Pharma and Politics

  Alzheimer’s is a progressive, neurodegenerative disease characterized by memory loss and impaired cognition, with as many as 5.4 million Americans living with the disease.  Today Alzheimer’s disease is the sixth leading cause of death in the United States and the 5th leading cause for those 65 and older.  The symptoms of Alzheimer’s slowly creep into our lives and affect loved ones in profound ways.  Throughout the years, research and medications have helped, hindered and or even prevented some of the serious symptoms, but currently, there is no cure.

There are only two countries in the world that allow for the marketing of pharmaceutical products directly to potential patients, the United States and New Zealand.  One must wonder why, if it such a great idea, that it isn’t more commonly allowed.  Well maybe it isn’t such a good idea, or maybe there is a compromise. In 2015 US pharmaceutical companies spent 5.2 billion dollars on direct to consumer (DTC) marketing.  Proponents of DTC contend that the ads inform patients about diseases and possible treatments and encourage people to seek medical advice. Opponents contend that ads misinform patients, promote drugs before long-term safety profiles can be known and stigmatize normal conditions like wrinkles and low testosterone.

Before you think I’m jaded, let me share a little perspective.  Some years ago I was an undergraduate, working as an Emergency Medical Technician in a rural emergency room, a bright-eyed aspiring doctor to be.  During a break in the action of a long night shift I was chatting with the MD and he asked me point blank “why do you want to be a doctor?”  I was caught by surprise, and I mumbled something about helping people in need–isn’t that the only real reason to go to medical school? The MD looked me straight in the eye and told me, “if you want to practice medicine, go to law school.” Life changes, as life has a way of doing, and I never attended medical school after all–I earned a graduate degree in chemistry and I am very happy with my choices.  But thinking back on that conversation, I think the doctor was right.

I have a 4-year son.  When my wife and I found out our child was a boy we were over the moon with excitement.  We already have a girl, and we wanted a boy.  Feelings of luck, fortune, gratitude and love filled our home with anticipation. During her pregnancy, my wife and I were approached by the doctor with a suggestion of genetic testing.  As the doctor stated, statistically there is a rise in genetic disorders with our “advanced” age in conjunction with an increase of autism in boys.

President Trump has made clear his desire to lower or even eliminate regulatory barriers for businesses; now he has brought this mandate to the door of the FDA as well.  In a recent meeting at the White House, President Trump notified pharmaceutical leaders that his administration would reduce taxes, regulations, and streamline the product approval process.  In turn, the pharmaceutical industry is expected to lower drug prices and bring manufacturing jobs to the United States.

“I’m going to bring down drug prices,” Trump told Time magazine, “I don’t like what has happened with drug prices.” Although biotech and pharmaceutical stocks initially rose after the election, the budding optimism drug makers enjoyed rapidly faded with Trump’s comments regarding drug prices.  President Trump is not the only one concerned about drug pricing in the United States.  The increasing cost of prescription drugs has become a source of concern for patients, prescribers, payers, and policy makers.  Public outrage has intensified over recent decisions by companies to levy significant cost increases, such as the EpiPen pricing scandal.  Even pharmaceutical executives are feeling the sting over drug pricing.  Recently, Chief Executive Officer Leonard Schleifer of Regeneron Pharmaceuticals Inc. and Ian Read of Pfizer Inc. have argued over the role of drug pricing in the pharmaceutical industry.  Schleifer’s comment to Read over the cost of drugs: “You’re not entitled to a fraction of the GDP.”