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Our Times: Patent Medicine

J&J’s Bankruptcy Ploy

Johnson & Johnson, deemed the “world’s most admired pharmaceutical company” by Fortune Magazine, has a net worth of $420 billion. In 2021, faced with more than 50,000 claims (and substantial scientific evidence) that its talc-based baby powder caused cancer, J&J created a subsidiary called LTL Management. LTL promptly filed for bankruptcy while offering to pay $8.9 billion to resolve the talc-related claims against J&J.

In 2020 J&J stopped using talc in baby powder sold in the US, substituting cornstarch as the primary ingredient. But they continued selling their talc-based product in third-world countries for three more years!

In March of this year the U.S. Court of Appeals for the Third Circuit in Philadelphia dismissed LTL’s obviously bogus bankruptcy claim. But for J&J’s lawyers, that was only one step on a long march. In July the U.S. Bankruptcy Court for the District of New Jersey, also threw out LTL’s claim. But that was only another step. J&J’s top litigator, Erik Haas, said these rulings were “contrary to the persuasive authority... and directives of the Supreme Court of the United States.” (As Clarence Thomas didn’t have to tell J&J shareholders: keep hope alive!)

A Balm in Gilead

About 1 million US Americans know they’re infected with HIV, according to the federal government, and another 150,000 have the virus but aren’t aware of it. It seems like a relatively small market from an advertiser’s point of view, but HIV drugs are also widely used by as prophylactics, and they are very profitable for the manufacturers. So all of us are exposed daily to ads for Biktarvy (only one pill/day) and Cavenuba (an injection every two months). Most of the HIV-drug ads feature African Americans. Everybody’s always doing fun things.

For many years the predominant HIV drug maker has been Gilead Sciences, a corporation with headquarters in Foster City and product-development labs in Oceanside. Their original best seller was Truvada (a combination of two antiretroviral drugs, tenofovir and emtricitabine). Tenofovir can have serious adverse effects. By 2004 Gilead researchers had developed a safer formulation that the corporate masterminds chose not to market until patent protection on Truvada’s patent protection ran out and generic versions could be marketed… c. 2015!

Gilead’s machinations have been exposed in lawsuits brought by patients who would have benefited from the safer formulation. The saga was recounted in the New York Times on July 22 by Rebecca Robbins and Cheryl Gay Stolberg, from which I quote:

“In 2004, Gilead Sciences decided to stop pursuing… an updated version of tenofovir. Gilead executives knew it had the potential to be less toxic to patients’ kidneys and bones than the earlier iteration, according to internal memos unearthed by lawyers who are suing Gilead on behalf of patients.

“Despite those possible benefits, executives concluded that the new version risked competing with the company’s existing, patent-protected formulation. If they delayed the new product’s release until shortly before the existing patents expired, the company could substantially increase the period of time in which at least one of its HIV treatments remained protected by patents.

“The ‘patent extension strategy,’ as the Gilead documents repeatedly called it, would allow the company to keep prices high for its tenofovir-based drugs. Gilead could switch patients to its new drug just before cheap generics hit the market. By putting tenofovir on a path to remain a moneymaking juggernaut for decades, the strategy was potentially worth billions of dollars…

“Today, a generation of expensive Gilead drugs containing the new iteration of tenofovir account for half of the market for HIV treatment and prevention, according to IQVIA, an industry data provider. One widely used product, Descovy, has a sticker price of $26,000 annually. Generic versions of its predecessor, Truvada, whose patents have expired, now cost less than $400 a year…

“Gilead’s apparent maneuver with tenofovir is so common in the pharmaceutical industry that it has a name: product hopping. Companies ride out their monopoly on a medication and then, shortly before the arrival of generic competition, they switch — or ‘hop’ — patients over to a more recently patented version of the drug to prolong the monopoly.”

A photo accompanying the Gilead story showed one of the plaintiffs, a 66-year old Florida man who took Truvada for 12 years and developed kidney disease and osteoporosis. His doctor told him he had “the bones of a 90-year-old woman.”

Temofivir was first synthesized in a Czech lab in the 1980s… Foster City is built on landfill and one of these days an earthquake might bring God’s wrath down on Gilead Sciences… Marijuana can’t be patented because it’s a plant. Capitalists have found other ways to commodify it.

Burning Man for Hasidic Jews!

This year both the Guardian and the New York Times covered the pilgrimage to Uman by Hasidic Jews. Here’s the Times lede by Jeffrey Gettleman:

“Every Jewish New Year, even this one during a raging war, thousands of Hasidic pilgrims turn this city in central Ukraine into a mini Jerusalem.

“They roam around in big groups sucking down Coke Zero and kosher pizza, paying in shekels. They pump out Hebrew hip-hop and dance hard together in the middle of the street.

“They exchange blessings — ‘I ask God to give you a sense of belonging, to give you stability, to grow your business this year’ — and drink copious amounts of red wine way past the wartime curfew…

“This year, even Europe’s biggest war in generations and extensive travel warnings could not stop the pilgrimage. More than 35,000 people, nearly all of them men and boys, showed up over the weekend, upending stereotypes of Hasidic Jews who often cut an austere image with their black hats and long black coats. Many of the Hasidim who came to Uman came to party.”

The reason the partiers were “nearly all” males is that Ultra-Orthodox Jews are male chauvinists and proud of it. 

Rosie and I were once on a cross-country flight with an Ultra-Ortho couple, both about 30 years old, and their four children ages five and under. The kids were ultra restless, crying and yelling from coast to coast. The overwhelmed mother was always trying to feed them or shushing them or leading them down the aisle. Her husband, who cut the familiar image in a beaver hat and a heavy black coat, kept mumbling into his prayer book, rocking back and forth, and never lifted a finger to help with the kids. 

The annual “pilgrimage” to Uman is supposed to honor Rebbe Nachman of Breslov, who died there in 1810. His great-grandfather is considered the founder of Hasidism.

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