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HEALTHCARE in the United States has become a megabillion-dollar business. It is responsible for over 12 percent of the gross national product. Revenues from the health industry, which currently exceed $360 billion a year, are second only to those of the defense industry. True profits are much higher. In 1991, the United States spent $750 billion on healthcare and the level of spending is increasing each year.

A key component of the health industry, the pharmaceutical business has one of the worst records when it comes to breaking the law. John Braithwaite, in his extensive and illuminating study, shows the profundity and gravity of the crime problem in the pharmaceutical industry. Bribery, corruption, the unsafe manufacturing of drugs, fraud in testing, false advertising, and price-fixing are just a few of the numerous crimes the pharmaceutical industry has engaged in. Braithwaite's research was conducted between 1977 and 1980 and published in 1984, over 20 years ago; unfortunately, not much has changed. The pharmaceutical industry is still involved in malfeasance.

According to the Multinational Monitor which listed the top 100 corporate crimes during the 1990s, 31 of the top 100 involved pharmaceutical companies. Some pharmaceutical makers have a long history of inadequately testing new drugs and products that eventually harm others, particularly women or their children. The organization and operation of the pharmaceutical industry may be a salient factor in understanding the crimes that are committed.

Research and Patents

The pharmaceutical business incurs tremendous costs in bringing a new drug or medical device from concept to market. These costs generally fall into four areas: Research & Development (R & D), the Food and Drug Administration (FDA) approval process, manufacturing, and advertising. Research and development is by far the most costly of the four and an area that is most open for fraud.

Pharmaceutical companies face great temptations to mislead health authorities, the FDA in particular, about the safety of their products. The companies expend an enormous amount of money, upfront, in the research of new drugs and are in great competition to be the first that obtains approval and a patent for the new discovery. With drug development, potentially hundreds of millions of dollars must be invested for a new compound that may never return a profit and, in a best-case scenario, will only begin returning money 12 to 15 years out. If another company gets its product on the market first, then a massive amount of money and time, already expended, is lost, not to mention the loss of future profits the company would have received if its drug were the one to obtain the market's share.

Currently, patents last for 20 years. The 20-year term is codified in 35 U.S.C. Sec. 154. Twenty years may seem like a lengthy and sufficient amount of time, but the 20-year term begins on the date of the patent application. This is very important for drug manufacturers, because drugs are generally patented before beginning the FDA approval process. Because the approval process can take so long, the “effective life” of the patent (the number of years left on a patent) is often less than half the original life once the product is actually available.

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