Healthcare System

It was 1994 and there was Pharmacopoli. The diary of those who lived it on the front line

It was 1994 and there was Pharmacopoli. The diary of those who lived it on the front line

“The three presidents of Farmindustria who preceded me in office were grappling with the judiciary. We needed a new president who was not under investigation ... ". And the choice fell on Francesco Costantini of the Parke Davis. It was January 1994 and there was "Pharmacopoli". A year and a half of passion, told in a book by Costantini himself that we present to you in preview

Francesco Costantini is an 83 year old gentleman. Tall and with a lean physique. He was born in a small town between Umbria and the Marche called Nocera Umbra. In 1994, when he was responsible for Southern Europe of Parke Davis, a pharmaceutical company at the time belonging to the Warner Lambert group, he was called to chair Farmindustria in the midst of the storm of "Pharmacopoli".
 
“The three presidents who preceded me in office - he himself tells it - were grappling with the judiciary: the first under house arrest; the second associated in prison; chased by warranty notices the third party. We 'Americans' had gathered in Milan and we had decided to react by identifying a new president who was not under investigation, who had experience in the sector and who enjoyed esteem within the category. The choice had fallen on me and at the end of January 1994 I had assumed a responsibility that would prove to be burdensome ... "
 
Almost 20 years later, we find that experience today told in a beautiful book (from which the passage you just read is taken), written by Costantini himself and just released in the library with Metamorfosi and entitled "Yes, Italy there can do it. The confessions of a skeptical optimist ”.
The book crosses, in a form halfway between the personal story and the historical diary, the whole life span of Costantini. A journey through eighty years of Italian life where that period at the helm of Farmindustria (from January 1994 to June 95) occupies only 5 of the 213 pages of the book.


But certainly, for us who deal with healthcare and for me in particular that I had the pleasure of working alongside Costantini at that time as his head of press office at Farmindustria (a position I held from '93 to '96 ), those 5 pages represent a unique opportunity to remember what those years have been for the pharmaceutical industry in our country.
 
For this reason, after receiving the book and reading it with pleasure, I phoned my ex boss to ask him for authorization to publish that particular chapter. His answer was affirmative and now you can read it as a preview below. (CF)

 
 
Italy, January 1994. The image of the pharmaceutical sector was polluted by scandals
“The Second Republic had begun thanks to the Mani Pulite pool which had demolished the First and had begun under the sign of Berlusconi.
It was then that I met Berlusconi at Palazzo Chigi.
At the beginning of 1994 I was called by my colleagues to preside over Farmindustria, an association of all pharmaceutical companies operating in Italy, because our business environment had been devastated by Tangentopoli (with a parallel version called "Pharmacopoli").
 
The three presidents who preceded me in office were grappling with the judiciary: the first under house arrest; the second associated in prison; chased by warranty notices the third party. We "Americans" had gathered in Milan and we had decided to react by identifying a new president who was not under investigation, who had experience in the sector and who enjoyed esteem within the category. The choice had fallen on me and at the end of January 1994 I had assumed a responsibility that would prove to be burdensome, because the image of the sector was polluted by scandals, by the connivances with characters of the institutions considered the architects of corruption, by the support given in passed to political parties now dead or dying and, above all, from the fact that many entrepreneurs were subject to precautionary measures or investigations by the judiciary.
 
For two years I would have fought a difficult battle against a public opinion that considered drug manufacturers "all thieves" and I had started it by persuading the politicians of the new government, trying to illustrate the merits of an industry that contributed with his research in a decisive way to the health of citizens.
 
The meeting with Berlusconi ...
I had started with the Prime Minister Berlusconi. I had gone to see him at Palazzo Chigi and had admired his intelligence and the frankness with which he expressed himself, free from any ambiguity. But the language of his body sent me nervousness and impotence, and an episode he had told me had been the confirmation. "The day after my election," he said, "he came to see me Cesare Romiti who gave me a piece of paper containing the shopping bill: everything I should have done for Fiat. I replied that I would not do anything about it and in the following days, Stampa and Corriere started a hostile campaign towards me ».
 
