Senator Eliot Shapleigh - El Paso, Texas

Two separate reports on health care come to sobering conclusions.

A government report released in January says health care spending in the United States has passed $2 trillion, is growing at the fastest pace since 1981, and now accounts for some 13 percent of the nation's total gross domestic product.

Another study, done by two Canadian professors, details the spending by drug companies on promotions. The numbers are astounding.

Professors Marc-Andre Gagnon and Joel Lexchin conclude drug companies spent about $57.5 billion in promotions in 2004, almost double the $29.6 billion they spent on research and development.

Why is that troubling?

Drug companies once were noted for their devotion to bringing new medicines to market. The findings indicate an evolution into marketing companies intent on selling proprietary drugs over generics.

So how does the 2004 total of $57.5 billion in promotions break down in how drugs are being pushed to consumers?

- Pharmaceutical companies spent $15.9 billion in offering samples to physicians. The amount is based on the retail value of these samples.

- More than $20 billion was spent on detailing, which takes into account the costs of a sales rep visiting a physician, the rep's salary and other compensation, transportation expenditures and the cost to house a regional manager. The total also includes detail aids such as brochures and advertising materials left with the doctors.

- Pharmas spent $4 billion on direct-to-consumer advertising and $2 million hosting meetings to promote products.

- Drug makers spent $14.4 billion in unspecified promotions, a figure derived after offsetting the incomplete information filled out by surveyed doctors, promotional costs to other physician categories and smaller trade journals.

A medical demographic may be even more telling. The same year pharmas spent these billions on promotions, there were about 700,000 practicing physicians in the United States. Doing the math, pharmas in essence spent $61,000 in promotion for each physician in the country.

And as the study authors point out, drug sales in 2004 topped $235 billion. That means promotions consume about 25 percent of the sales dollar, while research and development accounts for about 13 percent.

Generic drugs continue to become a bigger player (63 percent of prescriptions in 2006 were filled with generics).

It's hard to fathom why drug companies don't see the need to spend more money on R&D for one simple reason -- they must invent better drugs in order to survive.
This trend is not good for health care. Drug companies need to step up the pace in pursuit of innovation.

They should weigh which is the wiser investment:

Fund ways to discover new generations of drugs.

Or continue to pound the public with incessant television commercials on available drugs every five minutes.