VOICE ONE:

This is ____________.

VOICE TWO:

And this is _____________with the VOA Special English program,Explorations. Today we tell about the issue of how drug companiessell their products in the United States.

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VOICE ONE:

Drug companies sold about one-hundred-fifty-thousand-milliondollars worth of their products in the United States last year. Thisrepresents an increase of about nineteen percent overNineteen-Ninety-Nine. The prices of the drugs rose on average almostfour percent last year from the year before.

Economic experts say Americans are spending more on drugs becausethe population is getting older. One report says the prices of fiftydrugs most often ordered by doctors for older people rose more thanthe rate of inflation.

The drug companies say the money paid for the drugs helps supportresearch and development. An organization representing drugmanufacturers says companies produced new treatments for thirtydiseases in Two-Thousand. They included drugs for heart disease,cancer and AIDS.

Critics say prices for drugs are too high partly because the drugindustry spends too much money selling its products.

VOICE TWO:

People in the United States buy medicine in two ways. They canbuy some medicines in a store without an order from a doctor. Theseare called over-the-counter drugs. They usually are mild, likeaspirin. Over-the-counter drugs generally do not create unwantedeffects on the body.

Other medicines require the written or telephoned permission of adoctor for a person to buy them. These prescription medicines areusually more powerful than over-the-counter drugs. Under someconditions they can cause unpleasant or dangerous effects.Prescription drugs usually cost more than over-the-counter drugs.

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VOICE ONE:

For many years, drug companies have used sales messages aimed atthe public to help sell their over-the-counter products. Theyadvertised their prescription drugs mainly in publications fordoctors.

In the last few years, the companies have increasingly tried tosell prescription drugs directly to the public. They spent thousandsof millions of dollars on advertising the drugs last year. Someexperts say that is why American doctors prescribed six-percent moredrugs during Two-Thousand than the year before.

Some companies buy advertising messages, known as ads, innewspapers and magazines, and on the Internet. A number of companiesalso buy ads on television.

VOICE TWO:

One such television ad shows people of different sexes, ages andraces. They look tense and sad. An announcer says they are sufferingfrom severe depression. He asks if people watching the ad have thisproblem, too. If so, he says, they should talk to their doctorsabout getting the drug.

Drug-industry critics say such ads sometimes cause people to askdoctors for medicine they do not need. Or, people may ask for acostly medicine when a less costly one would be equally good.

Drug companies say advertising is helpful. They say ads helppeople recognize health problems. They say advertising alsoincreases public knowledge and choice of treatments.

VOICE ONE:

The Federal Food and Drug Administration began supervising adsfor prescription drugs in Nineteen-Ninety-Seven. This spring, theagency criticized eight manufacturers for their ads about drugs forHIV. The virus causes the deadly disease, AIDS. The government saidthe ads gave people wrong ideas. Officials told the companies tochange the message.

For example, one ad for an HIV drug shows a group of youngpeople. They are climbing on a mountain. They look healthy and fullof energy. But Food and Drug Administration officials and otherhealth officials objected. They say the ad misled people. They sayit communicated the false message that AIDS patients can livetotally normal lives.

VOICE TWO:

The prescription drug Celebrex treats arthritis. This diseasecauses joint pain and difficulty moving. It affects the neck, back,knees and other parts of the body.

A recent ad for Celebrex showed people doing demanding physicalactivities. At the same time, energetic music played. The peoplemoved their bodies easily. They appeared to have no pain.

The Food and Drug Administration said the ad promised too muchimprovement from taking the drug.

Celebrex changed the ad.

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VOICE ONE:

Drug companies also pay millions of dollars to place ads inpublications for doctors. In addition, the companies send salesrepresentatives to doctors’ offices. They tell the doctors moredetails about their products. The representatives also provideexamples their products.

Many companies offer doctors more than free samples.

A half-century ago, drug manufacturers gave doctors small giftslike pens and writing paper. Today, some companies are paying forcostly meals and holiday trips for doctors. In return, they hope thedoctors will prescribe their drugs.

VOICE TWO:

Drug companies also ask doctors to take part in focus groups.These discussion groups meet to gather expert opinions on healthissues. The companies sometimes pay as much as several thousanddollars to people taking part in the focus groups. Some doctorssuspect the main purpose of these groups is to increase support forthe companies’ products.

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VOICE ONE:

Millions of people in the United States belong tohealth-insurance plans. These plans help pay for services by doctorsand hospitals. Many insurance companies also pay part of the cost ofprescription medicines. Yet insurance officials say increased pricesmay force them to stop doing this.

One of America’s largest health-insurance companies is proposinga way to cut prices. It has asked the Food and Drug Administrationto permit three prescription drugs to be sold without prescription.These allergy medicines treat bad reactions to materials such asdust, trees and food. The insurance company says the drugs are saferthan most over-the-counter products. It says people do not need adoctor’s permission to take them.

Experts for the drug companies, however, say these medicinesmight harm people if used without medical advice.

VOICE TWO:

Almost five-thousand-million dollars worth of the three allergymedicines were sold in the United States during Two-Thousand. One ofthe prescription drugs costs more than two dollars for each pill inthe United States. The same drug sells over-the-counter in Canada.There, it costs seventy cents for each pill without tax.

Legal experts say it does not appear that the drugs will be soldover the counter in the United States any time soon. They say no oneis sure the Food and Drug Administration has the right to make sucha decision.

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VOICE ONE:

Drug companies hold patents which give them the legal right to bethe only seller of some of their drugs. These patents protectagainst competitors producing less costly copies of the drugs. Thecopies are called generic drugs.

Protection against generics is not permanent. When the time limitfor a patent ends, a competing company can sell its generic versionof the drug. The more costly drug often loses about half itsbusiness within months after the generic drug is first sold.

VOICE TWO:

Some companies are trying to use legal action to delay producersof generics from introducing competing products. For example, theSchering-Plough Corporation now holds the patent to sell the allergydrug Claritin. But its patent ends in about seventeen months. So thecorporation is bringing legal action against ten manufacturers ofgenerics.

Schering-Plough says people taking Claritin produce a substancein their livers called a metabolite. The corporation holds aseparate patent for the metabolite. This patent does not end untilTwo-Thousand-Four. The corporation claims generics cannot be solduntil its rights to the metabolite also end.

This kind of argument has never won in court. But such legalaction does delay introduction less costly generic drugs.

VOICE ONE:

Widespread concern about drug prices has caused President GeorgeW. Bush to propose a solution. The president proposes that drugcompanies help older people pay lower prices for drugs. Five bighealth-care companies have promised to co-operate with the plan.

Many members of the opposition Democratic Party oppose the plan.They say the measure does not provide nearly enough help.

There is only one agreement about the debate over the price ofdrugs and how they are sold in the United States. Everyone agreesthat there are no easy answers.

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VOICE TWO:

This Special English program was written by Jerilyn Watson andproduced by ___________. This is _______________.

VOICE ONE:

And this is ______________. Join us again next week for anotherEXPLORATIONS program on the Voice of America.