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DBL%20Hendrix%20small.png College chemistry, 1983

Derek Lowe The 2002 Model

Dbl%20new%20portrait%20B%26W.png After 10 years of blogging. . .

Derek Lowe, an Arkansan by birth, got his BA from Hendrix College and his PhD in organic chemistry from Duke before spending time in Germany on a Humboldt Fellowship on his post-doc. He's worked for several major pharmaceutical companies since 1989 on drug discovery projects against schizophrenia, Alzheimer's, diabetes, osteoporosis and other diseases. To contact Derek email him directly: Twitter: Dereklowe

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In the Pipeline

« Reading Our Own Press Releases | Main | Why All the Gloom? »

April 18, 2006

There Is a Tide. . .

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Posted by Derek

Looking back through the archives, I see that two or three years ago I spent a lot more time than I do now on the issues of drug reimportation and the industry's ability (or lack of it) to deal with Congress. I haven't written about these topics for a while, and by golly, there's a reason:

"After years of pumping millions of dollars into election campaigns, the pharmaceutical industry is reaping the benefits of a vastly improved political climate on Capitol Hill.

The increases in donations have moderated since the last decade as the industry has won passage of long-cherished legislative objectives or fended off challenges that it deemed a threat to its way of doing business.

In the last year, drug companies have won protection from lawsuits involving production of a pandemic flu vaccine. They have been invited to join President Bush in mapping a government strategy to fight a pandemic and have been sought out to assist in producing vaccines against flu and bioterrorism.

At the same time, legislative measures aimed at the industry - notably, bills that would permit importing cheaper prescription drugs from abroad - appear stalled, with little likelihood they will come up soon. . ."

The article goes on to say that the 2004 increases in drug prices (8.4%) were the lowest since 1982, a fact that seems to have been very slightly underreported. It also makes much of the passage of the Medicare drug benefit, which is something that I'm still quite ambivalent on. The provision which prohibits selection based on price worries me, since I'd rather have pricing signals than not. Of course, the flip side of that is that negotiating with Medicare would be a real Godzilla-versus-Megalon situation, and I worry that allowing the program to negotiate prices on individual drugs would be a backdoor route to general price controls. A middle ground would be allowing price discrimination between drugs in the same therapeutic category - just like private insurance does.

On the larger scale, part of this easing of the pressure on the drug industry is probably just other issues (Iraq, energy prices) coming along to take up the slack. Political outrage obeys conservation laws just like anything else. Somehow, I don't think it's safe to put the clip-on horns back in the costume box just yet.

Comments (6) + TrackBacks (0) | Category: Why Everyone Loves Us


1. Kay on April 19, 2006 6:07 AM writes...

Public perception will not matter much unless we can find a way to get a long list of new-mechanism-of-acton products to market. We've got too many mouths to feed with our current short list.

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2. Martin on April 19, 2006 9:14 AM writes...


What about using a reference pricing system, a la British Columbia, in which the government reimburses only the cheapest drug among a group of drugs (with drugs grouped by therapeutic use, substitutability, and efficacy). It seems to me that would leave the government out of the negotiating position while establishing some means for the government to garner savings. I do agree with you that the monopsony power of Medicare is frightening, but I'm not clear on what the consequences would be since the government already uses its power in setting hospital and physician reimbursement levels.

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3. Palo on April 19, 2006 10:04 AM writes...

Political outrage obeys conservation laws just like anything else....
... except lobbying dollars.

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4. TWAndrews on April 19, 2006 10:23 AM writes...

Public perception will not matter much unless we can find a way to get a long list of new-mechanism-of-acton products to market. We've got too many mouths to feed with our current short list.

This is exactly right. Current drugs and pipelines just aren't enough to support the entire weight of the pharmaceutical industry atm.

If we were bringing out novel treatments more rapidly, I think there would be minimal, if any, of the demonization of the drug industry that you see these days. Part of this is just a question of public perceptions. They tend to have the idea that when we understand anything about a disease, a treatment is right around the corner.

But I think another part is that time is spent with crap like "Restless Leg Syndrome."

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5. Milo on April 19, 2006 3:42 PM writes...

Here is a question for the "insiders" here, those of you who are actually in pharma: I keep hearing about shrinking and drying pipelines and how pharma is not producing new drugs etc... Why is this? What happened? Clearly there are lots of bright people working at the bench everyday. Do you guys who actually do the research have a theory?

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6. SC on April 19, 2006 5:34 PM writes...

As a physician and someone who actually experiences the "crap" known as RLS, I can assure you that just because you don't understand a symptom does not mean it doesn't exist. Having said that, I do not advocate pouring billions of dollars of research into RLS when there are far more pressing issues that require new-mechanism-of-action products.

I believe that part of the problem of perception comes from point of view - the importance of the issue is directly related to how close you are to it.

The reality is that almost 40% of North Americans will die of vascular disease, and this is mostly preventable. The most attributable risk factors come down to a few basic reversible and/or issues (as per the Interheart study). Our main focus should be on addressing these - high cholesterol, high BP, diabetes, better smoking cessation aids, anti-depressants/anxiolytics. Huge potential returns to be had in a large and growing portion of our population.

On the other hand, cancer, as the second leading casue of death at about 25-30%, is likely a group of diseases that we have grouped simply due to inadequate understanding. We spend billions of dollars on therapies that provide an additional month or two (maybe a year or two at most) of poor quality life to a very tiny number of patients, and only at the expense of great toxicity.

While I understand that targeting the cancer patients holds emotional sway with patients, from a (admittedly cold-hearted) societal point-of-view, I wonder if the money coulnd't be more efficiently spent.

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