The Claritin Question

Back in 2000, when I first moved here, I had some sinus trouble and went to the pharmacy to buy some Claritin. Sure enough they had the same pill I knew from home, but the price was completely different. I don’t remember how much it was exactly, but I do recall that my jaw dropped significantly. How was it possible that the exact same medicine cost so much less here? I wrote it off to some sort of subsidies from the French health care system and let it go at that. Since then, I have noticed that almost any medicine you buy here costs startlingly less than it does in the States. And from what I've gathered, drugs are not subsidized here, though I think there may be price caps. It would be one thing if these were French versions made by different companies, but often they are not. They are the same medicines with the same names made by the same company. So how is it that the same pharmaceutical companies who insist that they are obliged to charge outrageous sums for their products in order to keep on top of research, etc. still find it profitable to sell their products overseas for a fraction of the price? I mean, Schering Plough does not sell Claritin in France for charity. If it were not profitable to sell Claritin here, they wouldn’t do it.

What kind of price difference are we talking here? Today I went to the pharmacy to see what Claritin sells for these days. A package of 15 pills containing 10 mg of the active ingredient, Loratadine, costs 5.54 euros here in the suburbs of Paris, or 36 euro cents per tablet. A package of 20 of the same pills costs $18.99 at Walgreens online, or $.95 per tablet. That’s almost three times as much (OK, if you want to take the exchange rate into account, it’s about two times as much, but that’s still quite a mark-up and besides, if you live in euros they have the same impact on your wallet as dollars). Interestingly, when I looked around the Internet I stumbled on an article in the New York Times Magazine (“The Claritin Effect, Prescription for Profit,” March 11, 2001), that mentions this international price difference on the first page of an 11-page investigation into the machinations of Schering Plough in its quest to get this expensive, and not particularly effective, pill to market. What’s more, it seems that the price of Claritin has actually dropped in recent years; another NYT article shows that when it went over the counter in 2003 the price fell from $3 to $1 per pill (“Nothing to Sneeze At,” May 7, 2003). The author of the article seemed to think this was a great savings to consumers, which it was, but when you realize that overseas consumers are paying a third of that “low” price, the savings doesn’t seem that great.

So here’s my question: what’s the deal, Schering Plough? How do you justify your prices? Why is it OK to gouge American consumers, when you know you can make a good profit selling at lower prices in Europe? Is it because Americans are so used to sky-high pharmaceutical prices that they just don’t question them?

Let’s hope that new health care bill makes it through the Senate in one piece. It’s time to start questioning.

Blog Talk Radio Interview

True, I hacked and coughed through about a third of the interview (a huge frog jumped into my throat at one point), but most if it is relatively intelligible. Hear me jabbering about cheap travel to Paris and the latest issue of my guidebook, Pauline Frommer's Paris, on Blog Talk Radio, in an interview with Jason Cochran of Wallet Pop, by clicking here.

Velib' and the Bike Lane Conundrum

Speaking of health and well being, I took another spin on Velib’ the other day. While bike lanes are still few and far between in Paris, there are more of them than before, and I thought why not take advantage of the ample bus lane configuration on Boulevard Montparnasse. I set out from Gobelins on a bus/bike lane that runs in two directions in a parallel universe on one side of Boulevard de Port Royal. It’s like a separate street with two-lane traffic that just happens to run right next to another one. At this point in my travels, the bus/bike lane was on the left (to me) side. Once I got over my disorientation, I was a happy camper, because there was barely any traffic and I felt relatively safe, even if I did have to look over my shoulder from time to time to see if a bus was creeping up on me.

Then, as I crossed Avenue Denfert Rocherau, I saw a labyrinth of markings on the pavement and suddenly the two-way bus/bike lane switched to the other side of the street! “This is too much for me,” I gasped, as I ducked over to the crosswalk and walked my bike across the street, as I tend to do when I lack the courage to cross interminable Parisian intersections with angry cars snorting on every side. As my heart rate returned to normal, I got back on my bike and continued down the bus/bike lane thinking that now the way was clear all the way to Montparnasse.

