Fearing Pharma: The Crusade to Kill Drug Development

Dr. Marcia Angell does not like pharmaceutical companies.

A physician and former editor of The New England Journal of Medicine, Angell believes they are dishonest, deceptive, greedy, and duplicitous, unabashedly charging Americans sky-high prices for drugs while residents of other countries (for example, Canada) pay a fraction of those costs.

The good doctor's cure for what she sees as "Big Pharma's" corruption is as radical as her charges: In the short term, she encourages Americans to import cheaper drugs from other countries. For the long haul, she wants Big Government to take over Big Pharma and treat drug research, development, and marketing as just another public utility.

Bitter Literary Pill

Unfortunately, The Truth About Drug Companies is a perfect example of the old adage that "for every complex problem there is a simple solution and it is always wrong." Here are some factual antidotes to Dr. Angell's bitter literary pill:

• America's pharmaceutical industry is the envy of the world, with 90 percent of all new drugs in the world each year researched and produced here.

• In the past two decades drug companies have launched a dazzling array of new products that allow us to live longer, healthier lives and reduce hospital stays. These include cholesterol-lowering medicines that help prevent heart attacks, antidepressants, vaccines, drugs for treating HIV/AIDS, and the first generation of drugs aimed at slowing the progression of Alzheimer's disease.

• The prospect of economic rewards is the elixir of innovation. The very profit-driven system Dr. Angell deplores provides the essential environment necessary for investments in often-speculative research and development. Socialization of the drug industry would roast the goose that lays the golden Rx eggs.

• Prices of drugs in other countries, including Canada and England, are indeed lower than those here. But this disparity in pricing has nothing to do with free-market forces. Instead government-mandated controls in other countries set drug prices artificially low, resulting in little or no surplus revenue for companies to reinvest in new research. It is no surprise, then, that countries with price controls produce virtually no new drugs. They rely on the United States as their supplier.

• It is illegal for a country like Canada, which demands and gets cut-rate prices because of its national price controls, to resell its drugs back to America. But this law is not enforced and Congress may actually eliminate it. Such a move would, in effect, import price controls to the United States, along with all the disincentives for innovation that go with them.

High Price for Price Controls

Pharmaceuticals can indeed be expensive. But expensive compared to what? Premature death? Months of hospitalization and suffering? Exactly what "entitles" anyone to access to expensive pharmaceuticals ... or expensive housing, food, or clothing?

Clearly our society ought to maintain its "safety net" for those who are truly indigent and in need of our assistance, but we need to question why so many Americans feel comfortable spending thousands of dollars on cruises, golf games, and other discretionary pursuits, but get outraged when they face comparable expenditures for medications, which apparently they think they should get for free.

If we accept Dr. Angell's diagnosis and treatment plan, we may reduce prices for drugs in the near future. But the bigger price we (and our children and grandchildren) will pay comes later: The flow of new drugs that now gives us therapies we could hardly dream of a decade ago, will soon be reduced to a trickle. Today's drug prices really do finance tomorrow's miracles.

Dr. Elizabeth M. Whelan is president of the American Council on Science and Health (http://www.acsh.org). An earlier version of this article appeared in the New York Post. Reprinted with permission.