Anatomy of an ordinary drug company scam
At the pre-op office visit for my cataract surgery this fall, the scheduling clerk explained what would happen on the day of surgery. Handing me the last page of materials, she apologized because one of the eye drops, Bromday, isn’t available anymore. A new drug, Prolensa, was just released, she said, and handed me a $50 coupon to help pay for it.
After more than five decades of experience with the drug industry as a physician and pharmacist, I’d seen this before. I arranged to get bromfenac, the generic equivalent for Bromday, the discontinued brand drug. My copay was $15. With the coupon, Prolensa would have cost $160.
After my eye healed, I did an internet search and found the usual dance. I already knew that bromfenac is made by generic drug manufacturers. Bausch and Lomb manufactured it under the brand name of Bromday, and ISTA manufactured it as Xibron.
In 2012, ISTA pleaded guilty to what are now common charges against drug companies of kick backs to doctors and marketing Xibron to doctors for FDA unapproved uses. It was fined $33,500,000, and Medicare and Medicaid were prohibited from paying for it.
Early this year, ISTA became a subsidiary of Bausch and Lomb, and Xibron was discontinued. That opened the door for the next step in corporate subterfuge. Xibron’s formula was tweaked by slightly reducing the amount of bromfenac. Voila! A “new” drug, Prolensa, was born. Its price, of course, was jacked up. FDA approval was pro forma since bromfenac had been previously approved.
Pharmacists can substitute generic for brand-name drugs only if they have identical formulas. With a slightly different formula, Prolensa can’t have a generic equivalent until its patent runs out in 2024. With a prescription for heavily promoted Prolensa, pharmacists must dispense it or call the physican’s office for permission to change to the generically ‘different’ drug.
“That’s just wrong,” my ophthalmologist murmured when I told him the story of how Bausch and Lomb had deceived him.
To complete the corporate shell game, coincidentally with the withdrawal of Bromday and roll-out of Prolensa, an article on bromfenac appeared in Wikipedia, the open source, online encyclopedia. It doesn’t mention that bromfenac is available generically, that Bromday is no longer available, or that Prolensa’s formula differs from Bromday’s. It mentions them as being the same products.
In 2007, in the run-up to the great recession, faltering Bausch and Lomb was purchased by a private equity firm, Warburg and Pincus. In 2013 it was sold to Valeant, an international specialty pharmaceutical company based in Montreal. During these years, Bausch and Lomb’s corporate investment in research and development was slashed.
Valeant apparently has no research or manufacturing facilities. Its internet home page describes its growth strategy as adding new drugs through product and company acquisition and that it “…develops and markets … new compounds and products that make a meaningful difference in patients’ lives.”
There are 3,000,000 cataract surgeries per year in the US. Adding $160 for Prolensa to every patient’s out-of-pocket costs is the wrong kind of meaningful difference.
It’s a shame to see the good names of German immigrants John Jacob Bausch and Henry Lomb, and the company they founded in 1853, sullied. For a century and a half the company was a leader in producing quality eye products through invention and innovation. That’s the American way.
Gratuitously raising health costs isn’t the American way; neither is deceiving physicians, misleading patients by pretending to help them, or writing incomplete, pseudo-scientific articles for Wikipedia.