[Congressional Record (Bound Edition), Volume 151 (2005), Part 20]
[Extensions of Remarks]
[Page 27617]
[From the U.S. Government Publishing Office, www.gpo.gov]




 CONGRATULATIONS TO THE DEPARTMENT OF VETERANS AFFAIRS FOR SAVING ITS 
            MEMBERS FROM DANGEROUS DRUGS VIOXX AND CELEBREX

                                 ______
                                 

                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                       Tuesday, December 6, 2005

  Mr. STARK. Mr. Speaker, the Department of Veterans Affairs buys drugs 
for about half the market price, saving the American taxpayer billions 
of dollars. It does this by insisting on the best price offered to 
other customers, by negotiating for further discounts, and by moving 
market share through the use of a formulary or preferred drug list.
  The formulary is an excellent one that provides Veterans with the 
drugs they need that are safe and effective.
  This formulary is under attack by `think tanks' that may receive a 
lot of money from drug companies. PhRMA wants to convince the American 
public that, like the children of Lake Woebegon, all drugs are above 
average and should be readily available to be marketed to all Americans 
at whatever price the companies want to charge. The fact is, most 
drugs--about 80 to 85 percent in recent years--are me-too drugs: copies 
of stuff already on the market that bring little or nothing new to the 
fight against diseases. There is no need to cover all these drugs on a 
formulary. Rather, by using a formulary to list only the safest, most 
effective drugs, a buyer can obtain huge discounts from the companies. 
An exceptions and appeals process can ensure that in those rare cases 
where a non-formulary drug is needed, it will be available.
  Listing all new drugs on a formulary can also be dangerous, because 
many drugs are approved after only six months or so of testing on a few 
thousand people or less. As doctor and Senator Frist has said, there 
should be a 2-year moratorium on the mass advertising of new drugs, 
because we really don't know how safe they are. Vioxx and Celebrex are 
classic examples of drugs that added little new but have unacceptable 
risks.
  The VA formulary never listed Vioxx and Celebrex. Good for them. 
Vioxx alone has been estimated to have caused up to 40,000 unnecessary 
deaths and another 100,000 heart attacks or strokes.
  But the Manhattan Institute has just published a paper by a Frank R. 
Lichtenberg who says he is a Professor at Columbia University's School 
of Business. The thesis of the paper is that because the VA does not 
immediately cover every drug, like Vioxx and Celebrex, veterans are 
starting to die earlier. The Professor includes in his paper one of the 
most hilarious, or saddest examples of sophistry I've ever seen. He 
plots on a graph the life expectancy at birth of all males, and shows 
it rising from 72 years in 1991 to 74.5 years in 2002. He also plots 
veterans' life expectancy, which rises from about 77.6 years to 80.5 
years by 2004. But then he does something that, if he were a student, 
would earn an ``F''. He superimposes the two life expectancy lines in 
different colors on the same chart but uses different vertical lines to 
represent the two different populations. The Veterans' axis on the left 
starts at 77.0 years and rises to 81.5 years. The life expectancy at 
birth of all males axis on the right side of the chart starts at 70.5 
and rises to 75.0. By doing this, he makes it appear to the quick 
scanner or casual reader (i.e., most of us), that Veterans are dying 
sooner than the rest of American males. Instead, Veterans are living 6 
years longer.
  The Professor deserves an ``F''--and so does the drug industry for 
trying to libel the VA drug system.
  We need a system like the VA's for Medicare. It would save us 
hundreds of billions of dollars in the years to come--and save us from 
the Vioxx's of the future.

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