Friday, October 11, 2019

Does the Pharmaceutical Industry Really Withhold Cures?

Goya Attended by Doctor Arrieta by Francisco Goya
by Nina Zolotow

I’m tackling this subject today because frankly I’m a little upset about it. Recently I saw more than one person from the yoga community on Facebook share a link to an article that claims pharmaceutical companies already have a cure for cancer but are withholding it because they can make so much more money selling treatments for cancer. Also, I know that our readership includes people who have chronic and/or serious diseases, both common and rare, for which there is no cure as well as people who teach these populations. So I thought it would be worthwhile for me write a post that describes how and why pharmaceutical companies (and research institutes) conduct their research on cures for diseases. 

This is a hot-button issue for me because I happen to be married to a medical researcher who spent 31 years working in academia and who now does drug discovery research for a biopharmaceutical company that is currently working on cancer, among other serious diseases. My husband is Dr. Brad Gibson (he will be contributing to this article) and he works for Amgen, and I can assure you he would be thrilled to participate in a cure for cancer (Nobel Prize here we come!) and his company would shower him with praise and bonuses if he did because their stock prices and annual revenue would go through the roof. And, even more importantly, Brad would know that his efforts saved lives and improved the quality of life of untold number of patients and their families. In addition, through my husband, I know a large number of other medical researchers who work on trying to find cures for all types of diseases. For example, Brad’s friend Bob worked on Huntington’s disease for many years, and was extremely frustrated by the lack of progress. Not only is he sad about having done so much work that didn’t end in success, but he also has lots of friends in the HD community who are suffering and who he so badly wanted to help. The truth is that human biology is extremely complicated, and there are many things scientists still don’t understand. This is as true about our bodies as it is about the universe. Here’s to all the scientists who spend their lives studying these complex problems, most who are unrecognized and who make only incremental contributions. 

But since I’m in a myth-busting mood, I want to acknowledge that there are some serious problems related to the issue of how medical research is funded. One is that while no pharmaceutical company will withhold an effective treatment, it is true in the US that if the treatment is for a rare disease, the company might sell the drug for very high prices in order to earn back the money it spent to research and test the drug (something that is very costly). And the price might be so high that some people might even be priced out. That’s a terrible problem in our health system that definitely needs addressing. 

The other is the issue of which diseases pharmaceutical companies and research institutes focus their research on and which receive little or no funding. This is a serious issue because while common first-world diseases (cancer, heart disease, hypertension, diabetes, etc.) get lots of funding, many common third-world diseases (such as malaria and parasitic diseases) do not. Finally, there is the problem of rare diseases (which they call orphan diseases), for which the number of potential patients is very low. 

To understand how drug companies and research institutes chose what to work on and what not to work on, we need to look at them separately. 

Pharmaceutical companies are for-profit companies. So when choosing where to focus their research, they definitely take into account whether the money they can charge for the potential drug will result in enough income to allow them to recoup what they invested and make a profit as well. Otherwise, they would go broke. That means they tend to focus on common, first world diseases. So the problem here is a result of capitalism and economics.

Research institutes on the other hand allow medical researchers to work on anything they want as long as they can get funding from the government to do this (in the US via the National Institutes of Health). So in academic environments, scientists can not only work on finding cures for diseases without worrying about profits, they can also study basic biology questions in the hopes that it will lead to a better understanding of disease mechanisms and potential therapeutic intervention strategies. And in the US, the government does fund some research into third-world diseases and into rare ones. However, when there are tax cuts and funding for the medical research is reduced, not everyone can get funding for the work they are inspired to do. This, frankly, is a problem of politics and funding priorities. 

There are many private foundations that fund research into third-world diseases (the Bill and Melinda Gates Foundation funds research on malaria, for example) or into rare diseases (Bob did much of his research on Huntington’s disease for the Hereditary Disease Foundation and the CHDI Foundation). So if you have a particular disease you’re concerned about, you can help support the appropriate foundation. 

But the bottom line is that there is no world-wide medical conspiracy to withhold cures from us. There are, however, economic and political constraints that result in inequality in the way research into particular diseases is funded and that cause pricing problems for treatments for rare diseases. Solving these problems is complex to be sure. But while it is certainly frustrating to see a loved one suffer or to suffer yourself from a disease for which there is not yet a cure, passing around false accusations about scientists and drug companies is only going to make things worse. This encourages distrust of the scientific community, which in turn will lead to further lack of funding.

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