Monday, August 13, 2007

The evil of big Pharma

Ben Goldacre appears to be running a series on how pharmaceutical corporations contribute to the high cost of health care in the Guardian: Evil ways of the drug companies Spectacularly expensive cost of trial and error

In this post I will discuss the first article where he gives three reasons for thinking that Big Pharma are unethical,


They spent only 14% of that money on research and development, but 31% on marketing and administration. They are very careful not to let anyone see how much goes on marketing and on administration. Whenever you hear the drug companies explaining why they have to charge so much for their products - perhaps as they are denying their lifesaving Aids drugs to the 20 million HIV-positive people in Africa - the plea is that they need money to develop new drugs. That's not true if they spend twice as much on marketing as on research and development. This unhappy collision of facts makes them look very evil indeed.

They also charge this money in slightly evil ways. Drugs have 10 years "on patent." Loratadine is an effective antihistamine drug that does not cause drowsiness. Before the patent ran out, the price of this drug, by Schering-Plough, was raised 13 times in the US in just five years, increasing by over 50%. This is not a price rise in keeping with inflation. This is evil.

Me-too drugs are an inevitable function of research driven by a market: they are rough copies of drugs made by another company, but they are different enough for a manufacturer to claim its own patent.

They need to be tested and marketed just like a new drug; but for all that effort they generally don't represent a significant breakthrough in human health. They are merely a breakthrough in making money. Again, you have to admit, that is reasonably evil.

What Goldacre really seems to be reacting to is the running of pharmaceutical corporations as profit making companies. I'm happy to agree, there seems to be something troublesome about profit making from human misery, which inevitably is what Pharma companies are doing. But there is something powerful to the idea that we need profit making and taking to give incentives to take the risks inherent in developing new medication. I'm more inclined to think that what we need is a different incentive structures along the lines suggested by Pogge, rather than removal of pharma as profit making companies. Of course there is the bigger question as well, how much new medicine do we really need?