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Avg. Customer Rating:(based on 6 reviews) Sales Rank: 663745 Category: Book
Author:Hank A. Mckinnell Publisher:McGraw-Hill Studio:McGraw-Hill Manufacturer:McGraw-Hill Label:McGraw-Hill Languages: English (Original Language), English (Unknown), English (Published) Media: Hardcover Edition: 1 Number Of Items: 1 Pages: 256 Shipping Weight (lbs): 1.1 Dimensions (in): 9.1 x 6 x 1
Groundbreaking and provocative, A Call to Action reframes the dialogue on healthcare and offers people a way out of the zero-sum, win-or-lose game they now encounter. Distilling more than 30 years of experience in global healthcare, McKinnell provides concrete action steps to build cost-effective, inclusive healthcare that he believes can extend millions of lives and save billions of dollars over the next generation. He addresses:
A new, prevention-based approach to employee healthcare
Why pharmaceutical companies have lost trust, and what they must do to regain it
Why Americans pay more for prescription drugs than people in Canada and Europe
How competition can spur the healthcare industry to improve services and contain prices
How new technologies can reduce medical errors and improve the dialogues between patient and doctor
How we might lose the race between the world?s most insidious virus and the world?s best researchers
How we can take more responsibility for our health
McKinnell also assesses the global challenge of infectious disease, particularly the pandemic of HIV. He demonstrates why this pandemic ?the worst in human history ?is beyond the scope of governments acting alone ?and how, even in the face of devastating global catastrophes, public-private partnerships can deliver real hope.
The healthcare crisis can be brought under control. Sick-care systems can be changed to put patiens over payers. In this book, McKinnell offers a compelling case for change, and a plan of action to make healthcare systems work for us and our children.
Mostly Self-Serving December 29, 2005 11 out of 15 found this review helpful
McKinnell, Phizer CEO, begins by pointing out that our healthcare system focuses on sickness - containing, avoiding, and shifting the costs of disease. His suggestion (hardly the first one to do so) is that we instead focus on the costs of disease.
To do this, his suggestions include 1)replacing typical health insurance reimbursement with portable "health savings accounts" where those covered would have financial incentives to improve key lifestyle components - eg. exercise, diet, smoking, etc., 2)mandating the use of electronic medication ordering (minimize drug interactions, transcription and dosage errors), 3)"disease management" programs focused on high-expenditure maladies such as diabetes, and take an overall approach to improvement (eg. include lifestyle changes), and 4)specialization of physicians and facilities ("practice makes perfect"). While again, none of these suggestions are new, they are worth repeating.
McKinnell also suggests increasing the supply of healthcare providers - however, the evidence on this is not encouraging - experts have found that a greater concentration of specialists is associated with greater procedure rates - even after taking into account variations in population. He also blames health insurance for the rapid increase in healthcare costs. However, this conclusion is undermined by the fact that despite much lower dental (vs. healthcare) coverage rates, dental costs there have increased MORE than general healthcare costs.
The bulk of the book, however, is devoted to defending the drug industry in general, and Pfizer in particular, from charges of overcharging. McKinnell points out that prescription drugs comprised about 10% of healthcare costs 40 years ago and today, that major drug advances have occurred in recent decades, and that generic drugs costs LESS in the U.S. than elsewhere. He also defends TV drug ads as helping to improve consume awareness of certain diseases - ignoring the issue of how the information is often seriously biased.
To be fair, however, McKinnell also points out commendable Phizer programs to help African nations and American nations with low incomes to buy drugs. Nonetheless, the overall focus on and bias towards defending drug companies, and the lack of originality (eg. see Leapfrog.org) regarding solutions severely limits the book's value.
"A Call to Action" would be much more valuable if McKinnell had included an idea from his own company's V.P. of Marketing - Dr. Peter Rost. Dr. Rost has concluded that "free market" in the drug industry equates with "free to charge whatever you want," and that this is not appropriate in the drug sector where often there are no alternatives to a patented drug ("60 Minutes, 6/5/05). Thus, Dr. Rost proposes that the U.S. allow "parallel trading" like exists in Europe - moving drugs from low-price areas to high-priced ones.
McKinnell also "forgot" to mention that he will be receiving an estimated $6.5 million/year in retirement, starting in 2008, despite a base pay of "only" $2.3 million in 2005, and a stock price that has declined 46% since he became CEO 5 years ago. (The Amex drug index dropped only 27% in the same period.) This fattest retirement package among all the sitting S&P 500 CEOs just MIGHT have something to do with the high cost of drugs. (BW, 2/6/06)
Big Pharma's Mea Non Culpa August 10, 2005 10 out of 22 found this review helpful
If you buy the book "A Call to Action" by Pfizer's CEO, Dr. Hank McKinnell, with the notion that you will learn what this pharma executive believes the industry should do to reform itself, you are in for a big surprise. Notwithstanding an Amazon.com review of the book written by Peter Rost -- Pfizer's whistleblowing, soon-to-be non-head of Pfizer's endocrine care marketing unit and "Pharma's Black Knight" -- in which McKinnell is described as making "an impressive mea culpa," this book is actually a mea non culpa!
