A bit of a loaded question, I realize. My short answer is: "no". For many reasons (some valid, others invalid), people love to hate drug companies. As in any business, a few companies have done bad things to taint the image of their sector. We are seeing this now in the USA with the financial sector (e.g., Fannie May, Freddie Mac, etc.). We have all heard the horror stories of the drug company that sold unsafe drugs to third world countries that wouldn't pass health regulations in Canada/USA. But, let's not throw the baby out with the bath water.
Do we need drugs?Obviously, the answer is "yes", unless you hold some twisted, Darwinian "only the healthy should survive" attitude. Otherwise, we've all been sick, and we've all benefitted from pharmaceuticals. I think we can all agree that some drugs are essential. If you are going into cardiac arrest, you don't want someone to prepare you an herbal tea. You want to be taken to a hospital to receive a drug that will restore the function of your heart and allow you to live long enough to make wiser lifestyle choices. The same is true with epilepsy. If you are in
status epilepticus then you want to receive a
drug that will stop your seizure as soon as possible. So, drugs are important and we need them.
What are some of the problems with drug companies?One of the major problems behind drug companies is that they are held accountable to their shareholders (i.e., they need to make a profit). The average drug costs almost $1 billion US dollars to develop. This means roughly $1,000,000,000 of expense from the time you have the idea of developing a drug until the time that drug is available at your local pharmacy. Much of this expense occurs during drug testing (i.e., determining the safety and effectiveness of that drug). That is a LOT of money.
To protect their investment/intellectual property, drug companies patent their drugs for about 20 years. This allows them to sell that drug exclusively to try and earn back their investment. This is why new drugs are so expensive. Once the patent has expired, then other companies can make "generic" versions of the drug and sell it for much cheaper as they won't have spent the hundreds of thousands on research and development. So, the company has 20 years to make back their billion bucks. Another complication is that many of the drugs that a company tries to develop end up failing at some point along the testing process. They may prove toxic in animal studies. They may prove toxic in clinical trials. They may lack effectiveness in clinical trials. They may even prove toxic after they have passed all trials and the drug "makes it to market" (i.e., it's available at your pharmacy). This recently happened to Merck's COX 2 inhibitor, Vioxx®, which generated heart problems in some patients. This means that a company can spend hundreds of thousands of dollars and then be forced to abandon the drug. Yikes!
This puts tremendous financial pressure on drug companies. As a result, many drug companies have stopped/slowed the development of new, novel drugs needed in the treatment of serious, life-threatening diseases. Instead, most drug companies tend to focus on modifying existing drugs to make them less toxic. Also, because they need to worry about the "bottom line", many drug companies have focused simply on developing drugs that are used very commonly for non-life-threatening health problems-- which in my opinion, are the drugs we need the least. These are drugs like the proton pump inhibitors used to treat acid reflux or drugs used to treat indigestion. These are huge money-makers as they are so commonly used. They are drugs we take after a meal without even thinking about it. Although these drugs may be important to those who suffer from acid reflux, they rank low in the overall hierarchy as compared to the new drugs that we need to treat aggressive forms of cancer, for example.
So, drug companies have the ability to develop new drugs that are required for serious, chronic diseases, but they tend to be focusing on drugs that will bring them the most profit. This is understandable from an economic perspective, but less understandable from the perspective of someone who has 10 seizures a day and can't find a drug that helps.
What are possible solutions?One of my more radical ideas is that the Government should be in charge of all drug development (instead of corporations). This would mean that there are no shareholders, in the formal sense. Of course, the public would then have to fund the drug development process, but it would eliminate the need to make profit. The Government would simply seek to regain the cost of the drug development, not the extra bit to put profit into the pockets of shareholders and pay CEOs huge salaries. Obvious disadvantages to this would be that drug development would occur much more slowly and there would be less diversity in the drugs that would be developed. This is just a way to develop new, important drugs for chronic, serious diseases that lack adequate treatment, without financially strapping those that need them.
The current system uses Insurance Companies to help buffer the cost of drugs, so that a $100 prescription might only cost you $10-20, depending on your plan. Of course, if you can't afford a plan/have no plan, then you are faced with the horrible choice of financial health vs. physical health. Something that is unimaginable to me, but something that many face everyday in the USA. Here in Canada, we are fortunate to have a National Health Care Plan that ensures that you will get many drugs for free, providing the drug in question is covered under the Drug Registry. Unfortunately, not all drugs are covered, which means you could end up having to pay for it under your insurance plan, or even out-of-pocket.
