Deutsche Welle, 6 December 2012
A study on
the business practices of drug companies Bayer, Baxter and Boehringer Ingelheim
in Brazil criticized their pricing and marketing strategies as well as choice
of drugs. The companies reject the allegations.
Brazilis
known for its contrasts. The emerging market is attractive for international
pharmaceutical companies, yet many Brazilians live in poverty and rely on
low-cost drugs when they get sick.
To that
end, the German non-governmental organization "Federal Coordination of
Internationalism" (BUKO) launched a pharmaceutical campaign to investigate
business practices of three international pharma companies that have been
operating in Brazil for decades: Bayer HealthCare, Baxter and Boehringer
Ingelheim.
For the
study, which ran from January 2011 to June 2012, the organization examined the
companies' products, pricing and marketing. Despite mentioning some positive
aspects, the study's authors delivered a negative conclusion, pointing to high
prices that blocked access to essential drugs, dubious and, in some cases, even
dangerous drugs and misleading marketing practices.
More
studies to follow
The
Brazilian study, "At the Expense of the Poor," follows an earlier one
conducted by the group in 2010 involving the same companies in India. The
situation in South Africa will be the focus of a study planned for next year.
 |
| Rogério Hoefler questions how products are marketed |
Of the
three companies examined in Brazil, Germany's Boehringer Ingelheim was ranked
as the one with the "worst" business practices. The report's authors
were particularly critical of the company's painkiller "Buscopan
Composto."
The drug
contains the controversial active ingredient metamizole, which can cause
side-effects such as "agranulocytosis." The condition causes a sharp
decrease in white blood cells, which are important for the immune system.
Without
providing exact figures, the study estimates that about one in 3,000 patients
taking metamizole suffers from agranulocytosis.
The drug is
prohibited in the United States, the United Kingdom, Australia and Sweden. In
1987, all medications containing it were banned from the German market, and
approval to produce it was revoked three years later. But as a single agent,
metamizole can still be used in certain clearly defined situations, according
to the German Drug Commission.
Ethically
questionable marketing
In Brazil,
by comparison, "Buscopan Composto" is still available over the
counter as tablets or drops. In fact, the painkiller is on the list of drugs
recommended by the National Health Surveillance Agency (ANVISA), which approves
and controls all drugs in the country.
 |
| Developing new drugs can cost billions of euros |
"ANVISA
is only a little over 10 years old - it's still in its infancy," says
Rogério Hoefler from the Brazilian Chamber of Pharmacists, which participated
in the study.
The way the
product is marketed, Hoefler says, is ethically questionable. He believes
companies are taking advantage of weaknesses in the Brazilian health care
system. "Even though they know that certain agents are not suited for the
market, they sell them as long as the government allows," he points out.
BUKO
believes Boehringer Ingelheim continues to sell metamizole for economic gain.
Buscopan Composto is one of Brazil's best-selling drugs. It accounted for 11
percent of the company's sales last year.
"The
responsible national authority decides whether or not to approve a drug in a
country," Boehringer Ingelheim spokesman Michael Kagerbauer told DW.
"Boehringer Ingelheim only sells drugs that have a positive benefit-risk
assessment – in other words, where the benefits outweigh the risks."
Convinced
of safety and effectiveness
The drug is
approved in more than 20 countries, including Argentina, Belgium and Spain,
according to Kagerbauer.
 |
| Bayer HealthCare disagrees with the study |
Members of
BUKO's pharmaceutical campaign have maintained a critical dialog with
Boehringer Ingelheim for years, arguing that the drug is dangerous and should
be removed from the market.
The company
disagrees. "We are convinced of the product's safety and
effectiveness," said Kagerbauer.
In 1990,
Brazil set out to launch a health system aimed at guaranteeing access to free
basic medical care for all its citizens. Also, the state-run pharmacies, known
as "Farmacias Popular," would either sell critical drugs for less or
provide them free of charge.
According
to a pharmaceutical study, however, around 40 percent of the drugs to be
provided for free are not available in the state pharmacies. These can only be
purchased in private pharmacies and at a much higher price.
Only
affordable for the wealthy
The state
hospitals also lack sufficient personnel and equipment, unlike the private
hospitals, which are much better equipped, but also more expensive. Only
wealthy Brazilians can afford to purchase private health insurance to
complement their state coverage.
 |
| Many poor Brazilians can't afford higher-priced drugs |
High drug
prices are a central criticism of the study. About one fourth of Baxter's drug
assortment in Brazil is in the up-market sector.
Leverkusen-based
Bayer HealthCare manufactures "Nexavar," is a highly effective drug
to treat liver cancer. In Brazil, a package of 60 tablets costs about 2,940
euros ($3,851) - a price that is prohibitive for even the middle class.
Bayer
attributes the high price to research and development costs. But sorabenib, the
active ingredient in Nexavar, was developed by a smaller company as contract
research, argues the study's authors.
"The
assertions and numbers published in the study are false," Bayer
spokeswoman Kerstin Crusius told DW. "Nexavar stems from a joint research
project in which we collaborated with our partner to explore and develop new
drugs to combat cancer. The development of a new drug is a long, complex and
risky process that costs more than a billion euros."
Members of
BUKO's pharmaceutical campaign are also critical of Bayer's "Supradyn Pré
Natal" vitamin supplement. They claim it contains 25 different active
ingredients, which, when they interact, can cause unpredictable reactions. And
they criticize the products advertising, which involves a television commercial
with a mother and her son taking a vitamin tablet together along with eating
fast-food.
Abiding by
the law
Spokeswoman
Crusius maintains that Bayer abides by all rules governing global advertising.
"All our marketing activities carried out worldwide are in strict
accordance with national standards and laws," she said.
In fact,
Bayer HealthCare vehemently criticizes the study conducted by the BUKO
pharmaceutical campaign. "The published study," the company said in a
statement, "only partly describes our activities while neglecting others,
such as our involvement in the area of the chagas disease. And it also
contains factual errors."
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