Speaker 1: You're listening to the Bloomberg Opinion podcast. Catch us Saturdays
Speaker 1: at one and seven pm Eastern on Bloomberg dot Com,
Speaker 1: the iHeartRadio app and the Bloomberg Business App, or listen
Speaker 1: on demand wherever you get your podcasts.
Speaker 2: Welcome to Bloomberg Opinion I Amy Morris. This week we
Speaker 2: look at medicine, from generic drugs to legalizing marijuana, mental
Speaker 2: health to physical wellness. We'll talk with Jonathan Bernstein, who
Speaker 2: makes the argument that legalizing marijuana would be good policy
Speaker 2: for President Biden. And we're learning more about useless decongestants
Speaker 2: and they're not the only over the counter products that
Speaker 2: don't work as advertised. And we'll hear more about stress
Speaker 2: from the pandemic and how it continues to linger. Now
Speaker 2: we begin with generic drugs and how they may be
Speaker 2: too cheap for their own good. More than ninety percent
Speaker 2: of prescriptions in the US are filled with generic drugs.
Speaker 2: These cheaper alternatives to branded medications have expanded access to
Speaker 2: care for millions of Americans and saved the healthcare system
Speaker 2: hundreds of billions of dollars each year. While the prices
Speaker 2: of branded drugs have skyrocketed in recent years, generics prices
Speaker 2: have been falling steadily, So what's the downside? Well, earlier
Speaker 2: this year, Senate Majority Leader Chuck Schumer called the current
Speaker 2: drug manufacturing system broken, citing a national shortage of nearly
Speaker 2: three hundred critical drugs.
Speaker 3: From cancer drugs to everyday generics that deal with things
Speaker 3: like ADHD and asthma and even common infections. They're out
Speaker 3: of stock. Our doctors and our patients are near panic.
Speaker 2: Okay, so let's talk about this now. Bloomberg Opinion editor
Speaker 2: Rachel Rosenthal joins us. Now, Rachel, how can prices for
Speaker 2: in demand products fall too low? It seems like there
Speaker 2: would be no downside.
Speaker 4: It would sound like that, but as ever, in the
Speaker 4: healthcare market, the laws of supply and demand don't exactly
Speaker 4: meet up. So what you've got in the generic space,
Speaker 4: which has been a great boon to patients and providers
Speaker 4: in healthcare systems, which I mean generics have saved the
Speaker 4: US healthcare system hundreds of billions of dollars, as you've mentioned,
Speaker 4: you know, but when you've got prices that fall too low,
Speaker 4: you end up with companies that go out of business,
Speaker 4: and you think, like, well, how is that possible? You know, here,
Speaker 4: I am like, if I'm desperate for medication, I'd be
Speaker 4: willing to spend more. But the consumer doesn't necessarily have
Speaker 4: a lot of buying power. When you get to the
Speaker 4: prescription drug market, there are lots of intermediaries that buy
Speaker 4: on behalf of us sitting here as employees of Bloomberg,
Speaker 4: if you're an employee in many other places. And so
Speaker 4: what they do is they sort of aggregate their buying power.
Speaker 4: And because of that, because they have these massive amounts
Speaker 4: of buying power that is sort of aggregated among other
Speaker 4: buyers as well, they can become gatekeepers too, are access
Speaker 4: to prescription drugs, and so they can push prices where
Speaker 4: they want them to go, which is down and without
Speaker 4: that sort of floor that would be sort of driven
Speaker 4: by a competitive market. And these are often expressed in
Speaker 4: sort of contract terms that we don't see, you know,
Speaker 4: at the pharmacy counter, and we just wonder why why
Speaker 4: did this company go out of business? And it can really,
Speaker 4: it can be really hard for a lot of these
Speaker 4: generics manufacturers to pay their rise in costs of labor
Speaker 4: among a number of other inputs. And you know, this
Speaker 4: is this is all sort of boiled down to we
Speaker 4: have an artificially suppressed access to generic drugs.
Speaker 2: So I want to understand this middleman issue. Then you
Speaker 2: have this drug middleman who was able to influence the
Speaker 2: retail market by aggregating the contracts with pharmaceutical companies.
Speaker 4: So what they do, and you know, the way you
Speaker 4: can think about it, or the easiest way, and this
Speaker 4: will be an oversimplification if you look at any of
Speaker 4: these sort of drug supply chain float charts, which I
Speaker 4: don't necessarily recommend, if you think about it, there's there's
Speaker 4: a generics manufacturer supplier. They need to get their product
Speaker 4: to a pharmacy counter, you know, and where you and
Speaker 4: I go pick up our prescriptions. In between, there's a
Speaker 4: wholesale distributor, so they pick up, you know, those palettes
Speaker 4: of pills and they bring them to the pharmacy. That's
Speaker 4: really hard to get around, that wholesale distributor and middleman.
