Sunday, November 8, 2009

Public health

Seeing these proud and happy and faces, I feel like opening a bottle of champagne and raising my glass: Amérique, à ta santé! [Health warning: Alcoholic beverages must be consumed with moderation.] But there's still a long road ahead before the bill is transformed into effective law.

Here in France, a major step aimed at reducing the financial deficit of the public health system consists of requiring physicians to prescribe so-called generics rather than the original and expensive brand-name medicaments. For years, like millions of other people, in France and elsewhere, I've been taking the inhibitor of blood thickening named Plavix, in its familiar blue packet.

I would imagine that the giant French pharmaceutical company Sanofi-Aventis must have spent a tidy sum of money in the invention of the name Plavix, which would be fit for a luxury sports car. This product has always had the reputation of being particularly expensive... but this has not prevented it from becoming one of the most widely-prescribed medicaments in the world.

Well, a few days ago, the local pharmacist gave me the generic product that is proposed as a substitute for Plavix.

I almost broke out laughing when I discovered the name of the active molecule, which will be used universally for all generics intended to replace Plavix: Clopidogrel. Really, it rings in my ears like the name of some kind of supermarket soup for hungry horse-sized mongrel dogs that make a clip-clop noise when they canter. On winter mornings, after going out for a pee, I'm sure that Sophia would be delighted to get stuck into a steaming bowl of smelly Clopidogrel: the super synthetic dog food that's guaranteed to make your mongrel puppy as big and strong as a horse. Maybe, to promote the replacement of Plavix by this generic, health authorities might look into the idea of getting a rap group to put together a Clopidogrel-inspired slam, or a country singer could imagine some kind of Dylan thing: "My baby's gone and left me with the Clopidogrel Blues."

Meanwhile, as I finish my glass of champagne, I hope that all the citizens of Barack Obama's new and just society will soon have access, at last, to all the Clopidogrel and other great stuff that they need for their good health. In making that wish, I do not suggest that public health is merely a matter of low-cost pharmaceutical products. It's also, of course, a question of being able to receive treatment from excellent medical personnel, associated with great hospitals.

PS After having joked about the clumsy name of the generic product (which appeared already, in fact, on the Plavix packaging), it's only fair that I should mention prices, indicated explicitly on both packets. A packet of Plavix costs 56.82 euros, whereas the price of a packet of generic Clopidogrel drops to 30.75 euros. That's a huge difference. One wonders retrospectively where all that extra cash went, and why.

Incidentally, if anyone were to inform me that I might be breaking some kind of French law in talking publicly (and naively) about these pharmaceutical products, I would of course delete the present article immediately... but I don't see why this should be the case.

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