What about nutriceutical companies? A slight tangent"Why don't the nutriceutical companies face the same degree of public distaste as drug companies? They are in the same business of selling drugs- just prepared and marketed in their
galenical form. Let's be honest-- if you are taking something (e.g., a tea, a pill, a plant, a vitamin, etc.) that works to improve your health, then you are taking a drug (unless it is a
placebo ). "Vitamin C" is ascorbic acid. The active ingredient in white willow bark is acetylsalicylic acid (the pure form is sold as Aspirin®). The active ingredient, which is thought to yield mild antidepressant effects, in St.John's Wort is the chemical hyperforin. All this to say, if it works and isn't a placebo, then it is a chemical. The rest is a matter of marketing and a case of the wolf in sheep's clothing. What's scary, is that nutriceutical companies aren't (yet) as tightly regulated as the drug companies--> so they are allowed to sell chemicals without all the rules/regulations that drug companies face. When you buy 200mg of ibuprofen (e.g., Advil®), then it is 200mg. When you buy white willow bark, it's unclear and unregulated as to how much of the active ingredient (i.e., acetylsalicylic acid) is present. This is a problem.
Concluding thoughtsWell, the system isn't perfect. Not all drug companies are perfect either. Unfortunately, the system is set up to prioritize profit over "let's make drugs for diseases where they are most needed to save lives". That's what spawned my crazy idea of having Government in charge of drug development, but that has obvious down-sides too.
In the end, we need drugs. They are important in our health, and for many, they are required on a daily basis to keep us alive (e.g., those living with cystic fibrosis, cancer, heart disease, etc.). So, it's good that we have drug companies making these drugs for us.
Nutriceutical companies are no different from drug companies. What's scarier than that, is that they aren't regulated the same way that drug companies are -- and they should be! They also prioritize the bottom line, profit. That's why you are paying $25 for your bottle of fish oil.
I hope this has been helpful. I know some people feel very strongly about herbs/nutriceuticals being healthier than drugs. That said, this isn't a religion or belief system. These products can be studied by the cold, objective eye of science, so we aught to have a more objective point of view on them. Any chemical you take that changes the way your body works, be it a drug, a "nutriceutical", should be treated the same (i.e., read up on it, study whether it will interact with any drugs you are currently taking, tell your doctor that you are taking it, etc.) as it also has the potential to help you as well as harm you. Even foods can do this. Garlic, for instance, is full of sulphides (diallyl sulphide, for example), which act to inhibit drug-metabolizing enzymes in our liver.
Food for thought.
Kirk.
Do we need drugs?
Obviously, the answer is "yes", unless you hold some twisted, Darwinian "only the healthy should survive" attitude. Otherwise, we've all been sick, and we've all benefitted from pharmaceuticals. I think we can all agree that some drugs are essential. If you are going into cardiac arrest, you don't want someone to prepare you an herbal tea. You want to be taken to a hospital to receive a drug that will restore the function of your heart and allow you to live long enough to make wiser lifestyle choices. The same is true with epilepsy. If you are in status epilepticus then you want to receive a drug that will stop your seizure as soon as possible. So, drugs are important and we need them.
What are some of the problems with drug companies?
One of the major problems behind drug companies is that they are held accountable to their shareholders (i.e., they need to make a profit). The average drug costs almost $1 billion US dollars to develop. This means roughly $1,000,000,000 of expense from the time you have the idea of developing a drug until the time that drug is available at your local pharmacy. Much of this expense occurs during drug testing (i.e., determining the safety and effectiveness of that drug). That is a LOT of money.
To protect their investment/intellectual property, drug companies patent their drugs for about 20 years. This allows them to sell that drug exclusively to try and earn back their investment. This is why new drugs are so expensive. Once the patent has expired, then other companies can make "generic" versions of the drug and sell it for much cheaper as they won't have spent the hundreds of thousands on research and development. So, the company has 20 years to make back their billion bucks. Another complication is that many of the drugs that a company tries to develop end up failing at some point along the testing process. They may prove toxic in animal studies. They may prove toxic in clinical trials. They may lack effectiveness in clinical trials. They may even prove toxic after they have passed all trials and the drug "makes it to market" (i.e., it's available at your pharmacy). This recently happened to Merck's COX 2 inhibitor, Vioxx®, which generated heart problems in some patients. This means that a company can spend hundreds of thousands of dollars and then be forced to abandon the drug. Yikes!
