We better stop, hey, what’s that sound? Everybody look what’s going down . . .

Okay, so I'm showing my age by quoting a Buffalo Springfield song (though I was only 2 when "For What It's Worth" was released), but being female, in my 40s, an allergy sufferer and a breast cancer survivor means I've also taken my share of prescriptions, so two stories in the news this week struck a chord with me.  First, from the UK, was a report that British drugmakers are launching a legal challenge to moves by the state-run National Health Service to switch large numbers of patients to cheap generic prescription medicines. According to the BBC, Britain's Department of Health (DoH) argues that the National Health Service (NHS) could potentially save £84 million if patients with high cholesterol were switched onto generic versions of statins. "We are talking here about achieving best value for money for the taxpayer," said a DoH statement. "Cost-effective prescribing releases resources for more patients to receive treatment." Second, the Journal of the American Medical Association published research from the RAND Corp., which reviewed 20 years worth of studies and concluded, "Pushing more of the cost of prescription drugs onto consumers causes patients to cut back, sometimes with adverse health consequences." Upon reading that, my first instinct was to say, "Duh!" Then I thought, " . . .and isn't it interesting that these articles reflect issues raised by both Bikash Chatterjee and Girish Malhotra in our June issue? I wonder if the pharmaceutical industry is paying attention?" And then those words came into my head: "It's time we stop, hey, what's that sound? Everybody look what's going down."    Drugmakers, are you listening? Do you see a pattern here? The light at the end of the tunnel is an oncoming train, or at least Michael Moore with a camera crew. Health insurance programs are perennially tightening which drugs they will cover (demanding a switch to generics where available) and how much of the cost they will pick up for branded drugs. Patients are protesting, and the din will only get louder as the 55+ segment of the population grows. Some foreign governments are challenging patents or demanding that Western pharma companies provide certain drugs at a fraction of the list price. Congress is hashing out the details of a bill encouraging the use of follow-on biologics. And who knows how the nation's healthcare scene may change after the 2008 presidential election? The situation is mind-boggling -- I sure wouldn't want to be in charge of strategic planning for a major drug company right now. On the other hand, these issues cannot be ignored in the hope that they'll disappear -- complacency is partly to blame for the industry's current predicament.  The question, pharma professionals, is, "What's your next move -- and why?" Is your eye on the bottom line, or on reports such as the one from the RAND Corp.? (And might not patient non-compliance come back to bite you in the bottom line one day?)  Is it possible that, as companies that have invested in "green" buildings have found, you can implement solutions that will have a positive impact on both your bottom line and your higher purpose? The editors of Pharmaceutical Manufacturing are constantly, diligently seeking such solutions to share with the industry. Authors Chatterjee and Malhotra offered substantial food for thought in their recent articles, and each month Emil Ciurczak aims to demystify Process Analytical Technology -- while being entertaining -- in his Therapeutic Dose column.  If your team or company has implemented solutions that you're particularly proud of, we'd love to hear about it.  Contact us at ashanley@putman.net or hparsons@putman.net. -- Heidi Parsons