We have to question whether or not the drug industry can and should be trusted with something as important as human health. Like any commercial business, the drug industry invests money to develop products which it sells at a profit. The bigger the market it can generate and sustain for a product, the higher the profits. If it can develop products which are needed by large numbers of people, there will be even higher profits.
Given the cost and length of time taken to develop new pharmaceuticals, it is not surprising that drug companies want and need to continue selling the same product for many years and therefore take pains to sustain and protect the market with licences and trade agreements. Having invested over a long period in competition with other companies, who have similarly invested in competing products, they want to sustain income from the product as long as possible.
But this gives rise to tendencies that are not in the interests of those whose health the drug industry appears initially to serve. Why, for example, would any drug company be interested in curing a medical condition if instead it was possible to turn it into a chronic but managed illness? Commercially, this is an ideal outcome generating a large number of consumers who, by virtue of the chronic nature of the illness, will continue to consume the drug over long periods of time, sometimes for life.
And given the competitive nature of the research into new products, much of it will have been done before in other companies but will not be accessible because of commercial secrecy. So a potentially large proportion of the costs of development are consumed in reproducing research that has already been done - and the consumer pays for this wasted work.
And where do new products come from? Are they in response to new illnesses? Or are they in response to a wider definition of those chronic conditions that people are encouraged to believe they suffer from? In the latter case, the generation of new conditions is an important source of increased market. If people can be persuaded that they suffer from allergies, skin conditions, headaches, cold symptoms, aches and pains, and so on, they can be encouraged to sign up to long-term self-treatment generating increased revenues for the drug companies. Hyperchondria is highly profitable.
In order to protect their future product range, drug companies are now patenting genes. This absurdity gives huge commercial power to the companies investigating the genetic nature of some chronic illnesses. The implication is that once identified, any treatment that relates to the genetic basis of the illness involves a royalty payment. In other words, if you can identify the genetic basis of a chronic illness, you not only profit from any drugs you make to manage the illness, but anyone else using the same genetic information pay a royalty as well. Massive profits with a penalty for anyone else who tries to cure the condition. Research about the human genotype should be public domain.
So what's the alternative? Who is going to fund the research into these drugs? There is a strong case on health grounds for no longer trusting the drug industry to make, via the market, the choices about which new drugs are developed. It is clear that the commercial pressure to stimulate the perception of chronic illness and to avoid cure is not in the public interest. So let's consider a more sensible prioritisation.
Suppose that the research into drugs is made public domain so that all results are available to all researchers. That removes the competitive advantage from individual companies but increases the speed of research and removes duplication. State sponsored research would mean that the rights to these drugs would reside with the state as would all licencing rights. Companies would bid for development contracts to either carry out research or develop the drugs and produce them, or both.
The drugs chosen for development would be based on the health needs of the population. There would be far less diversity in the treatment of trivial conditions and much more focus on curative treatments. Rather than having fifty different preparations all containing paracetamol for cold symptoms, it may be that we have ten and the resources are redirected to something more medically advantageous.
If a drug is needed worldwide to treat the consequence of a disaster, we avoid the disgraceful scene of drug companies refusing to allow the cheap development of drugs in the third world. There would be no question of commercial interests because governments would own the rights and could make them available. Public health would be more important than private profit. Of course there will be an argument that without private investment, there wouldn't be the funding to do the research. It would be an interesting calculation to work out the wasted R&D through duplication together with the production of unnecessary drugs, coupled with the cost to the NHS of treatment of chronic illnesses, and offset costs required to direct medical research towards more socially important areas.
Public health will always be second priority to drug corporations making profits out of chronic illness. Drug companies can't be trusted to work in the public interest.
