Mario Giordano has chosen L'Aquila, the city of pharmaceuticals, to present his new book: Jackals, viruses, health and money. While waiting for the Coronavirus vaccine, we need to get to know the world of Pharmaceuticals
Mario Giordano has chosen L'Aquila, an important pharmaceutical site, for the presentation of his new book 'Sciacals, Virus, health and money'.
The capital - 20 July 2020 - by Roberta Galeotti
I wrote it this morning on the Truth: pharmaceutical companies do many extraordinary things (they treat and save people, they give jobs), but they also do some crap. Good things are known, nobody knows shit. The problem is communication, because it's difficult to talk about these uncomfortable topics.'
Pharmaceutical companies don't allow these problems to be talked about, "it took me a year to read up on documents, months to check the contents with the lawyers, I closed the book in February and then, this book too, was blocked by the Coronavirus. I was a guest at the Del Debbio, then nothing more!”
The thorny topics hold back the presentations of the new book by the former director of Tg4, de The newspaper, as well as presenter of the denunciation show 'Fuori Dal Coro' broadcast in prime time on Tuesdays on Rete4.
Despite having written the book before the arrival of the pandemic "I anticipate very current contents, splashed in the headlines with the Covid-19 crisis, because I tell of mechanisms".
“I dedicated this book to my daughter Camilla who dreams of becoming a doctor. She passionately watched all the episodes of Dr. House' said the Director, explaining how convinced she was that this was enough to become a doctor.
'When Camilla was born she was wide-eyed… this is one area where we need to keep our eyes as wide as hers. I hope that the new generations, like Camilla's, will be able to keep their eyes more open than we did!".
It was the beginning of 2019, "when I interviewed the former undersecretary for health of the Conte 1 government, who told me about when two emissaries from a pharmaceutical company asked him to pay 20 million euros to buy a right of first refusal for the production of a vaccine against the pandemic. This dream that there may be people who now have a preemptive right and therefore some who can have a vaccine before others ”.
A heated Mario Giordano tells us from the microphones of the underground hall of the Abruzzo Regional Council, moderated by the journalist from L'Aquila Alessandro Rico.
“There are consultancy firms that take millions of euros, such as in Calabria, where the consultants are paid 1,000 euros a day by the regional service. This system, as it was built, tends more to protect the balance sheets of companies than people's health".
“For years we have heard about cuts in health care, then we found ourselves without ventilators having to choose who to save. We have changed our perspective, now we know we have to start investing in health again. Now that we have to rebuild the importance of health, after years of cuts, we must however know the mechanisms behind this world”.
"In my book, I tell of a drug that increased by 1.500% in one day, the health system continues to 
buy it and pay for it, without anyone saying anything”.
“The topics of the new book ' Jackals, viruses, health and money' are forerunners of a world that, in recent months, we have had to get to know better. I had written Profugopoli, denouncing the system of making money on the skin of refugees, years later it has been discovered that one earns more with refugees than with drugs. In 2018 I wrote Vultures, denouncing the wrong motorway system, then the news of the Genoa bridge opened Pandora's box".
“To date we do not know how our national system purchases drugs, AIFA does not want us to know how much we pay for them. But we know that the European drug agency is financed by 84% by the pharmaceutical companies, the same ones it should control. I want to trust science, but science has to make sure I can trust it."
As always, director Mario Giordano is a river in full flow: “Half of the medicines we buy and use are useless!
In my book I publish the list of various medicines on the market, which are even harmful, according to what has been published by a system of free and independent French doctors”.
“Pharmaceuticals is the only sector in which progress has not implied a decrease in prices. The real game of the future is played on health, we have drugs that can cure more and more ... but they cost more and more! I have always been convinced of one thing: knowledge is the only thing that moves consciences and awakens from the torpor of resignation. Real changes are made with knowledge!”.
“I wouldn't write books that above all bring me complaints, if I weren't convinced that with knowledge consciences are awakened and change is achieved. Since 2016, pharmaceutical companies have chosen to publish lists of the money they give to doctors. They are huge and unmanageable files, I sifted through them and found that they only publish the data of doctors who give their consent. At the bottom there are some numbers with vague references to doctors who have not given their consent to publication. And that should make us open our eyes.”