... and with the ministers of Health Costa and Tesoro Dini
I had continued with the Minister of Health, Raffaele Costa, finding in him a careful and sensitive interlocutor on the theme of pharmacological innovation, who considered the true mission of a pharmaceutical industry worthy of the name. Costa had appreciated a series of initiatives that I had undertaken to restore a business ethics that lived up to our entrepreneurial mission and a transparency in the field of sales prices for our drugs, which the community considered (for the most part unfairly) excessive. And he had given me space and support of which, even today, I am grateful to him.
I had continued with the treasury minister again Lamberto Dini, whose intellectual level and independence of judgment I had appreciated. Dini understood very well the difficulties in which our sector was struggling, crushed by the fury of the magistrates of Milan and Naples, by a public opinion hostile in his easiness and applauding in seeing the heads fall from the guillotine, by a delay of many of my colleagues in the perceive the irreversibility of what was happening. Dini could not do much, and I realized it, and I ended up appreciating his spirit of Toscanaccio a little mocking and very disenchanted, also seasoned by a pinch of healthy cynicism.
 
When Gnutti (Minister of Industry) said to me: "You are all thieves"
I had concluded my wanderings with the Minister of Industry, Vito Gnutti, to which I went to visit his office, where I found him buried behind a monumental desk. And he, small of both physical and intellectual stature, barely emerging from his chair, to me who explained the importance of having a serious industrial policy for the good of the country, replied in a silly and sarcastic tone: "You are all thieves ». I insisted, I explained that those who had visited him to tell him the tales about the distinction between corruption and bribery represented neither the present nor the future of our category, and he smiled fatuately and reiterated: "You are all thieves". Alas, what an abyss towards his predecessor, Professor Paolo Savona, before which Vito Gnutti was the emblem of Peter's theory, of how ambition, arrogance and ignorance lead man to reach the level of his own incompetence.
 
All the power in Garattini's hand
Since then politics could not help me, I had turned elsewhere. And I had resumed attending the Ministry of Health, where the keys to power were all in the hands of an illustrious pharmacologist, Professor Silvio Garattini.
Here I was at ease because Garattini was a man of great academic preparation, with a strong practical sense and a determined decision-making spirit. Garattini had taken total control of the three levers that conditioned the interests of our sector: the approval of new products, their reimbursement by the National Health Service, their selling prices (the latter only indirectly). Garattini supported a thesis of clear rationality: for the same pharmacological efficacy, products different from each other only in the brand, in the packaging or in the chemical structure, had to receive an identical reimbursement from the State. And if not? Cancellation from the therapeutic handbook, loss of reimbursement and collapse of sales. Such an obvious thesis would have deserved attention and adherence from my colleagues, but it had not been so and many of them, in Italy, Europe and the United States, opposed thinking that the past could return. Instead he would not return and, with delay, the Italian pharmaceutical industry would end up undergoing a change which, accepted immediately by negotiating gradualness and compatibility, would have avoided years of suffering and raised the image of the sector promptly.
 
The relationship with the media. Meetings with Barbato, Vespa and Mentana
And finally, alongside numerous initiatives aimed at improving the transparency of associative behaviors, I had approached the media. And I was committed to writing articles and giving interviews in all the newspapers (appreciating the good quality and professional behavior of many journalists, first of all Laura Cesaretti, always direct and precise in reporting facts and opinions), but above all to participate in television programs in which to explain the good reasons for my category.
I remember with esteem and sympathy Andrea Barbato and his living room in the late evening, in which I had gone appreciating the words of Aldo Grasso: "He expresses his indignation and dissent from the official versions of the Italian political events in calm but firm tones". The sober style, refinement and, above all, respect for the opinions of others allowed all participants in the living room to express themselves without interruption and without abuse.
A "liberal" living room that would end a year later with Barbato's death and that we would all regret in the following years when the talk shows of Santoro, of Fazio need  Floris they would only have blown the fire of the civil war with words that would have set the country on fire, transforming the Italians from opinion bearers to fans of the "south curve".
 
