Beyond measure

Pre-empting the outcome of the OFT distribution report could be a move too far

I was struck by the difference: a couple of Saturdays ago, English sports fans were treated to a feast - the sort of fixture coincidence that happens, perhaps, once in a lifetime.

The English football team played Estonia, and the English rugby team played the Les Bleus. The footballers were on their way to collecting enough points to end up in the European play-offs, while the rugby boys were fighting for a place in the final of the World Cup.

Each in their own way important, each vital to their supporters and national pride. Both events were un-miss-able.

The rugby players played with heart and soul: crushing tackles, unbelievable brute force. The footballers ballet-danced their way between cheating, diving and play-acting.

Football is the 'nation's game'. Sadly, it has become bloated, effete and lacks soul. International football has become an unwelcome interruption in the premiership lifestyles of the vacuous celebrities who devalue the word athleticism and passion. Football exists to harvest money.

If you want a manifestation of the difference, play back the opening scenes of each game: the rugby players stood, arm in arm, and sang out their lungs to the national anthem; the pallid footballers stood in a line, like naughty schoolboys - some mumbled and shuffled their way through the anthem, others stood gormless, wooden and silent.

Soccer players will never persuade me that they wear their shirts with pride. They wear them to improve their royalties on the sales of shirts to the gormless, exploited followers daft enough to pay for them.

Rugby players are patriots. Footballers have an eye for the business. Rugby players endure bruising tackles and excruciating injury. Footballers fall over and choreograph their injuries with all the skill of an actor in the school play. They shout foul when there is no foul. They cry injury when there is no injury. They writhe and roll, exaggerate, falsify, lie and cheat.

It is interesting to speculate: is the pharma industry a rugby player or a soccer player? Are they heads down, full-on competitors or are they rule stretchers, exaggerators, licentious, shameless and brazen?

This thought came to me as I read that three leading drug companies are preparing to ignore an ongoing Office of Fair Trading (OFT) competition enquiry by forging ahead with changes to the way in which prescription medicines are distributed to patients across Britain.

What is the issue? From the beginning of October NAPP Pharmaceuticals, which is big in the supply of diamorphine pain relief, switched to a distribution deal with Unichem, the wholesaling arm of Alliance Boots, AAH and Phoenix.

There is more. If national newspaper reports are to be believed, two other leading pharma firms are planning to follow suit.

Why are they doing this? The answer is simple; they want to artificially buoy-up the price of their products.

At the moment, pharma companies sell their products to a range of wholesalers who then compete against each other to sell products to doctors, hospitals and others across the land. This competition has the effect of moderating prices, holding them down. That way life-saving drugs reach patients in the NHS at the best price possible.

The changes mean that pharma has much better control over the retail price of its drugs. To some commentators, including perhaps the OFT, this looks like a monopoly. Even more worrying is the thought that if a supplier runs out of a particular drug, if there is a foul-up somewhere in the 'just-in-the-nick-of-time' delivery chain, without an alternative wholesaler patients could go without their drugs. Vital and rare drugs, going short might even cause the death of a vulnerable and dependent patient.

All this in the name of avoiding competition. All this to avoid the scrum-down head-on struggle that is the demarcation between the real men of rugby and the coiffured actors that pass for real men who play football. All this marks the difference between men who lustily sing the national anthem with pride and the mutterers who do not.

Disappointment
Industry is shocked. Martin Sawyer of the British Association of Pharmaceutical Wholesalers was reported in the Times as saying he was 'disappointed that some manufacturers had decided to introduce changes before the OFT had published its report'. He added: '....it would have been better if they had waited. It could now make things even more complicated.'

The OFT became interested in UK distribution after the once great Pfizer made the controversial decision to appoint Unichem as its sole distributor. AstraZeneca, which of late has been uncharacteristically quiet on all fronts, ditched plans for a similar deal, opting to wait for the OFT report. Well done them!

The other companies, it seems to me, have 'dived' in the box and tripped themselves up. They could have waited for the referee, the whistle and the red card. This is not in the nation's interest. Not in patient's interest. This is in the self interest of the companies who will try to persuade you otherwise, but only exist to make profits for shareholders.

I am not against profit; profit won fair and square on the playing field of commerce. Playing by the rules. This is a move too far for industry. This marks pharma out alongside the dissembling footballers, who could never expect to appear on the same playing field as the heroes of rugby. There is a difference between making money and harvesting it. Pharma exists to harvest money.

The author
Roy Lilley is a (sometimes controversial) healthcare author and broadcaster