Showing posts with label news. Show all posts
Showing posts with label news. Show all posts

Thursday, April 11, 2013

Why depend on Big Pharma? And work, and fun, and decisions, and the proverbial long term

A few weeks back I was telling I-HEARD-YOU about not splitting posts, and here I find myself guilty for the same. But I think it is fine, since I got some new ideas after publishing the previous post.

To read further, make sure that you know about the Novartis issue in India. I would prefer if you could read the post I wrote a few days back, but it is not required. Here is another post on the issue, more like an editorial.

Before I start the post, remember that there are two ways to hold your right ear. The first is to bring your right hand up and hold the damn ear (simple). The other is to take your left hand across and use it to hold your right ear (somewhat complex). Believe me when I say that I am writing this post according to the second way.

Customary sex/hierarchy/work/fun joke

If there is one thing I learnt from noticing (only noticing, not listening or reading etc.) the Presidential debates in US, it is that you should open with a joke when starting some kind of presentation or writing. So, here goes:
An Indian Army Colonel is dining with a Major and a Lieutenant. The Colonel purposes: "I think sex is 20% fun and 80% work." The Major says: "No sir, I think you are mistaken. Is is actually 50-50." The Lieutenant chips in: "Sirs, in my experience, it should be 80% fun and 20% work." 
Just then a Sahayak comes around the room. The Colonel asks him the same question. His answer: "Sirs, it is 100% fun and no work. None at all." 
Other three (somewhat surprised): "How can you say this? What is your logic?" 
Sahayak: "Sirs, if there was even an iota of work in it, you guys would have me doing it in place of your honorable selves!"
I do not remember where I read it from, but it is a great joke. By the way, as of April, 2013, the sahayak system is a system in the Indian Army under which trained non-commissioned soldiers are made to do the personal work of seniors. (Sahayak: orderly, from British Army.) The funny thing about this system is that all the armies of the world have abolished this system, including even the Pakistan Army a few years back. Kudos, Pak Army! In the meantime, our Indian Army has the distinction of being the only Army in the world to still follow this tradition.


From what my Sainik School friends tell me, people in the Army are kind of serious when it comes to traditions. I thought of another word in place of serious, but there is only so much profanity I can handle in a blog post I am writing, especially when I live under the illusion that maybe someday, I will be able to persuade my parents to come and read it. They made me read to them the SSC interview post with interest, the rest of the blog, not even a cursory look :-)


What was that all about?

First some groundwork.

We all work in life. For the purpose of this post, even slacking/not-working is work, like zero work or something.

At individual as well as organisational levels, people have two natures with  respect to work. Some people like to take initiative and decide what to work on. Others like to be told what to do, whether because of their lack of initiative or plain old laziness. For the most part, I belong to the second category :-)

Again at individual and organisational levels, we do not exactly belong to one of the two natures. This is because it is not possible to define a fine line between the two.

How we think or act in a situation, whether we stand back or bite the bullet depends on a lot of things in addition to our nature, like previous experience and prejudices, the gravity of the situation and our mood at the time.

Similarly on an organisational level, the same things matter in almost the same way. Some organisations take risks and succeed once in many tries, some others just don't take as much risks as they can, settling for less but sure returns every time.

I cannot stress enough the importance of the thing I called prejudice that can be considered as a factor in a person or organisation's short-term or long-term decisions. It is something that comes from the group, demographic, area or industry or some other unifying/opposing factor that defines a person or an organisation. For individuals, it will look like I am creating stereotypes, but it is very easy to see this for organisations.

Suppose that a person swears a lot. This person will not think badly of some other person, who swears as much or more than him/herself. But someone who does not swear, might take offense to another person swearing at the top of their voice. Here, we are talking about the group of people who swear a lot, and belonging or not belonging to that group might be a major factor when you try to judge someone who swears. (I personally swear a lot, mostly in Hindi/Punjabi, but am fighting it currently and hopefully will get over it in some time)

