Anatomy of an ordinary drug company scam

Posted by on November 7, 2013 in Articles, Health, To Be Featured | 5 comments

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.

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  1. Here we go again. A guy named Martin Shkreli was in the news recently for buying a drop company and jacking up the price of its product by 5,000 percent. Well, his biggest sin wasn’t doing that; it was being so open about it so as to raise public awareness of this pervasive industry practice, one that increases healthcare costs for every American. Yesterday I was seen by my retinal specialist, who informed me ruefully that production of Bromfenac, an inexpensive generic eye drop I have been taking to reduce inflammation in my retina, has been ceased, leaving a patent-protected and only-slightly-different formula marketed under the name of Prolensa as the only alternative. And a far more expensive alternative it is. Although I immediately called my pharmacy and tried to refill my prescription of Bromfenac, sure enough, it has already been pulled from the market. My only recourse was to call the Mylan Corporation, former manufacturer of Bromfenac, and ask them how much they got paid off by Bausch & Lomb, holder of the Prolensa patent, to cease production. Milan’s pitiable customer service rep, a guy named Adam, had to take my call and listen to me opine on the worthlessness of his life’s work as a shill for drug industry profiteers. I warned him that when he gets to my age and looks forward to eternity and backward to try to see some meaning in his pathetic life he might find himself regretting his career choices.

    • This is actually a multi-party scam. Bromday was bought out and discontinued. Generic bromfenac in the same concentration is still available – I checked into it. Pralensa has an inconsequentially different concentration of bromfenac. At more than three times the cost of Bromday. Doctors are hoodwinked/scammed into thinking that since Bromday is no longer available their ‘supposed’ to prescribe Prolensa. And pharmacists can’t substitute generic bromfenac for Prolensa prescription because the concentrations are different.

      So what’s a patient to do? One option is to contact the eye doctor and ask him/her to prescribe the generic drug. Another is to ask your eye doctor if you REALLY need bromfenac. I’ve had two cataract surgeries and never had pain after them.

      We the people have to, and some day will, speak up about the dishonesty in health care.

      Thanks for the response.


  2. As I searched for online coupons to help offset the cost of my mom’s Prolensa prescription for her upcoming cataract surgery, I came across this article. I wish I was more surprised to read about such devious practices in the world of drug company business practices, but unfortunately this type of scheming seems all too common.

    I absolutely want to fund legitimate research and reward the intense process of approving and manufacturing quality pharmaceuticals, and I’ll pay a fair price to do so. But this type of artificial market manipulation is not contributing to those endeavors. It’s certainly hurting people like me and my family who need these drugs. I appreciate your article, Jim – thanks for helping to educate me about this world I’m currently navigating.

    • By knowing that your eye doctor is perhaps unwittingly participating in a drug company scam you can perhaps help by finding if the drug the “new” Prolensa is replacing is still available. Your pharmacist will know that. Then you can ask the doctor to prescribe the ‘old’ drug since it wasn’t proven toxic – as I pointed out, Prolensa actually has less of the active ingredient than the drug it replaced.

  3. My wife takes 3 different eye drops, one of them being prolensa. With coupon only costs $60. Regular cost at CVS $264. The thing that makes me mad is the dropper bottle is smaller and doesn’t last as long. It won’t last a month with a drop in each eye once a day.

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