I had reason to expect to see suggestions for changes in the way pharma operates because at the very beginning of the book (page 13), McKinnell said that "if Pfizer wanted a seat at the table where important healthcare solutions were being hammered out, we had to earn it by acting differently, partnering differently, and communicating differently." Unfortunately, the rest of the book does NOT carry through on this theme and focuses instead on how consumers, society, employers, managed care, and government need to act differently.
Before getting to the action items, McKinnell tries to answer the most important questions put to the industry by critics and the public. These questions are:
* Why are Prescription Medicines So Expensive? * Why Does the Industry Do So Much Advertising? * Why Do Americans Pay More Than Canadians for Drugs?
Unfortunately, McKinnell sticks to the standard pharma industry playbook except on one or two occasions where he seems to offer contrary opinions.
Why are Prescription medicines So Expensive? It turns out, according to McKinell, that drugs are not as expensive as you think (silly you!) and that branded drugs are cheaper than the alternative - the old "an ounce of prevention is worth more than a pound of cure" defense.
In essence, his argument is, drugs are not as expensive as you think, cheaper alternatives are soon available, and drug profits are good and well deserved.
I should acknowledge at least one refreshingly contrary view expressed by McKinnell: an admission that it is a "fallacy to suggest that our industry...prices a product to recapture the R&D budget spent in development." He suggests instead that it is "investors' confidence in the risk and rewards" that drives prices.
McKinnell takes exception to critics such as Senator Bill Frist who claim that "increased direct-to-consumer advertising has helped fuel escalating drug costs." McKinell, like PhRMA, insists that "studies show there's no correlation between prices or price increases and DTC advertising."
McKinnell cites a study done in 2001 by The National Institute for Health Care Management entitled "Prescription Drug Expenditures in 2000: The Upward Trend Continues." McKinnell claims that this study shows that the "average price of drugs that are advertised is lower than those that aren't." The report, however, concludes that the increase in prescription drug spending is due, in part, to "more aggressive marketing of prescription drugs to both doctors and consumers."
Why Does the Industry Do So Much Advertising? McKinnell wants us to believe that DTC advertising is really education (he prefers ro call it "DTC education"). This is not a new mantra. Johnson & Johnson Chief Executive William Weldon, for example, said in an address to PhRMA: "Our communication with patients should really be thought of as Direct to Consumer Education."
Why Do Americans Pay More Than Canadians for Drugs? To be honest, I didn't read this chapter. According to Peter Rost, "McKinnell ... admits that drugs from Canadian pharmacies are safe ...[and] that 'perhaps pharmaceuticals represent too low a percentage of total healthcare spending' and he calls for 'price controls to be lifted' around the world, because "It is time for Canadians and others to pay their fair share."
Chapter 13 is the chocolate nugget of the book. In this chapter McKinnell lists 10 actions that he believes should be taken to reform the healthcare system in the U.S. Only one action on the list, Reform Direct-to-Consumer Advertising, is an action item for the drug industry. All the others are the responsibility of individuals, society, employers, managed care, and governments, not the pharmaceutical industry. Coincidentally, at least six actions would either benefit the pharmaceutical industry in general or highlight specific Pfizer initiatives. Rather than focus on these - you can read more about it in the Summer 2005 issue of Pharma Marketing News - I'd like to focus on Mickinnell's suggestions for reforming DTC.
Reform Direct-to-Consumer Advertising This is the one action item mentioned in the book that applies directly to the pharmaceutical industry and can be said to require a change in the way it does business. Here's what McKinnel recommends for DTC:
* Improve communications about risk * Provide information about alternative therapies available, including therapies that do not require a medicine * Promote prevention and wellness, compliance with treatment regimens, and disease awareness * Promote access to medicines and do a better job communicating about patient assistance programs * Implement external oversight of DTC, including working with the FDA to get their views on advertisements before they are run
Mckinnell's action plan for DTC reform, however, does not go as far as some other emerging principles do. He does not suggest, for example, a 1-year moratorium on DTC for news drugs or to limit TV ads to the appropriate audience at the appropriate time of day (something that Congress may impose on ED ads). Both of these principles have been adopted by Bristol-Myers Squibb in its Direct-to-Consumer Communications Code. It should be noted, however, that McKinnell has said in another venue "No erectile dysfunction drug ads on television except for 10 pm to 6 am. I'm in favor of that." (Washingtonpost.com Viewpoint interview, 2004).