For private companies, it is normally about the industry they belong to and the target group, or customers/clients. For example, Novartis (a Swiss company) and Bayer (a German company), both a part of what we call Big Pharma, have a similar stand on most issues, like pricing and patents etc., but Cipla and Ranbaxy are Indian companies that have a similar stand on pricing and patents, but one different to Novartis and Bayer etc. For governments, you will see that the considerations are mostly of the politics and business-approach kind. North Korea is near to China/Russia and South Korea is near to US/Europeans, because of left and right-wing governing ideologies, respectively. (My personal view, as of April, 2013, is that there are only two kinds of governing ideologies: wings and center. You see, both left and right wings try to focus on providing all power to a few people while making others dependent on their whims and fancies, groups called the politburo and the capitalists, respectively. Again, as of April, 2013, as you might have noticed, I am the king of sweeping generalisations)

That is fine, but what does it have to do with the pharmaceutical patents issue?

Something about decisions that I probably should have mentioned earlier, but did not in order to keep the flow of nature, is that these are broadly of two kinds: short and long term decisions. A morally and logically consistent person or organisation will try to keep their short term goals in sync with their long term goals, unless it is an emergency or otherwise unusual situation, like, you know, a few months before elections.

And as with everything, logical/moral consistency between short and long term goals again depends on things like prejudice, gravity of the situation and mood or mental state (and a few other factors I cannot think of). For example, you are likely to get your weird-noise-making vehicle checked next Sunday (short term) so that you can drive it comfortably for many weeks to come((relatively) long term). But sometimes we just keep eating like animals (short term), even when we know we will have a hard time losing the excess weight (long term).

The million-tablet question

Since we had work and fun in the beginning of this post, now it is actual decision time.

What to do? Should I/we even be doing something? When should I/we start? To what limit am/are I/we to proceed? Questions, questions. Where are the decisions answers?

A big question is, should I/we even start? This one is normally simple. You feel hungry. Should I eat? Yes. Your company is making losses. Should we cut losses? Hell yes! Your government is not exactly the most liked one. Should we be doing something about our public image? Duh!

An even bigger, rather biggest, but more ambiguous question is, should I/we do it myself/ourselves, or let someone do it for me/us?

In the software industry, Joel Spolsky takes care of it in a great post: In Defense of Not-Invented-Here Syndrome. Quoting him:

The best advice I can offer:
   If it's a core business function -- do it yourself, no matter what.
Pick your core business competencies and goals, and do those in house. If you're a software company, writing excellent code is how you're going to succeed. Go ahead and outsource the company cafeteria and the CD-ROM duplication. If you're a pharmaceutical company, write software for drug research, but don't write your own accounting package. If you're a web accounting service, write your own accounting package, but don't try to create your own magazine ads. If you have customers, never outsource customer service.

The million tablet answer

Master Oogway's short answer: There are no accidents answers.

Long (and not really an) answer:  Lets consider two kinds of organisations: private ones and governments. What is the difference between the two? 

Both exist to serve people. Both want to stay the longest. Both exist according to the people's pleasure (Not exactly true for governments, but remember, companies need to be thrown off like authoritarian regimes too. What am I trying do with Novartis (albeit unsuccessfully) right now?)

The difference is in terms of their target. No matter what they tell you, companies' primary target is profits mostly, and secondary target is people's happiness (there are non-profits/NGOs etc. too, but let us ignore them for this post). Government's primary target, on the other hand is people's happiness (responsibility towards people), and the secondary target is revenues.

I know both the targets are the same if we forget which is primary and which is secondary. So, here is an example. Going by their prices, Novartis want money. They sell medicines for that. But if an epidemic comes up, will Novartis consider selling their drugs cheaply? I think not. Because some parts of Asia and most parts of Africa are in a perpetual state of epidemic, and Novartis have not done anything for anyone there. But this does not absolve the governments of these nations from their responsibility of helping their people. And therefore the governments will do what they can, hopefully. What it means, in the end is that when they need to change their priorities, different people/organisations are more likely to ignore their secondary targets than primary.

See, two birds with one arrow: explained my point and made fun of Novartis while doing it!

So, what I am saying is that it is upto the governments to decide what they should do and what not, and that by deciding to not create medicines themselves, the governments are in a way outsourcing this by accident. According to Joel's logic and my (admittedly sparse) common sense, I think that it should be upto the governments to research and develop medicines etc. And I am not talking of silly NIPER thingies. Just making institutions does not do the trick, what does it is actually doing it.