Speaker 4: So you know, for their services, you know, the church fees.
Speaker 4: That all makes sense, you know, But what happens what's
Speaker 4: been happening recently in the retail drug market, the pharmacies
Speaker 4: and the wholesale distributors have been joining joining forces effectively,
Speaker 4: and they've become sort of what's called retail buying groups
Speaker 4: for lack of a better term, and they have because
Speaker 4: they you can't get your pill to the counter without
Speaker 4: these guys. Then they become very very powerful and determining prices.
Speaker 2: How much responsibility then, does the drug manufacture are bear
Speaker 2: in this?
Speaker 4: It's really important to distinguish between generic drugs and branded drugs.
Speaker 4: So branded drugs almost by definition have no rival, you know,
Speaker 4: and so they what we see in the in the
Speaker 4: branded drug space is the conversation that has overtaken the
Speaker 4: public sector, the public sphere, and conversations in Congress about staggering.
Speaker 4: All we hear about is usually staggering the high drug
Speaker 4: prices and how damaging they can be, and that that's
Speaker 4: really because there's no competition there, you know, very little competition,
Speaker 4: direct competition in the generic space. You know, it's it's
Speaker 4: quite different, you know, because of the Hatchwaksmann Act, which
Speaker 4: was passed nineteen eighty four, You've got the very definition
Speaker 4: was generic drugs will are equivalent to each other and
Speaker 4: to the branded drug and so you get what is
Speaker 4: up happening is once a patent expires, you get this
Speaker 4: rush to get into that for to be that first
Speaker 4: generics maker to be able to compete, you know, and
Speaker 4: so and if you are the first one, then you
Speaker 4: get one hundred and eighty days of exclusivity. So that's
Speaker 4: a huge I mean, that's why, that's why this whole
Speaker 4: game keeps going because it can be very lucrative in
Speaker 4: those first six months. So what you end up with
Speaker 4: is very different from the branded space. You've got one.
Speaker 4: In the generic space, you have many, many, many competitors,
Speaker 4: and that that sort of drives the prices lower.
Speaker 2: Now, you mentioned the Hatch Waxman Act that was back
Speaker 2: in the mid eighties. Correct, just for our audience, just
Speaker 2: a background. What does that act to do?
Speaker 4: Sure, so that was really like the basis of the
Speaker 4: generic drugs, the generic drug market as it exists today.
Speaker 4: And you know it was I think it was designed
Speaker 4: to both protect you know, to protect innovation, so to
Speaker 4: make it to give incentives for branded drug companies to
Speaker 4: in that. I mean, you know, there's a tremendous amount
Speaker 4: of R and D that goes into you know, many
Speaker 4: men and we've heard these statistics many many failures before
Speaker 4: one successful drugs, and so I think part of this
Speaker 4: was designed to sort of protect that incentive to innovate
Speaker 4: and invest heavily, uh, you know, and then you know,
Speaker 4: I think the there are certain guide posts to when
Speaker 4: generics can enter in the market, and then you know,
Speaker 4: there's certain exclusivity windows, as I mentioned before, and I
Speaker 4: think sort of the the founding principle of patch Waxmen
Speaker 4: was that, as I mentioned earlier, that generic drugs are
Speaker 4: all equal to each other, and that if I take
Speaker 4: generic from manufacturer A, it is chemically the same as
Speaker 4: generic Manufacturer B is the same as branded drug you
Speaker 4: know X, you know, and so I think as as
Speaker 4: patients as people who take medicine, there have been many
Speaker 4: many reports that that might not necessarily be true because
Speaker 4: you know, the active ingredients can or the accipients or
Speaker 4: you know, the different parts of the medication that are
Speaker 4: supposed to do different things can can interact with your
Speaker 4: body differently, you know. And I think people have heard
Speaker 4: a lot about this, as there are increasing numbers of shortages,
Speaker 4: efforts at pharmacies to sort of substitute has not always
Speaker 4: been smooth. But that sort of explains that that sort
Speaker 4: of principle has sort of been a double edged sort
Speaker 4: of like that generics are all equal to each other,
Speaker 4: because it does make it very difficult to discriminate between
Speaker 4: when you're a patient, particularly and you go to the county,
Speaker 4: you know, and you go to your fill your prescription
Speaker 4: to say, oh, you know, I don't want this generic,
Speaker 4: you know, from this company, but I'd prefer the generic
Speaker 4: from that company.
