DECEMBER 1998 · VOLUME 19· NUMBER 12

"Uneven Justice," a report issued by Public Employees for Environmental Responsibility (PEER), found 60 percent fewer convictions, 52 percent fewer prosecutions and a 36 percent increase in "declinations" (refusals to prosecute environmental crimes cases) under the Clinton presidency as compared to the Bush administration. The report also found dramatic declines in criminal referrals, conviction rates and convictions per capita.

"The facts belie the Justice Department's claims that environmental prosecutions have risen during the Clinton Administration," says PEER executive director Jeff Ruch, a former state prosecutor. "An apples-to-apples comparison demonstrates declines across the board in virtually every measure of prosecutorial effort."

PEER compared federal statistics from a three-year period during the Bush administration (1989 to 1991) to a three-year period during the Clinton administration (1994 to 1996).

In a statement, Justice Department spokesperson  Michael Gordon said the Clinton Justice Department has "achieved a steady increase in convictions, obtained record fines and jail time, and brought significant environmental crime cases."

"To say otherwise is simply inaccurate," Gordon said.

PEER's Ruch says the reason the Department concludes that its environmental crimes indicators are increasing is because, in 1995, the Department expanded the definition of environmental crime. "They broadened the definition of environmental crime in 1995 which explains why they can claim progress in 1996 -- they are counting more cases," Ruch says.

FDA's Dangerous Approvals
Medical officers at the U.S. Food and Drug Administration (FDA) say that the FDA is giving the green light to dangerous new drugs.

Promising anonymity, Public Citizen's Health Research Group surveyed FDA medical officers -- physicians responsible for the primary reviews of New Drug Applications for drugs -- to determine their opinions about recent changes in the drug approval process.

Nineteen medical officers identified 27 new drugs that they reviewed in the past three years and thought should not be approved but were approved anyway. Seventeen medical officers described the current standards of FDA review for safety and efficacy as "lower" or "much lower" compared to those in existence prior to 1995.

One medical officer told Public Citizen that a high-ranking FDA official had said: "Everything is approvable. We can use the label creatively to lower the problems."

The study also found that 12 of the medical officers identified 25 different new drugs that they reviewed in the past three years which in their opinion had been approved too quickly.

Nineteen medical officers stated that the pressure on them to approve a greater proportion of new drugs was "somewhat greater" or "much greater" compared to the period prior to 1995.

The sources of this pressure were identified as the Officer Director, the Center Office, the pharmaceutical industry, Congress and the medical officers' own division directors.

The study, conducted in September and October 1998, followed the setting of two all-time FDA records.

First, the largest number of new drugs was approved in any two-year period (92 in 1996 and 1997). Second, a record three new prescription drugs (all among the record-setting 92) were banned in a 12-month period because they were too dangerous to be allowed on the market. For all three -- dexfenfluramine (Redux), mibefradil (Posicor) and bromfenac (Duract) -- data available prior to approval raised significant safety concerns, and the drugs did not represent any significant advances over drugs already on the market.

Unhealthy Merger
Block the Aetna-Prudential Healthcare merger. That was the call issued in December by the American Medical Association (AMA) and a prominent California consumer group.

The proposed buyout of Prudential Healthcare by Aetna would make Aetna the nation's largest health insurer -- covering 10 percent of all insured people in the United States -- and the second largest dental insurer.

With six million patients added to its rolls nationwide, Aetna would control more than 30 percent of the health insurance business in Texas and New Jersey and gain even greater market share in certain localized regions.

"The market power that would be created or exacerbated by this merger would limit the choices of patients and employers, reduce competition and further erode the ability of physicians to make medical decisions based on science and the medical needs of their patients, not share price," AMA executive vice president Dr. E. Ratcliffe Anderson Jr. said in a letter to the Justice Department.

In California, Consumers for Quality Care said the buyout should be blocked because "Aetna will crowd out competition simply by its new bulk, not by operating effectively."

"The fact that Aetna has grown so quickly based on a failed track record suggests the free market has already been compromised," the group said in its letter to federal and state regulators. "This buyout is certain to limit the healthcare options for patients and employers [and] erode the bargaining position of doctors and hospitals."