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**DECEMBER 16, 2022**
Kuttner on TAP
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**** One More French Lesson ...
... about America's dysfunctional drug system
As readers may recall, while I was in France this fall I gleaned a
number of lessons about such issues as hospital billing
<[link removed]>
and France's superior system of banning drugstore chains
<[link removed]>.
Here is one more.
Toward the end of our stay, my wife and I both got bad coughs (happily,
not COVID). We went to our wonderful local pharmacist in search of
something like Mucinex or Robitussin, which are not great but better
than nothing.
"We have something much better," said he. And he did. It's called
ambroxol. It works on an entirely different chemical principle
<[link removed]>, to thin sputum, facilitate
productive coughing, and also operates as a pain reliever and gentle
decongestant with no rebound effect.
We experienced it as a kind of miracle drug for coughs and colds. A box
cost eight euros.
Ambroxol is available nearly everywhere in the world as a generic. It
has been in wide use since 1979.
But not in the U.S.
A comprehensive review published by the National Institutes of Health
<[link removed]> judges ambroxol
to be safe and effective. But as far as I can determine, no U.S.
drugmaker has ever applied for FDA approval to sell it, which requires
extensive testing and clinical trials, as if the drug were brand-new;
the FDA does not take the word of, say, the European Medicines Agency.
As a drug manufacturer, you couldn't make much money marketing and
selling ambroxol as a generic, especially given the costs of getting it
approved.
This leads me to suggest two reforms. First, we need a public agency to
manufacture generics.
The promise of generics has been blunted because the big dogs at PhRMA,
who want exorbitant profits and restricted competition, have been buying
up generic drugmakers. (That should also be illegal.)
The FDA could also issue waivers to allow sale of generics that have
been approved by reputable drug agencies abroad and have been in wide
use for a long time with no problems.
In the meantime, it's possible to go online and order ambroxol from
Europe. This is decidedly a second-best.
When you track down all the anomalies and inefficiencies in the American
health system, they all lead back to one thing-too much corporate
power.
~ ROBERT KUTTNER
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Unionized Starbucks Stores Go on a Weekend Strike
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The action is over selective closures of union stores, as well as
retaliatory behavior against unionized employees. BY SAURAV SARKAR
Boeing's Lobbying Blitz
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The airplane maker is scrambling to get a deadline for improving cockpit
safety systems on all planes pushed back. BY JAROD FACUNDO
Altercation: The Journalism Business Is Bad, but We'll Miss It When
It's Gone
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As mainstream publications cut jobs, heavily subsidized right-wing
agitprop is filling the gap. BY ERIC ALTERMAN
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