Speaker 2: And we are talking with Bloomberg Opinion editor Rachel Rosenthal
Speaker 2: about how some generic drugs may be too cheap for
Speaker 2: their own good, some unintended consequences, if you will, Rachel,
Speaker 2: how do these drug discount programs like Medicaid or other
Speaker 2: insurance programs impact this?
Speaker 4: So I think, you know, what we've been discussing so
Speaker 4: far is sort of the fundamental economics, and then there
Speaker 4: are certain policies kind of exacerbate all this stuff, you know,
Speaker 4: And so I think it would be a struggle to
Speaker 4: say that, you know, all of this comes down to,
Speaker 4: you know, the rapacious middle men. But I think that
Speaker 4: as as you mentioned, there's Medicaid policies, the three forty
Speaker 4: B discount program that sort of add another layer of
Speaker 4: dysfunction on all this and all these sort of wacky economics.
Speaker 4: And so, for example, in the Medicaid program, there's an
Speaker 4: inflation penal of what I would call a penalty, I
Speaker 4: guess they would call it.
Speaker 2: Others would call it a.
Speaker 4: Policy whereby if the price of the drug acceleers faster
Speaker 4: than inflation, they get sort of an added discount they
Speaker 4: have to rebate to pay a rebate back to Medicaid.
Speaker 4: And so you might say, well, well, if prices are falling,
Speaker 4: how would it be rising faster than inflation, Which is
Speaker 4: the question I asked. And the explanation is, so if
Speaker 4: you're thinking about a drug that is pennies, you know,
Speaker 4: one penny can look like you know, change can look
Speaker 4: like a big change. That's one problem. The other problem
Speaker 4: is because of these contract terms that I discussed previously,
Speaker 4: the you know, there's these buyers can drop out really quickly,
Speaker 4: leaving manufacturers holding the bag. So there's a really brisk
Speaker 4: rotation of buyers that come in come out, and that
Speaker 4: creates a lot of variability in the prices depending on
Speaker 4: the advocause. It's an average price. So when big, big,
Speaker 4: big buyers are dropping in and out from quarter to quarter,
Speaker 4: you know, there there the price that you're seeing may
Speaker 4: made spike and then fall, and then spike and then
Speaker 4: fall and if you're sort of penalized by an average,
Speaker 4: it doesn't it's not really accurate. So you've got the
Speaker 4: structure of these policies that are it was sort of
Speaker 4: really designed for a branded drug market that has been
Speaker 4: sort of applied, i would say, mistakenly to the generics market.
Speaker 2: Bloomberg Opinion editor Rachel Rosenthal, and coming up, we're going
Speaker 2: to take a look at a proposal to legalize marijuana
Speaker 2: on the federal level and what that could mean politically
Speaker 2: for the Biden administration. You're listening to Bloomberg Opinion.
Speaker 1: You're listening to the Bloomberg Opinion podcast counts Saturdays at
Speaker 1: one and seven pm Eastern on Bloomberg dot Com, the
Speaker 1: iHeartRadio app, and the Bloomberg Business App, or listen on
Speaker 1: demand wherever you get your podcasts.
Speaker 2: You're listening to Bloomberg Opinion. I may Mee Morris. President
Speaker 2: Biden may be looking to boost his reelection hopes and
Speaker 2: his sinking poll numbers. And there's one policy position that
Speaker 2: is popular with voters and could help unite Democrats. It
Speaker 2: is legalizing recreational use of marijuana. Let's bring in Bloomberg
Speaker 2: Opinion columnist Jonathan Bernstein, who covers politics, and Jonathan, you're
Speaker 2: talking about in your column recreational marijuana not medicinal, which
Speaker 2: kind of surprised me. How could this help?
Speaker 5: Legalization right now is a very popular idea. Twenty four
Speaker 5: states have now made recreational marijuana legal, and when you
Speaker 5: do polls, there was a Gallup poll out this month
Speaker 5: and it was around seventy percent support legalizing recreational marijuana.
Speaker 5: So it's not a fringe position anymore. For those who
Speaker 5: might be in states don't have this and you know,
Speaker 5: may not realize, it's no longer a fringe position. It's
Speaker 5: a mainstream, popular position. And the truth is that especially
Speaker 5: among Democrats, but it's about fifty to fifty among Republicans.
Speaker 5: And the truth is that Joe Biden has been behind
Speaker 5: public opinion on this, and I think with good reason.
Speaker 6: But I think it's also time now for him to
Speaker 6: promptly switch now.
Speaker 2: It seems like there would be a risk of some
Speaker 2: division on this issue because it has already been handled
Speaker 2: by those states that want to legalize it. Why bother
Speaker 2: with something that could be this touchy.
Speaker 5: It's seventy percent, so yes, they're thirty percent to oppose it,
Speaker 5: but it's a popular position. Generally, you want popular positions.
