By Bob Aronson
A Treatment for Almost Everything but Few Vaccines & Even Fewer Cures — Why?
Fair and balanced journalism is a very nice catch phrase but the stated goal is more than illusive, it is almost non-existent and that’s because there are never just two sides to a story. There are often several sides so no matter how hard a reporter might try to be objective, there is no way you can cover every angle. I do not pretend that this post is the endeavor of an investigative journalist, nor do I contend that this is an objective report. What I offer here represents some observations and a few links to help illuminate the information. I hope you find it useful.
According to the U.S. Census Bureau, the average life expectancy at the beginning of the 20th century was just over 47 years. A century later, that number had increased to nearly 78 years, due largely to the development of vaccinations and other treatments for deadly diseases. We are living longer because medical science has provided us with treatments, medications, devices and surgeries that cure little but keep most threatening diseases at bay…and often at a phenomenal cost.
As a communications consultant specializing in healthcare I have worked with several pharmaceutical companies. I know many researchers and I am aware of the dedication they bring to their jobs and to providing help to patients. I know, too, how expensive it is to develop new drugs and all too often I have seen those efforts fail resulting in the loss of millions of hard-earned investor dollars. In short, I have at least a passing acquaintance with the pharmaceutical industry and the financial risks they take to bring new drugs, treatments, procedures and devices to the marketplace.
At the same time I also understand the desire and the necessity to be profitable. Without profitability no business can survive. It is only fair to point out that the pharmaceutical industry (Big Pharma) has been incredibly profitable, despite the investments and even the losses.
Here is the list of the five biggest pharmaceutical companies based on 2010 revenues, in billions of dollars.
4.Merck and Co $39,811
That leads me to my point which is really a question. Does the drive for profitability cause Pharmaceutical and related research organizations to seek better long term treatments instead of vaccines or cures?
Some believe there is a conspiracy among pharmaceutical companies to determine what to research, the level at which drug prices should be fixed and to generally deceive the public. I don’t accept that theory. That pharmaceutical companies seem to act in concert is not because of a conspiracy, it is because they all subscribe to capitalistic principles. If “Greed is good” this industry may have achieved excellence. No conspiracy is necessary when the capitalistic drive to have stratospheric profits is present.
Big Pharma knows one thing and it is what drives them – there is great profitability in keeping people alive. They also know that there is no profitability in allowing people to die. Most certainly they know that they can make a healthy amount of money on cures and vaccines but they only result in a one-time purchase per patient. The big bucks are in developing a drug or a device that people must pay for monthly for the rest of their lives. It pays big time to make sure they live a long time and continue to buy your product month after month until old age takes them to their maker.
Consider this fact alone. If cures were found for heart, lung, liver and kidney disease alone the entire multi-billion dollar transplant industry would collapse. There would be no need for UNOS, Organ Procurement organizations, Transplant centers, heart-lung machines, dialysis machines and centers, anti-rejection drugs…well, the list goes on and on. Look at the value of dialysis alone. According to Hoover’s, a Dunn and Bradstreet Company, the US commercial kidney dialysis industry includes about 4,200 centers with combined annual revenue of about $18 billion. http://www.hoovers.com/industry-facts.kidney-dialysis-centers.1906.html It is easy to see how tempting it would be to improve dialysis rather than find a cure for kidney disease.
Let’s look at just a couple of mankind’s worst and most profitable diseases. First Diabetes, which is one of the most profitable in the world because the disease itself isn’t an immediate threat. It is mostly manageable and therefore pharmaceutical companies and the dialysis industry in particular can make a significant amount of money because patients must buy their products until they die. An article in Click Rally magazine posed this question, “If a cure did become a possibility, would anyone fund it if the reality was that it would eliminate a $132 billion a year industry?” http://www.clickrally.com/diabetes-too-profitable-to-cure/
As a result, according to the magazine, funding for projects in diabetes research goes toward improving treatments, not cures. The focus remains on making treatment more “comfortable” and reducing long-term complications. Many drug companies will put millions into the development of a different type of insulin, often one that has already been made by someone else just so they can have a complete “portfolio.”