It was then that I came up on what my map tells me is Place Picasso, but my heart calls The Nightmare. This time, the markings on the road were clear: when the light changes, follow the white lines across the intersection and rejoin the bus lane on the other side. I looked over to the other side. It looked doable. It looked like a clear and simple procedure. It even seemed logical. So when the light changed, I crossed. I was the only bike on what felt like a freeway onramp, or a train turntable, or some other place where a bike just shouldn’t be. I pedaled across for what seemed like several kilometers, all alone, with about 14,000 cars staring me down from 12 different directions, all poised to come charging out of their starting blocks the second the light changed. What if I didn’t make it to the other side before that happened? “I’m going to die!” I shrieked as I crossed, my heart jumping into my throat, my body covered in a cold sweat.

To my amazement, I made it across. It took a good fifteen minutes for my heart to stop pounding. I know I’m a cowardly weenie, but could someone please build decent bike lanes in this city? Please? I understand that bus lanes make handy bike lanes too, but a bike is not a bus...

Heathy Living

Now here’s an addendum for Michael Moore’s film, Sicko: I have a French friend who is very pregnant with her second child. Due to the configuration of her pelvis, her first delivery was by Cesarean. She was all prepared to have another Cesarean, but this time around, the midwives at the hospital are turning themselves inside out to get her to give birth “naturally.” Without her requesting it, she has been treated to acupuncture, homeopathy, and something called sophrology, a touchy feely technique which I had never heard of before I came to France. By the way, she is not paying a Euro cent for any of this. While I am marveling that she gets all this free alternative medicine without her even asking, she keeps telling me that she’d rather just have the Cesarean and be done with it.

I admit, I am a major fan of the French health system. As I have mentioned before, I had brain surgery here at one of the best hospitals in Europe, and the only bill I ever saw was for using the telephone. French doctors love me. "What? You only get 23 Euros for an appointment? You deserve more than that!" They don’t get to hear that very often. In fact, there are French people who complain that 23 Euros is too much. Never mind that those 23 Euros are reimbursed by Social Security, so they don't even really pay anything. True, there are plenty of specialists who cost a lot more, and not all of their fees are covered. But most employers offer supplemental health insurance, so in the end, almost everything is covered. Even when it's not, it's a fraction of what it would cost in the US. Naturally, the system is outrageously expensive for the government, so there is constant talk of reform and then shrieks of horror from those same French people who were complaining (grumbling is sort of a national pastime here). So things change at a snail's pace, and at every tiny change, people start to say that now France is on the slippery slope and soon the health system will be like that in America. When this happens, I say "relax, you have no idea how much your system will have to change to reach that point..."

That said, the current proposed reforms regarding hospitals make my hair stand on end. I keep thinking about what happened to American hospitals a decade or so ago when our brilliant bureaucrats decided that it would be just too cool to run the public hospitals like for-profit businesses. I believe that was the beginning of the end, or perhaps the beginning of a new era of hospitals that have so little regard for patients that you don’t dare stay in one without an advocate (family or friend) to fend for you.

In France, access to good health care is considered a right, right up there with Liberté, Egalité and Fraternité. There was a mini revolution here in 1936, when social security was first established, along with paid vacations and retirement benefits. French people don’t consider themselves lucky to have a social security net, they feel they fought for it, and they deserve it. Maybe when we decide that we deserve it, it will happen in the US too.

Hot off the presses - self-hype!

The latest version of guidebook I wrote, Pauline Frommer's Paris, should be out in the bookstores any minute now. Quick! Run and buy one! If you buy enough of them, maybe the series will survive the financial crisis and there will be a third edition!

Speaking Frankly

I like to listen to the radio station France Inter as I attempt to wake up in the morning, and this morning there were two items that actually got me to stop and think (no small feat for me before 10am). The first was a short segment on a new tendency amongst politicians to “parler cash.” I had to ask my husband (who is French), what that could possibly mean. Were they speaking about money? No, apparently this is the new slang for straight talk, plain speaking. This tendency will be welcomed with open arms by most ex-pat North Americans, who for years have had to cope with the French way of verbally attacking even the simplest of matters, that is, sideways. Though I love the French language and am in a state of continual awe at how French people use it with such elegance and style, their abhorrence of just saying what’s on their mind can really complicate your life. Direct speaking is generally frowned upon here, and those who choose that path are considered borderline barbarians. For example, in the early years of my marriage, when I would foolishly ask for the butter dish by saying: “pass me the butter dish,” my usually kind and mellow husband would go ballistic because I had not used the conditional tense.