A lot of people would like to point out Left wing countries that have public health as one of their core things, and no private health infrastructure etc., and still have bad overall health. The reason is that these countries too take public health as seriously as we Indians take it. Also, when a country like North Korea has problems feeding its people, do you really think they would invest properly in the people's health?

I do not know about the rest of the world, and for a while forget about competing with GPS, GLONASS and Beidou. When a country like India can invest in IRNSS, spending I don't know how much, then I think it should not be a problem for our government to invest in medicine as much as in space programs. I know we have companies like Cipla and Sun and Ranbaxy and many more, but still, due to any reason, what if these companies try to increase their rates? Obviously, these companies did not enter the market for charity.

Is it over yet?

The point I am trying to make here is not just about Novartis. It is about our governments and the way these governments make decisions.

What is the Indian government doing for protecting farmers against Biotech seeds? For our tribals, whose natural resources are being mined and used by foreigners. I am as much a foreigner in a tribal area as an Indian or foreign mining/timber company. What kind of an example is the government setting by not helping Ashok Khemka?

So, in conclusion, it is probably most definitely a good idea to create cheap heart disease hospitals, but not a good idea at all if the the government is using people's money to build a new spa for rich people.

Feeling guilty

I spent the last 4 hours writing this post, and on weekends I go to the Rebol room and tell the great people there that I did not do any rebol over the week. Kind of sucks.

I wrote this post, with almost 75-80% part as the introduction, but am gonna sleep just when I came to the actual thing.

One thing I do not feel guilty about is writing about economics without knowing anything about it. There was an economics class in college, but we took it more like an aerodynamics or aeronautical class, making paper planes and all :-)

And I did not even talk about the proverbial long term, mostly since I don't know what the hell it is. Especially when everybody thinks in terms of 5 years!

Friday, April 5, 2013

Novartis: Confusing R&D with Patent Trolling, marketing with FUD, and justice with "my ball, my rules" aka polite-bullying

Oh, and it is not even their ball. Maybe that is the best form of bullying. It is like me telling Rahul Gandhi to return the 2 Lakh Rupees he owns me since the last 5 years. Or else....


At least that is what the Indian legal system told them.


Maybe I am a bit harsh on the marketing/FUD part, but who cares as long it makes for a cool-sounding but rather long heading? Long headings <--> credibility!

The whole thing has been documented in our newspapers, like the Hindu and the Indian Express, even with timelines and all, so its better I take to rant-mode sooner rather than explaining the whole thing.

For what its worth, the term Big Pharma will sound similar to the term Protection Racket to me for some time.

The judgement

It is very easy to go on and criticise our system, the polity, the electricity dudes, the TV channels, the bureaucracy, the traffic police, (my favorite) the IRCTC website, the neighbor's dog, pretty much everybody. And our judiciary too.  But have a look (or just see the headings on different pages) at the 112 pages long judgement in this case (something I have not been able to do, its beyond my capabilities I think), and maybe, like me, you will feel good about it.

I think its fair that I did not read the judgement in its entirety, because I did not read the patent applications either. And I am sure neither did the owners of Novartis.

It is not an isolated case. The SC's recent bashings of Punjab and Bihar state governments against unnecessary force against a young woman and agitating teachers respectively, and another ongoing issue in the court against the use of police as security for petty politicians, some even with a criminal past is appreciable too. As far as looking at the Supreme court goes, we are living in interesting times.

From the internet and the newspapers, it looks like our SC took a broad perspective and provided the Novartis judgement on the ground of the latest application being a case for evergreening. Another aspect was scolding them for expecting a favorable decision just because they had a well drafted appeal and all.

Looks like there is hope for infrequent, grammatically-and-politically-incorrect writers like me, after all. If only I could lay my hands on a law degree...

Elsewhere

So, turns out patent trolling is not something that only Big Pharma deals in. It happens in lots of other fields.

Software is one of such fields. And one of the motivations for me writing this post (apart from other bloggers, SethTheWizKid and I-HEARD-YOU, and some friends telling me to write, overtly and covertly) was a recent post by Joel Spolsky, on the issue of trolling in software patents. This post by Joel was widely discussed on hackernews.

