A recent PBS Frontline
Other Drug War," discussed the pharmaceutical industry, presenting
similar information to that in Katharine Greider's The Big Fix. However, while the Frontline editors
presented a balance of both pro and con on the way that the pharmaceutical
industry operates, leaving viewers to draw their own conclusions, Greider has a
single point of view. She presents her
case against the multinational corporations with an eloquent persistence,
giving the reader little room to draw any other conclusion than it is an
industry with far too much power, in need of either government regulation or
else more open to genuinely free market forces. She argues forcefully that Pharma currently both having its cake
and eating it, able to dictate high prices for its products and able to
manipulate government policy to protect its interests. While consumers sometimes benefit from the
new medications that the industry develops, they very frequently suffer because
of the extortionate amounts that the manufacturers charge for their
The Big Fix is written in
straightforward often journalistic prose, and while it is full of relevant
facts, it is not a scholarly work -- there are no footnotes or lists of works
cited. Greider illustrates her points
often by referring to the case of the McCuddy family of Ohio: 77-year-old Melva
who had breast cancer, diabetes, high blood pressure and depression, her son
Jim, 50 years old, who had a heart attack recently and also has asthma and
depression, and her 28-year-old grandson James, who has a stomach ulcer. None of them can afford health insurance and
have to spend large portions of their incomes on their prescribed
medications. Melva often travels up to
Canada to buy her medications there, because they are considerably cheaper
north of the border. Indeed, they are
cheaper in nearly every other country in the world, because those other nations
impose greater government regulation.
Furthermore, most other countries do not allow direct-to-consumer
advertising, and have great control over the inducements the drug manufacturers
provide to doctors to prescribe their products. Reducing the promotional budgets of the companies may help to
keep down their prices.
In short, Greider's excellent book
is a damning indictment of the pharmaceutical business, that shows how the
quest for profits is pursued at the expense of patients. Very often the industry pushes medications
that have few or no benefits compared to older, cheaper medicines and yet,
through aggressive marketing techniques, manages to make billions of dollars
profit. The main defense of the
profiteering of the industry lies in its claim that it needs to make the profit
to be able to afford the huge costs of research and development of new
medications that are major medical discoveries. However, the industry is in fact very secretive about its
expenditures, and Greider makes a strong case that often the costs of research
are exaggerated in order to improve their image. Some experts claim that if the companies were not allowed to
charge whatever they liked for their medications and had greater regulation
imposed on them, then there would be fewer new medications discovered. This may be true, but given the past
practices of the industry, they have about as much credibility as the tobacco
manufacturers. The US currently spends
more on medical care per person than any other country in the world, yet as a
nation, it has no better health than most other industrialized nation. Although traditionally Americans have wanted
the best possible treatments regardless of cost, the excesses of the pharmaceutical
industry may convince many that it is well worth the possible risk of slightly
fewer new medications available in the future if we can make medical treatments
affordable for more people.
© 2003 Christian Perring. All
Christian Perring, Ph.D., is Chair of the Philosophy Department
at Dowling College, Long Island, and editor of Metapsychology
Online Review. His main research is on philosophical issues in
medicine, psychiatry and psychology.
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