's fair?" Special Report, Dec. 10). New drugs are required to have a significant therapeutic effect, but this effect is not required to be relevant to the patient's treatment. Furthermore, the process includes no comparison with other drugs--only with placebos. It means that a new drug may be effective--even relevant--but it may also be weaker and more expensive than the existing drugs. Another opportunity to lower costs might be the empirical, or evidence-based assessment to prove the effectiveness of drugs that might differ after long-term evaluation versus short-term studies.

The pharmaceutical companies should be paid on the basis of their useful achievements--not for unnecessary and inadequate treatments. The mighty pharmaceutical industry knows exactly how ineffective or wrong their medicines are and how many of them are simply existing products sold under new names, perhaps with some minor modifications.

Laszlo Bense, M.D.

Norsborg, Sweden

Not too many people know that certain cholesterol-lowering drugs mentioned in this story were developed by Japanese arms of pharmaceutical companies specifically for the American population. It doesn't take a rocket scientist to realize that the Japanese, as a group, do not need cholesterol-lowering drugs. The makers were targeting the big bucks--in America.

What companies would jump through all the expensive hoops the Food & Drug Administration has instituted for bringing drugs to market just to break even or make a small profit? Not many. The truth is that pharmaceutical companies want the payoff from their initial investment in drug research, and U.S. investors (especially venture capitalists) want stock returns in their portfolios. That is why the American people and the U.S. government tolerate health-care being run as a business. Ultimately, high drug prices--and high profits--are good for the economy.

R.J. Myer

Temecula, Calif.

Tell me why the U.S. is one of the few countries that doesn't place government price restrictions on drugs. This makes for an uneven playing field in which insurance companies and patients in the U.S. support the profits and research of the pharmaceutical industry, while the world reaps the therapeutic benefit--at considerably lower expense. International pharmaceutical company self-regulation of drug pricing would be a step in the right direction.

William Hummel, M.D.

San Diego

The intellectual-property protection granted to drug companies should require payment of a fee that would be based on the actual sales of the patented item (usually a drug) during a first period of its commercial use. The proceeds from this fee should be collected in a fund that would finance the required service--vaccinations, medical care for the poor, or basic research at universities. The fee would apply only to those patents that are actually commercially used, and would be due after they are commercially used for a long enough period of time.

Such a fee can avoid potential problems of patents whose owners visualized no commercial use at the time of filing, such as the gene-sequencing patents.

Nicholas Georgakopoulos

Carmel, Ind. I couldn't agree more with Laura Tyson ("It's time to step up the global war on poverty," Economic Viewpoint, Dec. 3), but there is no need for the rich countries to spend money on foreign aid. It will be enough to liberalize trade and stop subsidizing their own inefficient industries.

According to World Trade Organization data, the rich countries spend $1 billion a day in agricultural subsidies alone. Fair trade would generate enough demand to develop poor countries' economies and improve global standards of living, including those of the rich countries.

Leonardo Viegas

S?o Paulo

Poverty and peace are inversely proportional. If we want peace, we must fight poverty. In our countries, there are many well-meaning initiatives to combat poverty, but all of them will amount to nothing unless the developed world stops agricultural subsidies--they are the main obstacle to development and therefore to peace.

Luis H. Lacayo

Managua, Nicaragua I'm afraid you missed the point in "The real confessions of Tom Peters" (American News, Dec. 3). You treat as amusing, "outrageous," and even comical, the issue that Peters describes as "small beer." In writing the famous In Search of Excellence, confesses Tom Peters, he and Robert Waterman faked the data. Nothing could be more shattering to McKinsey & Co. and the consulting profession at large. We all know only too well that the only justification for the big investments our clients put into our corporations is that they trust us completely. Faking the data is beyond comprehension to any one of them. That trust has been cynically betrayed.

Meanwhile, consultants all over the world in smaller firms are trying to demonstrate to their clients that they don't fake the data, and that they can indeed be trusted, Peters' "small beer" notwithstanding.

Jay Berry

Como, Italy

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