Speaker 5: On top of that, it's popular among Biden's in Biden's
Speaker 5: party party, particularly popular among some of the strong Democratic
Speaker 5: groups that he's had some problems with recently, young people,
Speaker 5: black people, and those populations. I've been looking for to
Speaker 5: have some signature thing that they feel like Biden's doing
Speaker 5: for them because they don't feel like the economy's working
Speaker 5: for them at other things. And you know, in politics,
Speaker 5: it's always a good idea, you know, everything else aside
Speaker 5: to find something that unites your party and splits the
Speaker 5: other party. And that's something that legal marijuana does now.
Speaker 5: So you know, up to this point where support was growing,
Speaker 5: but it wasn't at this level, my feeling was that
Speaker 5: there's no reason for Biden to get involved because as
Speaker 5: long as public opinion is moving his way, all that
Speaker 5: president involvement tends to do is polarize things. And so
Speaker 5: instead of support growing among Republicans, which is what's been happening,
Speaker 5: Republicans would tend to move against it if the president
Speaker 5: was for it. But now it's sort of reached that
Speaker 5: stage where it sort of doesn't matter anymore. It's so
Speaker 5: overwhelmingly popular that it's unlikely. And the other thing that
Speaker 5: I think it has going forward is that because it's
Speaker 5: been in so many different states, you can see that
Speaker 5: the policy as it rolls out doesn't generate backlash. It doesn't,
Speaker 5: you know, people don't regret it. Especially there aren't any
Speaker 5: states that have legalized and then said, oh my god,
Speaker 5: this isn't working, we need to go back. Biden has
Speaker 5: made some small moves to change it, but he hasn't
Speaker 5: really sort of come out full scale, Yeah, we support this,
Speaker 5: and it's probably time.
Speaker 2: To do that now. Historically speaking, you compare this in
Speaker 2: your column to the public push that then Vice President
Speaker 2: Biden gave President Obama on the issue of me marriage equality.
Speaker 2: How was this similar?
Speaker 5: Well as an issue, it sort of had the similar
Speaker 5: sense that it used to be very unpopular, it became
Speaker 5: more popular, the president got behind the curve on it,
Speaker 5: It became almost universally popular among Democrats and split the
Speaker 5: other party, and then eventually Barack Obama got on board.
Speaker 5: In fact, what I suggested in the column might be
Speaker 5: a nice way of doing this is if the vice
Speaker 5: president Vice President Harris was to simply answer the question
Speaker 5: what should the administration policy be? Which is what happened
Speaker 5: ten years ago to Biden gave a public push to Obama.
Speaker 5: And at that point, given the Democratic Party was one
Speaker 5: hundred percent favor of matter equality and Obama was way
Speaker 5: behind the curve, Obama didn't have much choice but to
Speaker 5: finally accept that that was where things were going, and
Speaker 5: he made his own policy change. And so, you know,
Speaker 5: Harris could do that at this point, could do it.
Speaker 5: She could you know, say well, yeah, you know, yes,
Speaker 5: I think we should legalize. And that might be a
Speaker 5: way to push Biden, who would be flip flopping. Politicians
Speaker 5: don't like to flip flop. That might be a way
Speaker 5: to push him to do it. And it also might
Speaker 5: help Harris a little bit to show that she has
Speaker 5: some foubt within the administration.
Speaker 2: Well, let's talk about that. The vice president's position on
Speaker 2: marijuana is a complicated one anyway, Remember she has a
Speaker 2: history as a prosecutor judicial reform, that sort of thing.
Speaker 2: Would she be the voice that would come out, you.
Speaker 5: Know, presumably she's in favor of Demographically these are Democrats, right,
Speaker 5: So Democratic Party is again something like ninety percent in
Speaker 5: favor of it. So my guess is that Harris in
Speaker 5: her gut probably supports it, but forget about that. Politically,
Speaker 5: if Harris wants to be president, she wants to take
Speaker 5: the positions of the Democratic Party, and of course every
Speaker 5: vice president eventually wants to be president. So you know,
Speaker 5: I think that politically it's it's a smart place for
Speaker 5: her to be. And you know, if somebody wants to
Speaker 5: throw back to her, throw it back at her that
Speaker 5: while she put people in jail years ago as a prosecutor,
Speaker 5: that's a conversation she's going to have to have at
Speaker 5: some point. She had it a little bit when she
Speaker 5: ran for president. If she ever wants to run for president,
Speaker 5: for the nomination, she's going to have to go through this.
Speaker 5: So why not get ahead of it now?
