Last Sunday (July 14th, 2002), in an unprecedented alchemy of corporate drug deals synthesized behind closed doors, a $60 billion transaction allowed Pfizer Inc. to acquire Pharmacia Corporation, creating the largest pharmaceutical company in the world. With anticipated annual revenues of $48 billion, the newly concocted Pfizer-Pharmacia mega-company will have unsurpassed global dominance on some of the most lucrative pharmaceutical drugs available on the market. The potential side effects of the merger on consumers, seems to have gone unnoticed.

When my pharmacist asks me if I would prefer the generic version of a particular prescribed drug, I, like millions of other drug consumers, count my blessings in so many dollars saved in multiple pharmacy co-payments. When only an expensive trademarked version of a drug, such as the anti-depressant Zoloft, or Celebrex, an arthritis drug, is available, there is little choice but to buy, and buy dearly.

But patients’ patience is wearing thin. Americans are increasingly outraged at the rising costs of pharmaceutical drugs.  In an effort to spank Big Pharma, Congress is currently considering a handful of bills aimed at curbing monopolies over trademarked drugs, and on ending the unethical practice of extending patents for profits. Currently, pharmaceutical companies have a nasty habit of drawing out billions in profits from patented “blockbuster drugs” by preventing competitor drug firms from selling cheaper, or generic, alternatives.

No fewer than 20 major drug companies — including Bristol-Myers, Eli Lilly, Pfizer, and Bayer — are being investigated by government agencies, including the Justice Department, the Food and Drug Administration, the Federal Trade Commission, and the Department of Health and Human Services.(1)  In order to reduce prescription drug costs to consumers, at least one proposed bill would limit patents to 30 months on trademarked drugs, at which point generic alternatives would be freely allowed on the market.  Needless to say, this prospect doesn’t digest well with drug companies and their investors.

According to Fortune magazine’s rankings, the pharmaceutical industry has been the most profitable US industry every year since 1982.(2)  In anticipation of a regulatory clampdown, and under increased public scrutiny, key players in pharmaceuticals are looking to hedge their bets by consolidating profits and expanding a global sphere of influence.  As many analysts say, the convergence of Pfizer and Pharmacia will likely hasten further consolidation of the pharmaceutical industry. 

The push for more trademarked drugs with more consolidated company patents, translates into fewer consumer options.  As Pfizer notes in an understated press release about the merger, “The combined portfolio will have a strong patent position.” (3) The merged Pfizer-Pharmacia is now, says the New York Times, “the most dominant drug maker in the world.” (4)

Dominating Depression
Dominance in the legal drug industry is no small territory. Last year, Pfizer alone generated sales of $32.3 billion.(5)  With double-digit, billion-dollar market power, and with a noteworthy lead in drugs of psychopharmacology, Pfizer-Pharmacia will have global reach over several key sectors.  In particular, drugs designed and marketed to modulate brain chemistry—those intended to make a person less depressed, more sociable, more happy at work—are currently the hottest segment of pharmaceutical drugs, with over $10.5 billion in sales for the year ending in February 2001. Industry analysts point to depression drugs as “a market with growing demand.”  And, the World Health Organization projects that depression will become "the leading contributor to the global burden of disease by the year 2020." (6) Add in market-driven diagnostic creep and prescriptions aimed at broadly defined “lifestyle indications,” and salivating investors with a hand in the business will be anything but depressed. 

But what are the likely adverse effects for consumers?  With drugs such as Zoloft (under Pfizer’s patent until December of 2005), (7) and other antidepressants already a multi-billion dollar industry aimed at altering mood or “changing” the way a person thinks, feels and acts, the consolidation of drug companies may lead to less diversity of consciousness, more brand-name brain function.

Prozac, the widely advertised, widely discussed superstar of antidepressants, became a household prescription as well as a household name. And, before the sandglass ran out last August on Eli Lilly’s protected patent on Prozac, at least 40 million people were franchised users. Prozac accounted for a quarter of Lilly's $10.8 billion in sales, and more than a third of its $3 billion profits in the year before its patent expired. (8) Efforts by Lilly to find other drugs in the pipeline that would mimic the euphoric economic effects of Prozac have become an understandable company addiction. Recently, Lilly push-marketed “Prozac Weekly,” a new patent-protected version of Prozac taken in a once-a-week pill, by mailing thousands of free samples of the drug direct to unsuspecting consumers in Florida.  [See: http://www.cognitiveliberty.org/News/prozac_mailing1.htm ]

In such a cultural climate of brand-name pharmaceuticals, and direct-to-consumer marketing of brain-changing drugs, we need to examine what may come about as a result of large-scale pharmaceutical conglomeration.  As innovations in biotechnology, pharmacology, and specifically neuro-pharmacology, change the ways we think about drugs, or even the ways we think on drugs, the trend of Big Pharma growing bigger by consolidation may have serious consequences for cognitive liberty.

Ultimately, individuals should be allowed to make intelligent decisions about the drugs they decide to take, and given as much choice as possible in controlling their own bodies and minds. Unfortunately, as we all know, from politicians to movies, those with the biggest budgets and best marketing teams tend to win at the polls and at the box office.  As with merged broadband media AOL/Time Warner seeking to dominate consumer choice in “Entertainment,” consolidated pharmaceutical companies of tomorrow threaten to overpower diversity, choice, and even perhaps, create for certain depression drug users a “mainlined” consciousness. From there, one has only to imagine a merger between Big Pharma and Big Media to seal the deal; happy movies, happy drugs, and happy meals—a smash hit, or a headcrash?

Wrye Sententia is Co-Director of the Center for Cognitive Liberty & Ethics.  www.cognitiveliberty.org

Notes

1 http://www.ariannaonline.com/columns/files/052002.html
2 http://www.citizen.org/publications/release.cfm?ID=7065
3 http://www.pfizer.com/pfizerinc/investing/pharmacia0715.html
4 http://www.nytimes.com/2002/07/15/business/15CND-DRUG.html 
5http://www.datamonitor.com/~570be004e0424bf5abac3634d494d29f~/all/capsules/companies/product.asp?pid=A0B328A1-3EB4-4B59-B11F-78556EDA8FC9&url=-SECTION2.HTM&free=free&menu=1&li=False  
6 http://www.inpharm.com/intelligence/ims050701.html 
7 http://www.myorangebook.com/Generic/S.php?QP_From=50   
8 http://www.businessweek.com/magazine/content/01_30/b3742106.htm

Additional Resources:

CCLE Pharmacology & Cognitive Liberty