Heart disease and related illnesses are the number one killers in the world. They are also the top revenue generators in the pharmaceutical industry and in all of healthcare/
In the U.S., all cardiovascular disease costs $273 billion each year, including heart conditions, stroke, peripheral artery disease, and high blood pressure. In fact, of all the money spent in the U.S. on health care, 17% goes toward treating cardiovascular disease, says Paul A. Heidenreich, MD, a cardiologist at the VA Palo Alto Health Care System in California and associate professor of medicine at Stanford University. Heart conditions such as heart failure, heart attack, bypasses, etc., account for nearly $96 billion of that total. http://www.webmd.com/healthy-aging/features/heart-disease-medical-costs
Then there is Cancer. The number two killer but probably the most terrifying of diseases. I lost my wife of 35 years to lung cancer in 1998 and it was a horrible experience. Radiation and chemo therapy gave her nearly two years of life after the initial diagnosis but the disease eventually won despite the hundreds of thousands of dollars it cost for treatment.
There are about 100 different cancers but most people hear the word and think the worst. Just hearing cancer in a diagnosis strikes ones deepest sense of despair and hopelessness even though there are many effective treatments. Way back in 1971 President Nixon declared a “War on Cancer” and immediately saw to it that billions of dollars were funneled into research. But we must ask, what was being researched? How much was spent on cures and how much on new treatments, drugs and technology that were aimed at keeping people alive with little hope of a cure. Sorting through all the answers to those questions would take months but there is no doubt a lot has been spent on relieving symptoms and extending life and that approach certainly has been beneficial.
Not everyone, though, thinks the cancer war is worthwhile. Two-time Nobel Laureate Dr. Linus Pauling (PHD) said, “Everyone should know that the ‘war on cancer’ is largely a fraud, and that the National Cancer Institute [NCI] and the American Cancer Society [ACS] are derelict in their duties to the people who support them.”
The National Cancer Institute (NCI) spends about $4.9 Billion a year on cancer research. $4.9 billion. Don’t you wonder why we don’t hear of more cures?
NCI estimates the total cost of treating cancer in the U.S. rose from about $95.5 billion in 2000 to $124.6 billion in 2010. The true tab is higher — the agency bases its estimates on average costs from 2001-2006, before many expensive treatments came out. Cancer costs are projected to reach $158 billion, in 2010 dollars, by the year 2020,
In Referring to the “War on Cancer” A CNN report in 2011 said, “Forty years later, clinical trials have shown impressive treatment outcomes, especially in the early stage of the disease. Unfortunately, few cancers can be cured after spreading from their initial site of origin. In clinical studies, many of the newer treatments for widespread or metastatic cancer extend median survival by just a few months. It is progress but clearly not satisfactory progress.” http://www.cnn.com/2011/12/23/health/forty-year-war/index.html
And finally HIV/AIDS. According to WikiAnswers, the current approach of HIV drug maintenance can keep patients alive, at a cost of $300 – $2,500 PER PATIENT/PER MONTH *INDEFINITELY*
This profits pharmaceutical companies at approaching $10,000,000,000.00 per year.
Over the course of the next few decades, this will likely grow to exceed $1,000,000,000,000.00 (Trillion) per year. A cure would instantly eliminate this entire profit margin.
As a drug ages, the price drops and customers and physicians expect something new. When the price drops it becomes necessary to create a new drug and get a new patent so no-one can compete with you. Often the new drug doesn’t work any better than the old one but it is new, has a different package, new name and sports the same old claims but comes all dressed up in Sunday go to meeting clothing. And … even if the new product is no more effective than the old one advertising will make it sound like it is — and which of us is astute enough to be able to study the clinical trials and know the difference?
