[Ip-health] Suprisingly excellent analysis of PhRMA's 2009 Special 301 filing on Poland -- by US Embassy in Warsaw

Jamie Love james.love at keionline.org
Tue Sep 6 22:02:23 PDT 2011


Excellent analysis of PhRMA's 2009 Special 301 filing on Poland -- by
US Embassy in Warsaw

This cable signed by US Ambassador to Poland Victor H. Ashe provides a
through and very tough critique of PhRMA's submission to the 2009
Special 301 list. Ashe rejects every one of PhRMA's main points, and
explains why continually putting Poland on the Special 301 list is
counter productive.

The Cable was written on March 10, 2009, and takes a quite different
tone than several cables on the same topics Ashe signed before
President Obama took office, leading to some speculation about the
motivation for the change. (See http://keionline.org/node/1230 )

In practice, many of the cables signed by Ambassadors are written by
subordinates, and it is possible that in March 2009, Embassy staff
felt free to question the PhRMA submission, under the popular
assumption at the time that Obama would be more independent of the
pharmaceutical sector. Victor Ashe also knew he would soon be replaced
by an Obama appointee (he served until September 2009), so he may have
let loose and expressed some of his frustrations from dealing with the
drug companies over the past several years. Ashe is also an
interesting figure personally -- the former republican mayor of
Knoxville, Tennessee, and much earlier a roommate of George W. Bush at
Yale, where both were reportedly cheerleaders and members of Skull and
Bones. In any event, this March 10, 2009 cable really takes apart the
PhRMA submission so completely that it is hard to summarize.

This is how it starts:

"The effectiveness of the Watch List as a tool to enhance IPR
protection in Poland has waned with time. Last year's announcement
that Poland would be maintained on the Watch List received almost no
media attention, while Polish officials charged with protecting IPR
greeted the announcement with frustration and cynicism, questioning
whether there were any circumstances that would lead the USG to take
Poland off the list"

Several of PhRMA's assertions are debunked, as "not true." Other PhRMA
points are shown to lack perspective or balance.

* The PhRMA submission states, "Anyone wishing to meet a MoH
representative must do so by formal request, with an attached, binding
agenda. At the meeting, at least three MoH representatives must be
present, and the meeting will be either recorded or documented with
minutes." The submission then correctly notes that this policy has
made it more difficult to meet with Ministry officials, but fails to
mention that these measures are designed to end long-standing
allegations of corruption in the drug approval process.

* Restrictions on Sales Calls: At the end of 2008, the Health Ministry
adopted a regulation prohibiting sales calls on doctors and hospitals
during working hours. The regulation was based on a similar measure in
effect in Sweden, and post understands that other European countries
with government-financed health care systems, such as the United
Kingdom, also regulate the frequency of pharmaceuticals sales calls on

* Fixed Prices and Margins: The PhRMA submission states, "An example
of a discriminatory government pricing activity which affects U.S. and
other foreign pharmaceutical companies is the planned amendment to the
Pricing Act of the Pharmaceutical Law, which would formally define
selling price and fixed margins." The bill has not yet been introduced
into the Polish parliament. More importantly, as one pharmaceuticals
company general manager told EconOff, fixed prices and margins are
part of the medical system in 20 other EU Member States.

The Cable end with this gem:

"The situation in Poland should be assessed in light of the general
European background. While Polish spending on health care has been
increasing (Poland now spends PLN 11 billion per year (about USD 3
billion) on pharmaceuticals), the cost of pharmaceuticals also
continues to increase. The Polish government has to make tough policy
choices regarding which drugs to fund, and at what level. While
pharmaceuticals companies often assert that they would be happy with a
transparent process, even if it led to decisions not to fund their
drugs, in practice they seem to resent all government measures aimed
at cost containment, as these also inevitably limit drug companies'

The full cable follows. Enjoy:


James Love.  Knowledge Ecology International
http://www.keionline.org, +1.202.332.2670, US Mobile: +1.202.361.3040,
Geneva Mobile: +41.76.413.6584, efax: +1.888.245.3140.

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