There is a company called Rackspace that is fighting against a patent troll. You might want to read their declaration of war on their blog, and another story elsewhere regarding the same troll's head, some Erich guy.

The above text aside, what surprises me is the overall pattern that rich (or soon-to-be-rich) people follow in bullying others is the same, more or less.

Novartis, and profits, and the need for bullying, almost in the same order

What I lack in economic knowhow, I am gonna make up in terms of fun that I have while writing.

Getting to basics of any kind of business, business is nothing but the process of doing something for others, or fulfilling a need, and expecting them to pay you for it. Some would call it the art of doing something that was not required, or fulfilling a need that was not a need in the first place, and then expecting others to pay you for it.

Doing something or fulfilling some need is not as simple as a YES or NO thing. It has two other aspects in my opinion, how important it is in the opinion of the user, and how important it is in reality. Which is which does not really matter, what matters is that both the aspects boil down to essentially one thing: desperation. 

The thing about the importance of something is that it is not a one-way thing, unless it is. Which turns out to be mostly. I might be desperate for getting people to my blog via advertising, but I am not desperate enough to pay for advertisements. So, no go, advertisements. But what if I have a bet with a friend about getting to, say, 10,000 views? My desperation will get a bit real. What if somehow I wind up jobless and hopeless, and the only way to get going is to make money from this blog? Now we are talking!

What you will pay for something, or whether you will pay at all, depends on how desperate you are for that thing.

Another desperation example: if a random dude had a hundred bucks, and he wanted to buy some chocolate, he would use some of the money. But if he had to walk a mile just to buy chocolate, he might not do it. This is because his desperation in this case is offset by the fact that he would have to walk a mile. But if he had a girlfriend and she wanted a chocolate, and he did not have any money, and the nearest shop or store was 10 miles away, he think he would crawl to the place and loot the shop/store and crawl back. Not the best example, but you get the point.

What happens if we were to up the stakes? What if it was a life and death matter for a near family member, and you were told that taking some magical pill might save them? Most people will do anything to get that pill and save that family member. That is where Big Pharma, or in this case, Novartis comes in, their superpower being your desperation!

There are very high chances that your family member can survive if you are willing to shell out a lot of money for them, to Novartis. A great company that works its ass off day in, day out, for the sake of the sick people in the world. But wait, if they really were that serious, they could have decreased the costs for their medicines. Looks like they are more desperate for money than most of us are for our lives.


What do you do to ensure that you have profits? Simple, make sure others cannot rip you off. We have something called patent law for that. This law means 2 things:

1. for 20 years, no one can copy your thing and make profit for it, unless,
2. they have (written?) permission from you.

This is necessary to make sure that the innovators get their due. But, the 20 years thing means that will only happen for a fixed time, and then it is a kind of free for all. Since Novartis is more desperate for money than you are for your family member's life (shame on you), they will do anything and everything to make sure they have the selling rights in exclusivity, even after the time limit.

How do you get a patent on something that you had patented a few years back? Simple. Show that the something you have now is better than the one before. For this, part (d) in Section 3 of Chapter II of the (Indian) Patents Act, 1970 reads something like the following:
3. What are not inventions? The following are not inventions within the meaning of this Act
.......... 
(d) the mere discovery of a new form of a known substance which does not result in the enhancement of the known efficacy of that substance or the mere discovery of any new property or new use for a known substance or of the mere use of a known process, machine or apparatus unless such known process results in a new product or employs at least one new reactant.
Explanation. For the purposes of this clause, salts, esters, ethers, polymorphs, metabolites, pure form, particle size, isomers, mixtures of isomers, complexes, combinations and other derivatives of known substance shall be considered to be the same substance, unless they differ significantly in properties with regard to efficacy;
The last paragraph kind of kills it for the purpose of evergreening by Novartis and Big Pharma in general. But wait, why would Novartis want to evergreen its patent on this medicine? The reason is the big generic drug industry in India, which caters not only to Indians, but to others too in the subcontinent and more importantly, Africa. One of these companies, Cipla, has been working really well in this aim of reaching to everybody (for profit of course). According to wikipedia, in 2001, when they reduced the cost of their AIDS medicine to $350 per patient per month, they led the the International Aids Society to state after a decade:
Cipla’s dramatic price reduction, which received widespread media attention, hammered the message home that many of the multinational drug companies were abusing their market monopoly in the face of a catastrophic human disaster.
(Too bad the wikipedia reference to that page returns a 404)

So, the second problem in the Big Pharma model, after the evergreening one is the urge to serve only a few people with expensive drugs rather than everyone with cheap drugs. What difference does it make? Well, no apparent difference. You can serve one person for $100, or 10 persons for $10 each, or 100 people for $1 each.

