First published 3/7/11 on Gooz News
Two stories in the New York Times over the weekend told readers nothing new about the drug industry. The first, on Sunday, revisited the two-decade-old, reimbursement-driven trend among psychiatrists to prescribe drugs instead of engaging in talk therapy. The second, this morning, reminds readers that expiring patents on blockbuster drugs like Pfizer’s Lipitor will cost the industry about $50 billion or around 16 percent of its revenue next year. There goes research and development, the story suggests.
Like the industry they cover, reporters on the drug beat appear to be having difficulty coming up with something new. Mapping the genome was supposed to open the doors to personalized medicine. Cancer drugs targeted at specific cell receptors were supposed to be the new magic bullets. Both strategies, while still promising, have not delivered in a timely fashion to bolster the industry’s bottom line.
And given the huge resources being poured into research by the private sector (still about 20 percent of industry revenue), how likely is it that the health care system will be able to afford new medicines of marginal efficacy? If one in ten PhRMA-backed drugs candidates (or venture-backed firms’ candidates) succeed in reaching the market, the payoff must justify the money poured into all the failures under the rules of our market-driven system, no matter how effective the medicine. You don’t have to be a deficit hawk to recognize that public sector health care payers, which now comprise more than 50 percent of all spending, can no longer afford $100,000-a-year drugs that extend life in terminal cancer patients by several months.
But the public wants those drugs. Abandoning hope or science is not the American way. We are badly in need of a new drug development model, one that recognizes the primacy of health and science, not markets and profits. The press should start exploring alternative drug development models, like those in the non-profit sector that addresses neglected diseases of the developing world. That model may be appropriate for targeted therapies and personalized medicine. There are some old stories that are quite relevant to these times, just not those that we’ve read about lately in the papers.
Merrill Goozner is an independent health care journalist. He also writes at Gooz News.