Good for Suckers

Good for Suckers

Congress is investigating why drugs are so expensive in Brazil. After
two weeks of hearings, the committee did not seem closer to a conclusion about high
prices, but had to add new problems to be investigated.
By Émerson Luís

Aparecido Bueno Camargo, the president of Abrafarma (Associação Brasileira de Redes
de Farmácias e Drogarias—Brazilian Association of Pharmacy and Drugstore Chains) was
candidly talking to the members of a CPI (Comissão Parlamentar de
Inquérito—Parliamentary Enquiry Committee when he dropped the bomb: "The
medicine market is full of trash BO." BO? What does it mean, a committee member
wanted to know. "Bom para otário" (Good for suckers), Camargo explained.
And continued, a little puzzled by the commotion he caused: "This is a traditional
classification. BOs have existed since pharmacies have." He wouldn’t name names, but
promised to prepare a list of these products for dupes.

The BO medicines, which are placebo products, are shelved together with the real stuff
and are not illegal or clandestine. They are even licensed by the Health Ministry. In the
days following Camargo’s revelation, some pharmacists disputed the meaning of BO, saying
that it stood for bonus medicine, that is, drugs that bring a special commission to the
pharmacist every time it is sold. What brings still another problem of the drug industry,
the so-called empurroterapia (pushtherapy). Pharmacists and clerks are in the habit
of trying to convince clients to buy those products that give them a bigger profit.

Medicine in Brazil is a $12-billion-a-year business. Multinationals represent 95
percent of this market, which has grown by 14 percent during the 1990s. Congress is
investigating why drugs are so expensive in Brazil. After two weeks of hearings, the
committee did not seem closer to a conclusion about high prices, but had to add new
problems to be investigated. Pharmaceutical laboratories have been accused of intensely
campaigning for and boycotting the introduction of generic drugs in Brazil.

Earlier in the CPI, doctors’ representatives talked about a promiscuous relationship
between physicians and pharmaceutical laboratories. For Edson Oliveira Andrade, president
of CFM (Conselho Federal de Medicina—Federal Council of Medicine), there is
"without a doubt, a significant interference of the pharmaceutical industry in the
professional practice of doctors." To promote some drugs, doctors get from small
souvenirs like pens to cars and trips overseas.

Among the ideas being aired to prevent abuses are the prohibition of free sample
distribution, the exclusive use of generic drugs on prescriptions and the ban of medicine
ads outside medical publications.

The president of the Doctors National Federation, Héder Murari Borba, thinks that is
high time to curb the interference of labs. During his deposition he cited several
instances in which this interference was very clear. He also brought stickers, which were
distributed by a lab, for doctors to place on the prescriptions. They said: "I do not
authorize the substitution of this drug." Representative Fernando Zuppo showed a
communication by Pfizer urging doctors to participate in a competition whose top prize was
a car.

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