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The $800 Million PillReview - The $800 Million Pill
The Truth behind the Cost of New Drugs
by Merrill Goozner
University of California Press, 2005
Review by David M. Wolf, M.A.
Feb 27th 2007 (Volume 11, Issue 9)

This highly factual account of the recent histories of drug research and development is for readers who really want to know about prescription drugs and the pharmaceutical industry. Such readers would be people who are deeply concerned about untreated diseases for which drugs are desperately wanted; people suffering from such diseases and disorders; those worried that not enough is being done to prevent and cure disease in this country and around the globe; and especially, the millions of people who want the cost of drugs to come down.

There are a number of distinct subjects tied somewhat loosely together in this book's composition. First, the author presents a detailed narrative of a "long search" for Epo, a decisive enzyme in the production of red blood cells and long sought as a potential cure for aplastic anemia and other maladies. The search was the lonely obsession of one brave scientist, Eugene Goldwasser, whose decades-enduring quest left him a somewhat depressed University of Chicago professor without a result. But his story didn't end there, because a researcher in Japan, Takaji Myake, in an act of profound scientific serendipity, offered to provide Goldwasser with human urine collected from persons with aplastic anemia and those materials eventually produced the breakthrough. Soon an entire industry, biotechnology, evolved from this work. Companies like Amgen made millions on Goldwasser's molecules while the old professor made nothing (because he forgot to secure the patent he applied for--"too busy" researching). So, the subject here is a history of science and a paradigm of how one industry evolved out of the twilight struggle of one perhaps great man.

The other subjects are, in the order they appear, the dramatic narrative of the AIDS crisis and the search for drugs, and later, drug cocktails effective against HIV retrovirus; the largely unsuccessful "war on cancer" and the many drugs associated with it; the many "me too" drugs that have come to dominate drug companies' research and development efforts, crowding out real innovation and authentic research; and finally, the title subject, the $800 million pill, that is, the high cost of developing any new drug which turns out to be not nearly as high as the industry wants the public and the government to believe.

Together these weighty subjects comprise a virtual textbook on the recent history of the pharmaceutical industry, and this is a good thing. The book has a wide vision encompassing the most important questions concerning the major diseases affecting both modern society and the undeveloped world. The names of all the key researchers, essays about their backgrounds, the participating companies in the biotech and drug fields, the important drugs and their histories of funding and development--all these are detailed and placed into historical perspective for review. And in the end, the economics of these industries are laid bare, their dependence upon governments and universities are carefully examined and confirmed, and the true cost of discovering and developing each new drug is pegged closer to $250 million, on average, than the industry's claim that it takes $800 million. Goozner says that the importance of refuting the industry's claim is paramount: the high cost has been used to buttress the industry's notoriously high prices for new drugs.

If the book-author's chief purpose was to expose how the biotech industry and the pharmaceutical giants have driven up the cost of drugs, he succeeds at this. But if the deeper purposes include arming readers with what they need to help lower prices, the result is less certain. Many prominent shops emerge along Goozner's narrative boulevard, but it's not clear where the pavement leads us. We discover at the end that, indeed, the industry-touted figure of $800 million (average) to develop any new drug is bogus. The actual cost, murky and hard to define after tax write-offs, etc., may be only one-third of $800 million. But what's it prove? Industries inflate their difficulties when it serves--tell us something we don't know. Industries lie to the public and the government to get what they want--same thing.

What can anybody do about this dreadful state of affairs in which so much human misery is grounded? We get only a short sketch of possibilities in the last chapter. This seems out of balance with the long investigation into the recent history of the industry.

 

© 2007 David M. Wolf

David M. Wolf, M.A. has been leading a Philosophy Evening twice- monthly for the past year at Yoga Bookstore & Cafe in Honesdale, PA.  He is the author of Philosophy That Works, a book about the foundations of knowledge, truth, and philosophy; you can read sections at Google Book Search or Chapter One at http://www.xlibris.com/philosophythatworks. David is presently working on a new novel, and a  growing collection of sonnets, and other works


 


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