Speaker 2: And we are talking to Bloomberg opinion columnist Jonathan Bernstein,
Speaker 2: who says a push to legalize recreational use of marijuana
Speaker 2: that actually helped Democrats win the White House in twenty
Speaker 2: twenty four. It also seems, though, Jonathan, that it might
Speaker 2: be better to get a coherent message together with the
Speaker 2: administration on the strength of the economy. We've been hearing
Speaker 2: how the economic numbers are very good, people are spending more,
Speaker 2: but consumer sentiment is just rock bottom and there's a
Speaker 2: disconnect there. Maybe that should be like, that sounds something safer, right,
Speaker 2: that sounds like a safer thing for them to tackle.
Speaker 6: Well, there's no.
Speaker 5: Question that is going to have to push the economy,
Speaker 5: and if people do not change their minds about the
Speaker 5: economy over the next year, he's in grave danger. Talking
Speaker 5: on marijuana could generate some positives for a few days,
Speaker 5: it might linger with some of the groups who care
Speaker 5: about this the most. You know, this is one of
Speaker 5: the great puzzles of US politicians right now, is where
Speaker 5: what's the reason for the perception gap and will it
Speaker 5: continue going forward?
Speaker 6: And we could talk about that, but.
Speaker 5: Yes, that's you know, whether that's a question of presidential
Speaker 5: messaging or something about the economy or how things work,
Speaker 5: and you know, generally it's a complicated topic.
Speaker 2: Your column lays out a really good argument for the
Speaker 2: administration to embrace this policy and move forward on it.
Speaker 2: Do you feel like it's not likely to happen and why?
Speaker 6: That's a good question. It wouldn't surprise me at all
Speaker 6: if it happens.
Speaker 5: I do think that it's something that you know, again,
Speaker 5: this isn't a fringe thing anymore. This is Ohio, you know,
Speaker 5: and other states that are lean Republican or are swing states.
Speaker 5: It's a majority issue, and politicians they don't like flip lobbing.
Speaker 5: They do like getting on the side of a popular issue.
Speaker 5: So would it surprised me. It would not surprise me
Speaker 5: a lot either way, because those are the sort of
Speaker 5: two dynamics going going into it. I don't think that
Speaker 5: they are afraid of taking a huge backlash, but it is,
Speaker 5: you know, with things going on in the world and
Speaker 5: with the economy, as you suggest, talking about something that's
Speaker 5: not necessarily considered that important might not be where they
Speaker 5: want to spend their time. Again, that's one of the
Speaker 5: reasons why I thought it was sort of fun to
Speaker 5: think about, Well, what if Harris forces the issue, because
Speaker 5: if it really comes down to having to talk about it,
Speaker 5: I don't think that Joe Biden wants to be there,
Speaker 5: you know, defending a minority view within the party.
Speaker 6: If it becomes something that people are talking about.
Speaker 2: All right, Jonathan, we're going to leave it there. Thank
Speaker 2: you so much for taking the time.
Speaker 6: Thank you.
Speaker 2: Jonathan Bernstein is a Bloomberg opinion columnist who covers politics
Speaker 2: and coming up is that decongestin not quite working for you.
Speaker 2: There's a reason. Don't forget. We're available as a podcast
Speaker 2: on Apple, Spotify or your favorite podcast platform. This is
Speaker 2: Bloomberg Opinion.
Speaker 1: You're listening to the Bloomberg Opinion podcast. Catch us Saturdays
Speaker 1: at one and seven pm Eastern on Bloomberg dot com,
Speaker 1: the iHeartRadio app and the Bloomberg Business App, or listen
Speaker 1: on demand wherever you get your podcasts.
Speaker 2: This is Bloomberg Opinion. I Amy Morrison. We are deep
Speaker 2: into cold and flu season. You've probably already made at
Speaker 2: least one trip to the farm to find relief. I
Speaker 2: know I have, But buyer beware. Over the counter oral
Speaker 2: decongestants are not all they're said to be. Bloomberg Opinion
Speaker 2: columnist Faith Lamb cover Science and his host of the
Speaker 2: Follow the Science podcast and joins us. Now let's start
Speaker 2: fae with PE. We've seen those two letters on pharmacy shelves,
Speaker 2: on different boxes and containers for quite a while. What
Speaker 2: is PE.
Speaker 7: It's something called phenol epron, and it's actually the dominant
Speaker 7: drug for decongestants. It's the dominant ingredient and it came
Speaker 7: to be dominant after several others were removed from the
Speaker 7: market for different reasons once it actually worked pretty well.
Speaker 7: The phenol epron has been in the news recently because
Speaker 7: a couple of pharmacists did a deep investigation and found
Speaker 7: that it really does not work.
Speaker 2: And so they've all been pulled. Is that right?