Needless to say, this book is not going to shake up the pharmaceutical industry nor does it offer much new defense against critics of the industry. It often sounds like an advertorial for Pfizer's programs. A Pfizer spokesman referred a reporter to McKinnell's book as the "best source" for the company's perspective on advertising. I wouldn't recommend it, however, as the best source for an action plan to reform drug advertising in general.
(...)
A catalyst for debate. July 28, 2005 6 out of 7 found this review helpful
Look, there is a lot of misinformation in the media and in public forums about the pharmaceutical industry and healthcare in general. I've read and heard many stories that strike intensely emotional chords where the only purpose is to assign blame or seek out and expose the villainous (whatever moves the print I guess).
The issues in healthcare, both global and domestic, are complex. They are too complex to draw simplistic conclusions about them or apply simplistic solutions toward resolution. To add these issues in affect are intimately personal to almost everyone, almost everywhere.
We need experts who are closely related to the issues on a day-to-day basis to pull apart and reassemble our healthcare system, yes, in a pragmatic way but also with an unprecedented level of objectivity, creativity and compassion.
I believe in this book Dr. McKinnell succeeds in relaying my point above. He also provides the basic building blocks to stimulate thought and he takes us far enough down the path to suggest dramatic changes. I believe we have reached the point of dire necessity. To ignore this would be in my estimation disastrous.
READ THIS BOOK. Take the time to understand and do not draw your conclusions to quickly as some apparently have. I ask that you keep this basic thought in the back of your mind when reading: It takes on average 12 years to bring to market a new drug. Internalize this fact and apply it to your personal situation. Seek out the facts.
These are my own views, take them or leave them.
A Decent Book Raising Legitimate Questions July 7, 2005 7 out of 9 found this review helpful
Like it or not, to discuss about the healthcare system this book raised some legitimate questions such as sick-care vs prevention-care, free riding on the global market, malpractice law suits, third party payment system, etc.
There are some industry and Pfizer PR stuffs in the book. Anyway, you cannot expect a current CEO of a company to suggest something that would hurt his company or industry. (By the way, Peter Rost seems to be an interesting exception. When he does this, you need to do some research on history and ask why.) Still Hank McKinnell discussed seriously about the overall structural loopholes and possible reforms of the system.
Don't simply blame the pharmaceutical industry as the only "bad" boy in the game. It's true that not everything the companies do seems "right" under the bright sunshine, but who does in capitalism? That's why the system is designed to have balances and checks, while money chasing is the ultimate incentive in the market and real life.
If you know fair amount of biomedical science, you understand how little we know and how difficult it is to develop a novel and really effective and safe treatment under current knowledge. Healthcare as a whole is a very large and complex system. Because of the sensitivity the system deals with, which is the length and quality of human lives, it is already under the toughest regulations among all industries.
If you are open to new ideas and want to seriously think about the healthcare, you may find this book useful to provide some perspectives.
MEA CULPA BY A BIG PHARMA CEO July 5, 2005 Pfizer's CEO, Dr. Hank McKinnell has written an astonishing book in which he admits that he doesn't always believe in what he's saying [11], that drugs from Canadian pharmacies are safe [69] and that high US drug prices have nothing to do with past R&D expenses [46]. He also writes that "perhaps pharmaceuticals represent too low a percentage of total healthcare spending" [45] and he calls for "price controls to be lifted" around the world [64], because "It is time for Canadians and others to pay their fair share." [65]. He also calls for a doubling of drug patent life [185] which would result in a drastic reduction of new, low-priced generic drugs.
Dr. McKinnell starts his book with the surprising confession that he doesn't always believe in what he's saying. "They listened to my logic, but I could tell they weren't convinced, and to tell you the truth, I wasn't either." [11]
He also doesn't shy away from embarrassing facts, "Branded drug prices are anywhere from 25-100 percent more expensive in the United States." [50] He even admits, "Drugs from Canadian pharmacies are as safe as drugs from pharmacies in the United States." [69]
But his impressive mea culpa doesn't stop there. He slams everyone who makes a connection between drug prices and R&D. "It's a fallacy to suggest that our industry, or any industry, prices a product to recapture the R&D budget spent in development." [46]
Finally, in an astonishing intellectual somersault, Dr. McKinnell claims that "price controls always make prices higher in the long run." [64] And since he wants to give people lower drug prices, by eliminating price controls, he writes, "Starting with pharmaceuticals, I call for price controls to be lifted in Canada and elsewhere." [64]
Dr. McKinnell ends his book with a wonderful quote by Gandhi, for those who desire change. "First they ignore you. Then they laugh at you. Then they fight you. Then you win." [193] Dr. McKinnell just doesn't realize that he has become "them."
Dr. Peter Rost is a Vice President of Marketing at Pfizer. The views expressed here are his own opinions.
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