RENO AT LARGE

U.S. Would Do Well To Prescribe Truce In `Other' Drug War


America is fighting not one but two parallel and exceedingly costly
drug wars.

One is against suppliers of mood-altering illegal substances. The
other is among suppliers of legal drugs, with particularly savage
competition in the market for lust-promoting and depression-fighting
substances. The suppliers seem to be winning both wars despite the
occasional setback. And the cost to the nation - measured in bulging
jails, drug-associated violence, clogged courts, the rising cost of
health care and a growing uninsured population - is huge.

To give an idea of what's at stake, shares of Eli Lilly & Co. dove 12
percent in a single day this week despite a 12 percent rise in net
income in the first quarter and sales that reached a record $2.26
billion, up 8 percent from the first quarter of 1998. No matter,
investors punished Lilly because of a 4 percent drop in first-quarter
sales of its showboat drug, Prozac.

The market was mercilessly indifferent to the company's explanation
that Prozac sales were artificially depressed because big purchasers
had stocked up last year in anticipation of a price increase.

Meanwhile, Bob Dole has enlisted as a soldier in the war for the drug
dollar by appearing in tasteful commercials that break down old
barriers to discussing flaccid penises on television. When a grown
man goes on TV to confess his impotence, we can guess the huge
profits involved. Television, once a world of hemorrhoid cures,
laxatives and remedies for vaginal dryness, has now become saturated
with drug commercials that seek to create new demand for remedies in
the hope people will nag their doctors into prescribing them. The side
effects are vividly described even when they include such ghastly
experiences as nausea, incontinence, sleepiness, sleeplessness,
incoherence, constipation, diarrhea and uncontrollable itching.

The war for the drug dollar may be contributing positively to public
awareness, but much of the stuff being so expensively promoted does
not involve life-threatening illnesses. Toenail fungus is not even one
of our leading killers but in the drug trade, the profits justify
lavish TV outlays.

Pharmaceutical companies defend steeply rising prices by citing the
need to recoup the huge investments they must make in developing and
testing new products and paying for lawsuits. Now, I suppose, they
must add exploding promotional costs. Lilly, for instance, announced
it will step up its campaign of direct contacts with physicians to
remind them of Prozac's wonders.

I guess we don't have to ask why prescription drug prices have risen
5.4 percent in the past year while overall health care costs advanced
3.4 percent and all consumer prices were up less than 2 percent.

And do not imagine the drug makers welcome programs that would make
their products more available or affordable to sick people. They have
been the chief opponents of extending Medicare coverage to
prescription drugs and attacked the Clinton administration's new
proposal to give old people up to $1,700 a year for prescription
drugs. Obviously they have calculated that whatever they might gain in
new business would be offset by the federal government's ability to
bargain for lower prices.