Speaker 7: They are working on that, I see, But at least
Speaker 7: we it's been made public now that these drugs don't work.
Speaker 7: The thing that I think was particularly deceptive is that
Speaker 7: there's a there's a drug called sudafed pe, and there
Speaker 7: was a sudafed actually did work really well, and then
Speaker 7: it was taken off the market because if you remember
Speaker 7: the series Breaking Bad, people were using it to make
Speaker 7: crystal meth, and so it got it got actually got
Speaker 7: taken off the shelves. But it is available if you
Speaker 7: go to the pharmacist and ask for it. It's just
Speaker 7: hidden away so that it would be harder for the
Speaker 7: drug the illegal meth cooks to get it. But then
Speaker 7: this suit of fed pe is actually a completely different drug.
Speaker 7: It's not the same thing at all, and in fact
Speaker 7: it it doesn't seem to work.
Speaker 2: See. Okay, I'm glad you explained that. Because I take
Speaker 2: zertech and sometimes Zirtec d D being a decongestant. I assumed,
Speaker 2: and this is on me, that sudo fed pe was
Speaker 2: just like an additive to classic sudo fed. What you're
Speaker 2: saying is it's not even sudafed.
Speaker 7: No, it's a completely different thing. If you want the
Speaker 7: real Suita fed, you're supposed to ask the pharmacist. But
Speaker 7: people just don't know that. You know, I've talked. I
Speaker 7: talked to someone who was in the drug industry and
Speaker 7: he said, well, you know, you can get the real
Speaker 7: stuff if you just ask, but but people haven't. You know,
Speaker 7: those two people call these sort of decoy medicines now
Speaker 7: on the shelves. And you know, they had a good
Speaker 7: reason for pulling the pseudofed from the shelves because there
Speaker 7: was a problem with the manufacturer of this this dangerous
Speaker 7: illegal drug. But the problem was then there was all
Speaker 7: of this deceptive marketing so that people thought they were
Speaker 7: getting the same thing when they were getting something that
Speaker 7: was in fact grandfathered in. It just hadn't really been
Speaker 7: thoroughly tested for efficacy because a lot of over the
Speaker 7: counter drugs were already on the market before FDA started
Speaker 7: requiring that things be tested for efficacy.
Speaker 2: Wait say that again.
Speaker 7: Oh yeah, So you know, and the battle days before
Speaker 7: there was an FDA, you know, anybody could sell anything,
Speaker 7: and people sold terrible toxic things. And the initial directive
Speaker 7: of the FDA was to that drugs be safe, that
Speaker 7: they not harm people. And then by the nineteen sixties,
Speaker 7: FDA was also requiring efficacy. But there were a whole
Speaker 7: slew of drugs already on the shelves that hadn't been
Speaker 7: tested for efficacy, and so FDA had to deal with that,
Speaker 7: and they dealt with that by sort of grouping drugs
Speaker 7: into these categories and then they would try to determine
Speaker 7: whether the categories were sort of generally effective, so they
Speaker 7: didn't really go back and test every individual drug that's
Speaker 7: on the shelves. So that's why some things on the
Speaker 7: drug store shelves have been tested for efficacy if they're
Speaker 7: relatively recent arrivals. But that there are a lot of
Speaker 7: old drugs that we're grandfathered in and haven't been thoroughly tested.
Speaker 2: So are there other drugs or products out there besides
Speaker 2: pseudo fed and other decongestants that are being sold as
Speaker 2: being effective but they're not not really?
Speaker 7: Uh yeah, yeah, I think a lot of I talked
Speaker 7: to the two pharmacists, pharmacy professors who really spearheaded the
Speaker 7: effort to look into these decongestants, and they said, oh, yeah,
Speaker 7: there are other things that have also been grandfathered in,
Speaker 7: often things with fairly vague claims that I think they
Speaker 7: mentioned some drugs for gastro intestinal problems and anything that's
Speaker 7: marketed as homeopathic. Usually the claims are pretty vague. But
Speaker 7: those none of those are actually approved by FDA for efficacy,
Speaker 7: and supplements also are only very loosely regulated.
Speaker 2: And we are talking with Bloomberg Opinion colonist Faith Lamb
Speaker 2: about ineffective drugs on our pharmacy shelves, and you were
Speaker 2: talking about the role that the FDA is playing and
Speaker 2: how that role has evolved over the past few decades.
Speaker 2: So what is the FDA doing now? Is it just
Speaker 2: a matter of screening them. I know that there are
Speaker 2: some that are going to remain on the shelves because
Speaker 2: they've been grandfathered in, but that's not sustainable.