This puts tremendous financial pressure on drug companies. As a result, many drug companies have stopped/slowed the development of new, novel drugs needed in the treatment of serious, life-threatening diseases. Instead, most drug companies tend to focus on modifying existing drugs to make them less toxic. Also, because they need to worry about the "bottom line", many drug companies have focused simply on developing drugs that are used very commonly for non-life-threatening health problems-- which in my opinion, are the drugs we need the least. These are drugs like the proton pump inhibitors used to treat acid reflux or drugs used to treat indigestion. These are huge money-makers as they are so commonly used. They are drugs we take after a meal without even thinking about it. Although these drugs may be important to those who suffer from acid reflux, they rank low in the overall hierarchy as compared to the new drugs that we need to treat aggressive forms of cancer, for example.
So, drug companies have the ability to develop new drugs that are required for serious, chronic diseases, but they tend to be focusing on drugs that will bring them the most profit. This is understandable from an economic perspective, but less understandable from the perspective of someone who has 10 seizures a day and can't find a drug that helps.
What are possible solutions?
One of my more radical ideas is that the Government should be in charge of all drug development (instead of corporations). This would mean that there are no shareholders, in the formal sense. Of course, the public would then have to fund the drug development process, but it would eliminate the need to make profit. The Government would simply seek to regain the cost of the drug development, not the extra bit to put profit into the pockets of shareholders and pay CEOs huge salaries. Obvious disadvantages to this would be that drug development would occur much more slowly and there would be less diversity in the drugs that would be developed. This is just a way to develop new, important drugs for chronic, serious diseases that lack adequate treatment, without financially strapping those that need them.
The current system uses Insurance Companies to help buffer the cost of drugs, so that a $100 prescription might only cost you $10-20, depending on your plan. Of course, if you can't afford a plan/have no plan, then you are faced with the horrible choice of financial health vs. physical health. Something that is unimaginable to me, but something that many face everyday in the USA. Here in Canada, we are fortunate to have a National Health Care Plan that ensures that you will get many drugs for free, providing the drug in question is covered under the Drug Registry. Unfortunately, not all drugs are covered, which means you could end up having to pay for it under your insurance plan, or even out-of-pocket.
What about nutriceutical companies? A slight tangent"
Why don't the nutriceutical companies face the same degree of public distaste as drug companies? They are in the same business of selling drugs- just prepared and marketed in their galenical form. Let's be honest-- if you are taking something (e.g., a tea, a pill, a plant, a vitamin, etc.) that works to improve your health, then you are taking a drug (unless it is a placebo ). "Vitamin C" is ascorbic acid. The active ingredient in white willow bark is acetylsalicylic acid (the pure form is sold as Aspirin®). The active ingredient, which is thought to yield mild antidepressant effects, in St.John's Wort is the chemical hyperforin. All this to say, if it works and isn't a placebo, then it is a chemical. The rest is a matter of marketing and a case of the wolf in sheep's clothing. What's scary, is that nutriceutical companies aren't (yet) as tightly regulated as the drug companies--> so they are allowed to sell chemicals without all the rules/regulations that drug companies face. When you buy 200mg of ibuprofen (e.g., Advil®), then it is 200mg. When you buy white willow bark, it's unclear and unregulated as to how much of the active ingredient (i.e., acetylsalicylic acid) is present. This is a problem.
Concluding thoughts
Well, the system isn't perfect. Not all drug companies are perfect either. Unfortunately, the system is set up to prioritize profit over "let's make drugs for diseases where they are most needed to save lives". That's what spawned my crazy idea of having Government in charge of drug development, but that has obvious down-sides too.
In the end, we need drugs. They are important in our health, and for many, they are required on a daily basis to keep us alive (e.g., those living with cystic fibrosis, cancer, heart disease, etc.). So, it's good that we have drug companies making these drugs for us.
Nutriceutical companies are no different from drug companies. What's scarier than that, is that they aren't regulated the same way that drug companies are -- and they should be! They also prioritize the bottom line, profit. That's why you are paying $25 for your bottle of fish oil.
I hope this has been helpful. I know some people feel very strongly about herbs/nutriceuticals being healthier than drugs. That said, this isn't a religion or belief system. These products can be studied by the cold, objective eye of science, so we aught to have a more objective point of view on them. Any chemical you take that changes the way your body works, be it a drug, a "nutriceutical", should be treated the same (i.e., read up on it, study whether it will interact with any drugs you are currently taking, tell your doctor that you are taking it, etc.) as it also has the potential to help you as well as harm you. Even foods can do this. Garlic, for instance, is full of sulphides (diallyl sulphide, for example), which act to inhibit drug-metabolizing enzymes in our liver.
Food for thought.
Kirk.