Many were unable to attend the book presentation and stayed out due to the distancing.
The interview of the capital with Mario Giordano:
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Ed: Without going into the merits of Giordano's book, we deem it useful to clarify the following.
In Italy, the price of medicines is agreed with AIFA which makes use of the support of Technical-Scientific Commission (CTS) he was born in Pricing and Reimbursement Committee (CPR) and data on pharmaceutical consumption and expenditure provided by theNational Observatory on the Use of Medicines (OsMed), The result of the negotiation, in the event of admission to reimbursement, is submitted to the definitive evaluation of the Board of Directors of AIFA.
In the United States, the piece is free and each pharmaceutical company sets the price it deems appropriate.
Giordano's news comes from American cases such as the case of Turing Pharmaceuticals dthe young man Shkreli who bought the patent of the Daraprim, a old drug for toxoplasmosis, dramatically raising its price: from 13.50 dollars per pill to 750 according to what is documented by the Infectious Diseases Society of America. Other cases, still in America, of vertiginous increases concerned cycloserine, bought by Rodelis Therapeutics and which went from 500 dollars to 10,800 for 30 pills; or that of the antibiotic doxycycline which went from 20 dollars a pack in 2013 to 1849 in April 2014 or of epipen, the life-saving drug epinephrine for anaphylaxis, which went from 100 euros in 2007 to 500 euros, which is unsustainable for the vast majority of families.
In Italy the multinational had tried aspen to apply an unjustified price increase from 300 to 1500% on old anticancer drugs (which, however, did not have their respective generics), but got a 5 million euro fine from the antitrust. In this case, however, the starting price was extremely low and the percentage indication can be misleading. Leukeran, one of the "offending" drugs, costs €90 after the increase, a price that is in any case lower than its competitors.
In Italy these dizzying price increases cannot take place precisely because of the mechanism described above (doxycycline in Italy costs €3.96 for 10 tablets) and even if a company asked for an unjustified price increase, AIFA would exclude it from reimbursement, therefore from the market, especially if there are generic alternatives or, in the case of Daraprim, galenics.
The world's most expensive drug is Zolgensma for the treatment of pediatric patients under 2 years of age with spinal muscular atrophy (SMA) with bi-allelic mutations in the motor neuron 1 gene. One dose/treatment costs $2.15 million. The price, however, was originally much higher: Novartis had estimated a cost per dose/treatment equal to 5 million dollars, clearly based on research and 
experimentation. Zolgensma will compete with Biogen's Spinraza, the first approved treatment for SMA. Spinraza, whose list price is $750,000 for the initial year and $375,000 for subsequent years.
Financial analysts have forecast Zolgensma sales of $2 billion by 2022. Spinraza sales reached $1.7 billion last year and are expected to rise to $2.2 billion in 2022.
In Italy, the "potentially" most expensive drug was Glybera, the first gene therapy ever approved in Europe. The treatment, produced by the Dutch company Uniqure and marketed by Chiesi, was intended for people suffering from lipoprotein lipase deficiency, an ultra-rare genetic disease which is estimated to affect one in a million people in Europe and which prevents the metabolization of fats eaten with nutrition, leading to recurrent pancreatitis, even lethal. The cost of the treatment, to be performed only once in a lifetime, was around 1 million euros. Uniqure has decided to discontinue the drug due to difficulties in finding patients and due to the high costs of maintaining the production facilities.
Even if they cause scandal such high prices, it must be considered that they are drugs for rare diseases. In Italy the average price of prescription drugs is the lowest among the 5 major European countries.
to prescribe is an independent association that has been analyzing the benefit-risk ratio of medicines marketed in the European Union, publishing every year an updated list of those that should be avoided precisely because the disadvantages outweigh the positive effects. In total in the black list of drugs more harmful than useful 105 specialties finish (here you can find thecomplete list )
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Zolgensma for SMA: the most expensive drug in the world, 2.15 million dollars
"Prescribing". To heal better. Report 2019: drugs to discard, more harmful than useful