I remember with equal esteem and with equal sympathy Bruno Vespa and a late evening broadcast, which I had attended together with Minister Costa and the lady Teresa Petrangolini, a beautiful woman, cultured and committed to fighting the cases of medical malpractice and "far-matruffa". A lounge, that of Vespa, very different from that of Barbato. Because Vespa wanted a themed transmission, not only clear and free, but always rigorously in the theme, without deviations (in the end, a little less free). He asked me why the pharmaceutical entrepreneurs had practiced corruption and to me, who had replied that there was still no entrepreneur convicted even at first instance, he asked again if I thought there had never been any corruption. So I replied that corruption is a fact that feeds too bureaucratic structures (therefore also the ministerial ones) and, with extraordinary sincerity, Minister Costa gave me reason.
 
I remember with equal esteem and with a little less sympathy Enrico Mentana that, yes, he aimed at demonstrating his own prepackaged thesis. And in a broadcast in which they talked about the corruption perpetrated by pharmaceutical entrepreneurs, to me - who claimed that none of them had yet been sentenced - he had reiterated pierced: "Yes, but there are confessions". As if the confessions - which were sometimes extracted with prolonged imprisonment, sometimes with the false declarations of fake witnesses, who too often had polluted Clean Hands because they were obtained in the name of mors tua vita mea - deserved credibility. As sadly happened to an emeritus servant of the state, Professor Francesco Antonio Manzoli, director of the Istituto Superiore di Sanità, who would have been imprisoned for four months because of a completely false confession by a small businessman who had invented a story to be exonerated and return to his home. Manzoli would have been acquitted with full formula, but his career would have been devastated by the cowardice and opportunism of a colleague of mine. A new Tortora case.
 
What Tangentopoli taught me
In conclusion, in the two years in which I had chaired Farmindustria, I had offered chest and face to all the shovels of mud that civil society spilled on us. I had done it honestly and had managed to ferry my sector from a heated witch-hunt climate to a more temperate climate in which my colleagues could have resumed a serious dialogue with institutions and with society. They did it and today I am happy to see how many of them have been able to transform their companies and have led them to effectively face the new market challenges and new opportunities, proving to be excellent interpreters of the culture of change: from Alberto Aleotti ad Arrigo e Giovanni RecordatiSergio Dompé, just to name a few.
 
The complex story of pharmaceutical Tangentopoli has taught me something.
For example, that pre-packaged thesis processes and based on testimonials considered valid only because they confirm the power of attorney's thesis are proof that the law can produce monsters and is not the same for everyone (because not all powers are the same).
For example, that the use of coercive systems to extract confessions, instead of a diligent collection of evidence against them, is an Inquisition court system (in which the alleged culprit was brought to rely not on justice, but on the only courtesy).
For example, that the leak of information from the prosecution, a practice that has become habitual, and the publication in the press of the same news in a banned way does not approach the ascertainment of the truth and, unfortunately, decrees de facto sentences, outside the most elementary protections of the rights recognized to any human being.
For example, that large print newspapers and weekly magazines - exhibiting large-scale titles that in fact, implicating it, praise the condemnation of human beings awaiting trial, and relegate the presumption of innocence in the credits - devastate people's lives whose guilt is far from proven and the search for truth is not needed.
For example, that a civil society is not such if it hopes to see heads roll or is excited to participate in the joy of an inquisitor, by definition innocent, exposed to the torture of the pillory in its modern, unfair and cruel version of the so-called " media pillory ".
For example, and I conclude, that the use of codes and not common sense has deprived our country of intelligence and skills that in a common law country would have remained a heritage for everyone ".


Source:

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