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Executive Summary

Pharmacy should join the research-based pharmaceutical industry in its public efforts to inject drug cost-effectiveness into public policy debates on reducing health care costs, Pharmaceutical Mfrs. Assn. (PMA) President Joseph Stetler, suggested Oct. 8 in a speech to pharmacy recipients of Robins' Bowl of Hygeia Award. Stetler referred to the studies PMA commissioned and released earlier this year on the cost benefits of drug v. other therapies and on the effects on pharmaceutical services of several different countries' drug regulatory systems ("The Pink Sheet" June 25, p. 5). The studies' findings "are of more than academic interest," he asserted. "But if they are to enlighten and inform our public policy debates, they must be given wide currency. We are doing what we can to get the word out. But we would certainly welcome your help." Since taking over at PMA in early September, Stetler has said he intends to reestablish close working relationships with health professional groups. After representing the American Pharmaceutical Assn. and American Society of Hospital Pharmacists during his recent years in private law practice, the pharmacy community is a logical place to begin the coalition-building effort. Discussing the potential for pharmacy efforts to highlight drug cost-effectiveness, Stetler pointed out that the issue is proactive one for both mfrs. and pharmacy. Cost-effectiveness is "an area where we are not contesting any critic or public policy, an area where both pharmacy and industry have a positive story to tell and where we can, and should, be on the public relations offensive," he declared. Third-Party Payment, NDA Process, Animal Testing Are Areas Where PMA, Pharmacy Should Work Together -- Stetler The PMA president cited three "problem" areas, which affect both PMA and pharmacy and "on which we would do well to cooperate in the months and years ahead": third party reimbursement and restrictive formularies; the NDA approval process; and animal testing. Pharmacy and the drug industry "need to work together" to thwart unrealistic third-party payor efforts to reduce medical costs through restrictive formularies, Stetler declared. While the industry and profession must remain sensitive to govt. and private third party payor efforts to reduce health care costs, he maintained, "if we acquiesce in some of the proposals we have seen in the name of economy, we will be committing economic suicide, while serving as accessories to the stifling of advances in therapeutic science." Stetler used the formulary issue to point out to the pharmacy audience the threat the industry perceives from internatl. consumerist efforts to establish a World Health Organization marketing code. "There is a worldwide trend towards greater use of restrictive formularies, of MAC-type programs and of other mechanisms designed to save money through restrictions that channel consumer purchasing power towards those products that are cheapest or -- in the opinion of the regulatory authorities -- equally effective," he said. Stetler referred to the assn.'s position that restrictive formularies would raise the costs of research. Stetler asserted that animal testing is another issue for which the drug industry needs pharmacy support. "As alleged assassins, our views don't carry much weight with [animal rights] folks," he said. "We would be advantaged to have another voice of reason speaking to the issue. A voice such as that of organized pharmacy."

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