Speaker 7: Yeah, No, I think that because these pharmacy professors, you know,
Speaker 7: called attention to the fact that there were already a
Speaker 7: number of studies that were really damning about these these
Speaker 7: decongestions that have been dominating the market. That there were
Speaker 7: some controlled trials where people took the real SUITO fed
Speaker 7: and got a lot of relief, and they took these
Speaker 7: drugs and it was no better than placebo. So, you know,
Speaker 7: it may take a while, but I think these are
Speaker 7: going to eventually get pulled from the shelves, and the
Speaker 7: CBS chain has already started getting rid of some of them.
Speaker 7: So some of the pharmacies are are already kind of
Speaker 7: trying to be ahead of the curve because the consumers
Speaker 7: have now heard that these things don't work as advertised.
Speaker 2: What did happen to the pseudoaphedrin or the phenol propanolamine?
Speaker 2: We've heard all of the I mean I remember hearing
Speaker 2: that growing up, that these are the two drugs that
Speaker 2: you really need if you want to get some congestion
Speaker 2: real relief. Where'd they go?
Speaker 5: Well?
Speaker 7: Right, So one of them was was and it was
Speaker 7: also an ingredient in some weight loss drugs. There was
Speaker 7: one called dexatrim. Yeah, they were in higher doses in
Speaker 7: those drugs, but they those drugs were associated with stroke
Speaker 7: and so even though there was no evidence that the
Speaker 7: doses in the cold remedies would cause a stroke. Nobody
Speaker 7: really wants to take a cold remedy that is even
Speaker 7: you know, as any connection with stroke, So that I
Speaker 7: think that was that was smart they got rid of that.
Speaker 7: And then the sudofied was taken off the shelves and
Speaker 7: people can still get it if they ask the pharmacist
Speaker 7: for it, but there was a certain amount of red
Speaker 7: tape you have to go through to get it because
Speaker 7: it was it was taken off the shelves because of
Speaker 7: the its use in making illegal crystal meth. Right that
Speaker 7: was in the early episodes of Breaking Bad. You know,
Speaker 7: they would go to these pharmacies and try to get
Speaker 7: sudofed and so that had they had to do something
Speaker 7: to keep the the meth cooks from getting it. So
Speaker 7: you don't only have to ask the pharmacist for it,
Speaker 7: but you have to register and put your name in
Speaker 7: just so that there can be some tracking so that
Speaker 7: you're not getting you know, different boxes from different pharmacies
Speaker 7: and building up collection to cook your crystal meth. But
Speaker 7: you can, you can get it, It's just I think
Speaker 7: most consumers don't know that. And because the sudafed pe
Speaker 7: looks so much and sounds so much like the old
Speaker 7: drug that people assume it's going to be the same thing,
Speaker 7: and it's not so.
Speaker 2: Now that we are well into the cold and flu
Speaker 2: season and people sound congested and are congested and are
Speaker 2: dealing with head colds. Present company accepted, how is that
Speaker 2: the way we have to get relief? We actually have
Speaker 2: to go to the pharmacist and say, hey, I'm help
Speaker 2: me out here.
Speaker 7: You know, I think it's actually a good idea, because
Speaker 7: you know, I talked to these two pharmacy professors. They
Speaker 7: were great, and they said, you know, that's what we're
Speaker 7: here for. We may look like we're busy and where
Speaker 7: we're stressed, but our job is to help people navigate
Speaker 7: what's on the shelves and that people should not hesitate
Speaker 7: when they're not feeling well to ask the pharmacist to
Speaker 7: recommend something. And if you're really congested and miserable, then
Speaker 7: getting the drug that's behind the counter might be the
Speaker 7: right answer, or it might be just to rest it out,
Speaker 7: you know, but I think people would rather not take
Speaker 7: a drug that's not going to help them.
Speaker 2: That is terrific stuff. Thank you for doing all of that. Legwork. Fay,
Speaker 2: we appreciate it.
Speaker 5: Thank you.
Speaker 2: You're listening to Bloomberg Opinion. I'm Amy Morris. The COVID
Speaker 2: pandemic may be over. The impact lingers not just when
Speaker 2: and where to wear masks, are scheduling your booster shots,
Speaker 2: but the universal stress that we are all collectively feeling.
Speaker 2: Bloomberg Opinion columnist Lisa Jarvis covers biotech, healthcare, and the
Speaker 2: pharmaceutical industry, and she joins us. Now, Lisa, talk to
Speaker 2: us about the level of stress. How intense is this
Speaker 2: If we look.
