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Saturday, August 15, 2015

Another rant about how drug companies are not acting for the common good

A few weeks ago I was feeling angry and disappointed when I noticed that many of the articles I was reading in my favorite medical journal were funded by companies who made the products those articles evaluated (that blog here). This is nothing new, but it looks to me like there are increasingly more of these articles which celebrate products and fewer interesting articles about the science of medicine. The other thing that is particularly irritating about this trend, if it is a trend, is that the drugs and devices that are being sold are increasingly more expensive and benefit fewer and fewer people. The reason they benefit fewer people is that they are designed for very specific, and often pretty rare, diseases. Also, since they are so expensive, only a subset of these few people can afford them. They must be very expensive because they benefit fewer and fewer people, so in order to make the money to pay for the research to come up with these drugs and devices, the companies charge small fortunes, which are paid, usually by insurance companies for those who have insurance, and those costs are handed on to everyone who buys insurance or pays taxes.

So drugs and devices are getting more expensive and less useful. But why is this true? Apparently the low hanging fruit of drugs has been picked. We have more drugs for high blood pressure, high cholesterol, infections, diabetes, seizure disorders, depression and lung disease than you can shake a stick at. What's left is rare conditions or subsets of what people commonly get, like like cancers with specific genetic profiles. Also treating diseases that have millions of sufferers is fraught with trouble. If a company produces a drug or device that helps many people who are likely to live a long time in basically good health, any side effect, even a rare one, will eventually become evident, with terrible consequences including lawsuits and even withdrawal of a blockbuster from the market. If a company produces a drug that gives a few people with terrible diseases a few more months or even years of life, not only are those patients often willing to spend a fortune on the drug, but they are very unlikely to notice a rare side effect or be able to connect it with the drug.

So what we are getting now from the pharmaceutical industry (with occasional exceptions) is wickedly expensive drugs of limited scope, whose safety and effectiveness is never studied adequately. These cost so much that they will likely increase the already unsustainable price of medical care. We all share the burden of those costs. The only non-regulated way to fix this problem is to quit agreeing to pay these high costs for miracle (or not so miracle) drugs. I'm not sure that, in our culture, we are willing to make that choice.

1 comment:

herbert said...

Thanks! Your insights are a recognition of this 'disconnect' in medicine between the general focus on compassion by your profession and the drug industry's focus on Profit.
The Federal funds for research are "drying up" for medicine and agriculture, because the "private sector" is 'stepping up' to spent THEIR money (which leaves more of the "discretionary spending" by the U.S. Congress to go elsewhere... the "military" portion now taking nearly 60%, and "the rest" for EVERYTHING ELSE). So the 'private sector' wants research to focus on areas that MAY BE PROFITABLE to Them FIRST... and what was called "pure research" (ie not driven by the 'profit motive') is pushed down the line... or "off the table".
In the 1990s (the only decade that I researched on this issue) "Research and Development" funds allocated by the Fed went over 80% to "military applications"... which Did provide useful to the general public, occasionally (eg the Internet), but for the most part was about maintaining military superiority, often at the expense of damaged human bodies. Now, techniques for keeping people alive after traumatic incidents are vastly improved, because of "research" dedicated to that cause.
We-as a country- are still about War, and making Money. The rest will have to wait... ^..^