So I was fascinated to hear that politicians like president Nicolas Sarkozy and Ségolène Royal would go so far as to “parler cash.” As the commentator pointed out, French politicians traditionally speak in a language so florid that even French people have a hard time figuring out what they are talking about, using unbearable tenses like the imperfect of the subjunctive. But he then went on to make the case that in fact, “parler cash” wasn’t as great as all that. That there was something vaguely sinister about it, and that while these politicians were daring to tell reporters how they felt about an issue, they were using this new way of talking to avoid saying what they might actually do about an issue. As if this new trend, which admittedly has an American tang, goes so against the cultural grain that it could only be a political subterfuge meant to confuse your average citoyen.

The other item was a hilarious riff by France Inter’s resident humorist Stéphane Guillon (photo above). At least, I thought it was pretty funny, I can’t imagine what a devout Catholic would think of it. Guillon, to put it mildly, took the Pope to task. In case you are not aware, Pope Benedict has been on a tear lately, not only re-instating four excommunicated bishops (including one that denies that the Holocaust happened), not only excommunicating a mother who obtained an abortion for her 9-year-old daughter who had been raped, but also declaring during his visit to Africa, a continent ravaged by AIDS, that condoms were not beneficial and even made the problem worse. I can’t recall all the highlights of Guillon’s rant, but neither he nor the radio station censored his detailed descriptions of condom use, nor his suggestion that the real problem was that the Pope, being chaste, was in need of sex ed, specifically on how a condom works, and even more specifically that the use of a certain type of vibrating ring is guaranteed to make lovers believe in the existence of God. Keep in mind that France Inter is basically government owned. Whatever prudishness French people may have about the use of the conditional, they are clearly way ahead of us when it comes to being direct and frank about sexual matters. Can anyone even begin to imagine NPR serving up a similar dish?

Movies in Paris, Paris in Movies

Let’s say that it’s a cloudy, rainy day (for a change) in Paris, and you don’t know what to do. I say, go to the Forum des Images, the massive film archive in the bowels of the Forum des Halles where for five euros you can watch films until your eyes go buggy. I usually avoid the Forum des Halles at all costs—riding the escalator down into that claustrophobic underground shopping center generally feels like a descent into the lower reaches of Hell. But out in one of the outer tunnels of this giant ant farm there is a stretch of cine-mania that merits braving the depths of this 1970s architectural nightmare.

First there is your conventional movie multiplex, offering recent films. Then there is the new François Truffaut library, where Parisians can check out books and DVDs and other less fortunate mortals can peruse mountains of material on-site. And then there is the Forum des Images, which recently reopened in groovy shades of pink and white and black. The initial mission of this archive was the “preservation of the audiovisual memory of the city of Paris,” whereby any film that made any reference to the capital was stored in its ample database. This translates into 5,500 films, documentaries, shorts, and even newsreels and advertisements. Gone With the Wind made it in because at one point Rhett brings Scarlett a hat from Paris. The Forum then decided to branch out and include another thousand or so films from other specialized collections. Chances are, you’ll find something you like, which you and a friend can then watch on an individual screen (with headphones) in the high-tech, orange and pink (it’s not as bad as it sounds) collections area. If you are into group viewing, you can rent a small screening room for 15 euros. Or you can simply plonk yourself down in one of the five movie theaters which show samples from the collection, or themed series (right now it’s New York), or kid’s films or heaven knows what else. True film junkies can take master classes with directors like Claude Chabrol or James Gray, or take in movie “concerts” where silent films are accompanied by live musicians.

What’s amazing is that as far as I know, there is nothing like this in either New York or Los Angeles, and God knows both cities are swarming with film fans. The Forum des Images is the brainchild of the Paris city hall, who is it’s primary source of funds. Now there’s an interesting concept to pitch to Hollywood….