Speaker 8: At it as the general average level of stress we're feeling,
Speaker 8: that hasn't necessarily changed over time. But what has changed
Speaker 8: is that a growing proportion of Americans are feeling the
Speaker 8: highest level of stress. The American Psychological Association does a
Speaker 8: survey every year. It sounds kind of silly, but it's
Speaker 8: a stress survey to gauge where we're all at. And
Speaker 8: they found at this point, twenty four percent of adults,
Speaker 8: so nearly a quarter of us, are rating their stress
Speaker 8: at an eight or higher out of ten, so eight,
Speaker 8: nine or ten out of ten, and that's increasing. You know,
Speaker 8: obviously we've all gone through the pandemic, but there's just
Speaker 8: been this relentless kind of pressure that at some point
Speaker 8: we run out of resources to deal with it. And
Speaker 8: I think we're seeing that in the data.
Speaker 2: But where is this coming from. I thought the pandemic
Speaker 2: was pretty much over well, I think not for.
Speaker 8: Everyone, but I think it's parents. A lot of parents
Speaker 8: are continuing to feel a lot of stress, but a
Speaker 8: lot of people are citing the economy as a source
Speaker 8: of their stress. I think seventy percent cited the economy
Speaker 8: as really being one of the reasons that they're feeling
Speaker 8: a lot of pressure these days. And that's significantly higher
Speaker 8: than pre pandemic. And it's just kind of layering on
Speaker 8: top again. You know, you have a period of relentless
Speaker 8: kind of fear, uncertainty, social, social isolation, and it's hard.
Speaker 8: You know, at this point, we're not just coming out
Speaker 8: of that from our base point. We need to get
Speaker 8: back up to our base point of where we are
Speaker 8: managing our stress.
Speaker 2: Is it worse for kids or the elderly who's feeling this?
Speaker 8: You know what's interesting is it to really younger adults,
Speaker 8: people in the eighteen to forty four range, And so,
Speaker 8: you know, on some levels, I asked the folks who
Speaker 8: ran the surveytion. I think of it as there's just
Speaker 8: more awareness and so people are feeling more open about
Speaker 8: talking about it, and I think their feeling was you know, yes,
Speaker 8: that's part of it, but it's not all of it.
Speaker 8: And I think it's a combination again of parents just
Speaker 8: not when it comes to that population having the time
Speaker 8: to ever get back to their baseline pre pandemic, and
Speaker 8: then now feeling other you know, kind of layers of
Speaker 8: stress that are adding on top of that.
Speaker 2: And that's why the stress didn't abate as the pandemic receded,
Speaker 2: because their feeling stresses from other areas and their nerves
Speaker 2: are already kind of raw from the pandemic. Is that
Speaker 2: what I'm interpreting, Yeah.
Speaker 8: That's exactly it.
Speaker 9: There's just kind of this you know, I think if
Speaker 9: you think about the amount of resources we have to
Speaker 9: deal with, you know, kind of what life is throwing
Speaker 9: at us. It's finite, and some of us naturally have
Speaker 9: more than others too, and so when those get depleted,
Speaker 9: it can be hard.
Speaker 8: To get back to that base level. And then you know,
Speaker 8: when you add more stress on top of that, we
Speaker 8: know that kind of chronic pressure really makes it hard
Speaker 8: to recover back to that base level. So that seems
Speaker 8: to be what's going on. People are just continuing to struggle, So.
Speaker 2: What's the solution. Is there any guidance for us?
Speaker 8: It sounds so squishy, but some of it. One psychologist
Speaker 8: I talked to I really kind of liked this was
Speaker 8: to have someone stop. She asked her her patients to
Speaker 8: stop and do like a self assessment and ask themselves,
Speaker 8: where's the fire? You know, is there something really immediately
Speaker 8: stressful going on that is an emergency? If not, like
Speaker 8: take a breath and try to take things down a
Speaker 8: notch and like ground yourself. I think some other advice,
Speaker 8: because some of it has to come with just everything
Speaker 8: we're seeing in the news. Turn off and sometimes the
Speaker 8: news if it's too much, Get what you need to
Speaker 8: know for your to make decisions for yourself and your family,
Speaker 8: and then just try to get out of some of
Speaker 8: your maybe social isolation that ruts we all got into
Speaker 8: during the pandemic.
Speaker 2: Bloomberg Opinion columnist Lisa Jarvis covers biotech, healthcare, and the
Speaker 2: pharmaceutical industry and that does it. For this week's Bloomberg Opinion.
Speaker 2: We are produced by Eric Molow, and you can find
Speaker 2: all of these columns on the Bloomberg terminal. We're also
Speaker 2: available as a podcast on Apple, Spotify, or your favorite
Speaker 2: podcast platform. Stay with us. Today's top stories and global
Speaker 2: business headlines are just ahead. I maybe Morris send. This
Speaker 2: is Bloomberg.