Despite the extraordinary contributions the pharmaceutical industry has made to the quality and longevity of human life, it stands charged in the court of public opinion on a multiple-count indictment.
Below, I have listed what I believe are the sentiments, concerns, and judgments of the average well-informed person who is concerned about the state of health care in the U.S.
I list these in no particular order for the purpose of helping all of us who work in pharma, and all who can help the industry, sort through what is true and false, what is relevant and what is not.
- Pharma’s profits are too high. They hover around 3 times higher than the median for all other industries.
- Despite these profits, which Pharma claims it needs for drug development, the number of new drugs approved by the FDA is less than half what it was ten years ago, and only 14% of the drugs approved between 1998 and 2003 were new molecular entities likely to be improvements over older drugs.
- With the number of new drugs cut in half, sales and marketing budgets have grown to twice the budget for R&D.
- During the 90s, when there were more new drugs, price increases were at one times the CPI. In 2003, they were 2.5 time the CPI.
- To promote its me-too drugs in over-crowded therapeutic areas, it has tripled the number of reps in ten years. Genentech Chief Arthur Levinson says, “If you are developing novel drugs, you don’t need sales forces of tens of thousands.”
- The credibility of the value/price ratio has been eroded. Is a cancer drug that extends life for four months worth $30 to $40 thousand dollars? Furthermore, consumers don’t understand the difference in cost between generics and brands, or between in-country and out of country prices.
- Spending on Phase IV trials designed for marketing purposes is up 90% in four years. More spending designed to find some minor advantage for a me-too product.
- Yet two-thirds of the post-marketing trials required by the FDA have yet to be initiated.
- Pharma is disease mongering. Prescriptions for sleeping pills are up 45% in 5 years, yet there have been no reports of an epidemic of insomnia.
- Respected journals hint that Pharma corrupts science. When pharma undertakes head to head trials with competitive compounds, more often than not the trials come out in favor of the sponsor’s drug.
- Pharma corrupts Congress. Pharma has the largest lobby in Washington DC. There are more pharma lobbyists there than members of congress. And you know how voters feel about lobbyists.
- Pharma is responsible for a large percentage of medical errors. There are an estimated 120,000 deaths per year in the U.S. due to adverse drug reactions.
- Some see Pharma as heartless because it failed to provide assistance to Africa until it was forced to do so.
- It is widely believed that doctors are influenced to put medicines in our bodies because Pharma supplies them with golf outings, dinners, honoraria, and meetings in resort locations.
As a result of all these charges, the top ten pharmaceutical companies have lost $30 billion in market value and the industry is rated as trustworthy as big Oil and big Tobacco.
Those of us who work in the industry, or who support it, find ourselves trying to defend it. We would like to know the facts, and we would like to feel good about our industry.
I offer these charges as an opportunity for dialogue and education. I do not assume they are true. I have gathered them from public sources and look forward to gaining greater clarity from the discussion.