Business Week Review: I'm right, just not right enough

Business Week gave “The $800 Million Pill” a mixed review in this week’s (April 19th) edition. Reviewer John Carey calls the book “provocative but insufficiently reflective.” I failed, in his view, “to explore further solutions to th(e) dilemma” that drugmakers’ self-interest and public health don’t often coincide.

I’ll return to that criticism. But I first would remind readers that it was never my intention to resolve the drug industry’s moral dilemma or convince industry executives to focus more of their R&D budgets on socially useful products.

What I set out to do (and this is clearly outlined in the introduction) is to debunk the myth, which the drug industry propagates on television, in newspapers, in the halls of Congress, and from the bully pulpit of the executive branch, that unless the industry is allowed to continue charging exorbitant prices and raking in huge profits, innovation will dry up. On that score, I succeeded entirely, in Carey’s view. “He proves that Big Pharma need not require $800 million to develop an important new drug” and that “many drugs were created with government funding – then were sold to consumers at sky-high prices.”

But then he goes on to ask: “Is it really a shock that companies spend a big chunk of their R&D budgets on drugs that sometimes show no clear medical advantage but that bring surefire profits?” The goal of business, after all, is to make money.

Of course it comes as no surprise. But it is not common knowledge. And public policy is being driven by the myth.

I’m a reporter, not an investor. My goals are to counter industry lies, protect the public purse, and expose practices that make health care unaffordable – practices, I might add, that receive scant attention in the pages of Business Week (this has nothing to do with it being a business publication; some of the finest journalism on drug industry practices gets reported in the Wall Street Journal).

That said, I would like to quibble with Carey’s assertion that I failed “to explore further solutions to this dilemma” of how to make drugsmakers self-interest coincide with public health. “Should drugmakers be held to a higher standard than, say auto makers?” he asks at one point. “Do we need new regulations or incentives to prod the industry into focusing more if its R&D on important medical needs?”

I recommend that Carey go back and reread my last chapter. It is chock full of suggested reforms aimed explicitly at getting drug companies to focus more of their R&D budgets on significant medications.

Moreover, as far as holding drugmakers to a higher standard is concerned, allow me to repeat a criticism from an industry insider included in both the opening and closing chapters of the book. It’s not a moral question. Unless the big drug companies figure out how to tackle pressing medical needs, Hoffmann-La Roche's former R&D chief Jurgen Drews wrote in 1999, they will go the way of the dinosaurs. As I said in a Washington Post op-ed last December, when drug consumers and their representatives are properly informed and empowered, they will force the industry to change.

Posted by gooznews at April 11, 2004 10:11 PM