The real reason is that big multinationals drive on scarcity, and desperation. Except that after the time limit of 20 years, this option leaves itself out. I am sure you have heard/read the following- We did all we could, spent every last dime on his/her treatment, but to no avail.

Now to the need for bullying. Novartis India CEO saying something on the lines of No multinational drugs company is going to invest in India, you are all gonna die like dogs, you are all doomed, hahahahaha is, in its simplest form, bullying. (I don't think I get a copyright on stating his words in the simplest form, do I?)

This statement, whatever it was (I don't feel like quoting it exactly), is nothing but telling us to suck it up and just do what they want us to do, in terms of innovation and judging and our buying choices etc. Such statements are like poison to people suffering from rare forms of diseases who are normally told by doctors about a new drug in testing phase. And, our record as a nation on clinical trials is not very good, but the Supreme Court is working on that too, and more importantly, making the respective ministries work on that too.

(By the way, there is this great book, called Big Pharma, that I will read someday)

Who stands to benefit?

Something I learnt after working for a while, was that companies have three groups of people: owners/shareholders, management/employees and customers/clients. (Considering outsourcing as employees only)

Companies' allegiances lie only with the owners/shareholders. I don't think it is fair enough, but that is what happens. In this aspect, pharma companies are a bit good, with the concept of sweat equity and all.

But the problem is the only people who will benefit from the evergreening fad are the owners, when it should have been a case of patients benifitting from the drugs. If Novartis wants so much money, they should really try the recreational drug market!

Another party that really benefitted was the lawyers, but I saw how Jolly got beat up by other lawyers, so I am not gonna say anything about them. :-)

Wrapping up

The fun of writing on Novartis has now given way to boredom, so, here are a few points that I would like to write before I go on and do something else.
  1. Novartis, and all big western multinational pharma companies are evil.
  2. The need greed for generating more money is more important to them than the lives of the people their drugs can save.
  3. Somehow, these companies find ways of overestimating their investment and therefore making the costs for drugs skyrocket. Examples include showing marketing expenses as genuine R&D expenses.
  4. What is it with the time required to produce a drug? Is it really 10-15 years? How much is it excluding marketing? Also excluding the initial, no-research, only documentation phases etc.?
  5. India is not the only such nation, Indonesia is too. And I am sure others will follow.
  6. All big companies, irrespective of their field or lobby-ability must remember that India is a sovereign socialist secular democratic republic, and that at least in the near future (40-50 years), we are going to take a left-of-centre approach on most issues.
  7. Getting your management officials to say silly things does not really change anything. Ditto for your silly organisations in US or elsewhere.
  8. If you are so good at lobbying and R&D at the same time, you should try getting the government to change the patent law, and get a patent for testosterone occurring in its natural form. That way you might be able to control the whole world in terms of reproduction. And countries like India, with so many people and growing will be like little kittens in your hands.
  9. Maybe it is their drugs talking, but Novartis seems to have forgotten a basic business thing: if you won't provide something people want, someone else will. So, cry all you want, some other (preferably not similar to you) company will fill the void that you leave after you move out from India. Or, you will not move out, because we are such a huge fricking market!

To Novartis: this was me having some fun at your expense. If you feel this was not the best thing to do at my (a random person's) part, you have got bigger problems than patent issues and all. If you do not like it, please consider changing your tactics. I hope you won't sue me, but if you do, remember that I am kind of bankrupt. 

Also, if you intend to keep on with these silly, over the top court cases, consider providing a free medicine for vomiting, at least to me :-) :-)

In any case, remember that you are serving the market, it is NOT the other way around.

Feel free to have me as a researcher or a lawyer or a marketing professional or as a strategic guru. Then maybe we can delete this post :D

Cheers!