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The United States of America is the largest market for pharmaceuticals inclusive of biopharmaceuticals, accounting for approximately 35 percent of the global market. It is also the world leader in biopharmaceutical research and development . According to the Pharmaceutical Research and Manufacturers Association , the U.S. firms conduct the majority of the world's research and development in pharmaceuticals. The United States also spends a much higher amount on health care. In 2010 the USA spent 17.6% of its GDP on the health sector and in 2014 , 17.1%

Having stated these facts however the health care outcomes from life expectancy to infant mortality , in the USA are average .The question is why is that so ? According to the November 2013 issue of the Journal of the American Medical Association (JAMA), the primary reason for the rise in health care costs between 2000 and 2011 was an increase in the price of drugs, medical devices, and hospital care. The pharmaceutical companies in the USA have been criticized for excessive interference in health care. Not only has the rising prices for various drugs been questioned but also the need for them. The justification for the same vary but pharmaceutical companies are aware of the dependence on drugs and use it to their advantage.

In the U.S. , pharmaceutical companies directly engage in what is called Pharmaceutical marketing or pharma marketing , where not only do they sells drugs directly over the counter but as the name suggests Pharmaceutical companies are allowed to market and advertise their drug. The system also allows a drug discoverer to have exclusive sale over a new drug for an extended period of time .

These companies send in their samples to doctors for trails so that these drugs get added to the list of frequent prescription. Well this level of marketing seems fair but companies dont stop there . many of these companies send various ‘gifts’ to doctors , hospitals and resident students. A sale representative for a pharmaceutical is expected to entertain a doctor by buying them ticketing to various events and treating them to 5 star dinners . Gifts such as pens , coffee mugs , stuffed animals and stethoscopes which are personalised with the company name on them are frequently given . Tropical vacation in the guise of education seminars are also a technique used to influence doctors. Companies see this relationship as beneficial to medicine and public health.

Even though doctors swear not to be influenced by these ‘gift’ studies have proven otherwise . Many practitioners show a preference for the sample drug even though it has no demonstrated advantage over the existing prescription.

The advertisements of requiring various drugs for the purpose of staying healthy is also a method used by these companies . The U.S. and New Zealand are the only countries where Direct to Consumer ads are legal. Pharmaceuticals spent $5.4 billion on these ads in 2015 and in the same year Americans spent $457 billion on prescription drugs. Many of these drugs when consumed to manage chronic disease cause severe side effects that can be fatal. Some drugs which when frequently consumed are highly addictive like painkillers, are still marketed as a need . Cases of pharmaceuticals participating in illegal transactions have also been recorded. The Department of Justice accused Johnson & Johnson of spending billions to target children and the elderly for unapproved drug uses, exposing them to serious side effects, including death.

Pharmaceutical companies also hier doctors as speakers which is termed ‘thought leaders’ and are paid to talk about the advantages of their drugs . investigations by ProPublica have revealed that many of these ‘thought leaders’are doctors accused of professional misconduct. For a long time now , pharmaceuticals also have a say in the curriculum in medical schools throughout north America , further establishing their monopoly over the health sector .

Although regulations to control the above practices by the pharmaceutical industry are prescribed , more stringent regulations on such practices of the pharmaceutical industry is the need of the hour .

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Written By Nikita Kotecha

Studying Literature

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