What if the pharmaceutical industry had a formula for projected drug profits from a massive rise in autism? A formula such as: PY=P×Y
And what if the same industry simultaneously rewarded scientists, media companies and organizations which disseminate the concept that there is no autism epidemic, that the rise is “false”, that the numbers have always been with us, but that there’s just increased diagnosis due to increased clinical and public recognition of autism? And what if this industry went on a massive campaign to proselytize the dangers of any treatment method—or any scientific authority— which threatened PY=P×Y?
Profiting from something while claiming it doesn’t exist isn’t anything new. According to some historians, the myth of the flat earth was perpetuated by the Phoenicians to prevent maritime trade rivals from voyaging to England to mine tin. Tin, which seems to have been scarce in ancient Canaan, was an essential ingredient to bronze; bronze was the essence of military power and trade at the time. Advantage in the tin trade gave the Phoenicians untold power. As long as the lie held, Phoenician fleets regularly made mining expeditions north, trading freely with the natives of the British Isles—while neighboring states feared plummeting off the edge of the world if they dared to sail through the Straits of Gibraltar.
For the analogy, imagine the existence of the epidemic as “England”; autism recovery treatments as the “Straits of Gibraltar”; and maybe psychopharmaceutical drug profits as “tin”.
The epidemic-based profit formula actually exists. It was published in a 2003 study for Eli Lilly by researchers Robert and Julia Gerlai (HERE). From the study
The question whether the epidemic status of ASD is due to true increase of incidence of the disease or simply its better detection and diagnosis is debated. Nevertheless, according to a most recent report to the legislature on the principal findings from the epidemiology of autism in California, the M.I.N.D. institute has confirmed that the increase of incidence is real and cannot be attributed to changes in diagnostic criteria or misclassification. Autism was estimated to have a frequency of more than 1 in 500 children, while more recent studies found its prevalence as high as 1 in 150 (for examples, see; also see CDC website). Researchers, private (e.g., Alliance for Autism Research), and government (e.g., National Institutes of Health, USA) agencies have recognized the enormous need. As a result, funding for research has significantly increased. Surprisingly, however, autism is still not among the neurological or neuropsychiatric diseases onto which large pharmaceutical research companies traditionally focus. This is unfortunate as ASD represents a significant unmet medical need with an enormous market size. Consider the following: ASD may be diagnosed as early as 2–3 years of age. Some even argue that successful diagnosis may be made at 8-12 months). Autistic persons can live a normal life span. The market size can thus be calculated as follows:
where PY is the number of “patient years,” P is the number of patients and Y is the number of years for which patients live after diagnosis. Calculating with the conservative prevalence estimate of 1 in 500, there may be approximately 600,000 ASD patients in the USA alone. These persons may live for an average of 76 years. Using the conservative age of 3 years for the time of diagnosis, PY may be calculated as follows.
PY=600,000×73=43,800,000, i.e., almost 44 million patient years.
To put this number into perspective, let us consider Alzheimer's disease, a disorder that is considered to represent the largest market by big pharmaceutical research companies. Calculating with P=9 million (say 15% of people above 65 years of age will have Alzheimer's disease in the Unites States) and Y=6 (Alzheimer's disease patients live, on average, for 6 years after first diagnosis), PY=54 million for Alzheimer's disease. The actual numbers may slightly vary. The number of Alzheimer's disease patients is actually smaller than 9 million but the disease may be diagnosed earlier and patients may live longer than for 6 years after diagnosis. On the other hand, the number of ASD patients can easily be twice or even three times higher than the presently estimated 600 thousand. Thus, it is clear ASD represents an unmet medical need that is comparable in order of magnitude to the largest neurological disease market, that of Alzheimer's disease. Thus, ASD should be of major interest to pharmaceutical research companies even when the 17-year patent expiration rule is considered.
The study abstract was sent to me by Ben Hansen, a Michigan mental health activist and satirical blogger (Bonkers Institute). Hansen was covered by the New York Times when his Freedom of Information Act inquiry of Michigan Medicaid turned up evidence that an Eli Lilly account executive may have influenced drug prescribing within the program, which had generated a 100% rise in child drug prescriptions in just 10 months.
HPY= goose egg
Adriana Gamondes lives in Massachusetts with her husband and is the mother of twins who are currently recovering from vaccine-induced GI disorders.