So every new drug comes out and gets marketed at a premium price till the patent expires. This goes on for decades. The research and development of such drugs is where the expense is accrued. The cost to make the pills is next to nothing. A cure for herpes would eventually cost $25 a person, whereas most people now spend as much as $60 a month every month on treatment — and will do so for the rest of their lives.
So…what are some of the most profitable drugs ever?. Here’s a list from the Village voice. http://blogs.villagevoice.com/runninscared/2010/11/the_5_most_prof.php and guess what they all have in common? They never cure you.
1) Lipitor (2009 gross revenue: $7.5 billion): Designed to lower cholesterol, Lipitor uses statins to decrease LDL cholesterol and triglyceride levels and increase HDL cholesterol levels. Studies indicate that high cholesterol increases one’s chance for heart disease, the leading health problem in the U.S.
2) Nexium (2009 gross revenue: $6.3 billion): This well-marketed drug decreases the amount of acid produced in the stomach, but it’s not an instant cure for heartburn.
3) Plavix (2009 gross revenue: $5.6 billion): Nobody likes a nasty blood clot, and this drug prevents that from happening, particularly after a stroke or a heart attack. The downside: Plavix increases your chances of small-injury bleeds and, if drinking alcohol, heightens your risk of stomach and intestinal bleeds.
4) Advair Diskus (2009 gross revenue: $4.7 billion): For asthma sufferers, a twice-daily inhaler to reduce the swelling in your respiratory system. Helps keep attacks from being more severe.
5) Seroquel (2009 Gross: $4.2 billion): Rounding out our top 5 is Seroquel, an anti-psychotic drug that treats schizophrenia, severe depression, and bipolar disorder by altering chemical activity in the brain.
Profitability works as a motivator but it can also be a de-motivator. There are scores and scores of rare diseases (AKA orphan diseases) that are left with little or no research being conducted because there simply are not enough people affected and that means little or no money is being spent on research because the probability of making a profit is far too slim. Orphan diseases include some you have heard of often like: Addison Disease, Amyotrophic Lateral Sclerosis, Juvenile Rheumatoid Arthritis, Asperger Syndrome, Crohn Disease and Cystic Fibrosis to name but a few.
To be sure the industry has worked on cures and Vaccines. Here’s a list of Vaccines developed since 1900 http://en.wikipedia.org/wiki/Timeline_of_vaccines
- 1921 First vaccine for diphtheria
- 1921 First vaccine for tuberculosis
- 1924 First vaccine for scarlet fever
- 1926 First vaccine for pertussis (whooping cough)
- 1932 First vaccine for yellow fever
- 1937 First vaccine for typhus
- 1945 First vaccine for influenza
- 1952 First vaccine for polio by Jonas Salk
- 1954 First vaccine for Japanese encephalitis
- 1954 First vaccine for anthrax
- 1957 First vaccine for adenovirus-4 and 7
- 1962 First oral polio vaccine
- 1963 First vaccine for measles
- 1967 First vaccine for mumps
- 1970 First vaccine for rubella
- 1974 First vaccine for chicken pox
- 1977 First vaccine for pneumonia (Streptococcus pneumoniae)
- 1978 First vaccine for meningitis (Neisseria meningitidis)
- 1981 First vaccine for hepatitis B (first vaccine to target a cause of cancer)
- 1985 First vaccine for Haemophilus influenzae type b (HiB)
- 1992 First vaccine for hepatitis A
- 1998 First vaccine for Lyme disease
- 1998 First vaccine for rotavirus
- 2003 First nasal vaccine for influenza approved in US (FluMist)
- 2006 First vaccine for human papillomavirus (which is a cause of cervical cancer)
So, all of this leaves us with still another question. What do you think a pharmaceutical company (and its stockholders) would do if they came up with a cure for a major disease like cancer?
I have provided a great deal of information here but none that points to any real evidence that research efforts only seek to find treatments as opposed to vaccines and cures. Having said that, the information doesn’t prove otherwise either. The ultimate decision is up to you. As for myself I can only say that I’m left with more questions than answers. So I ask our readers, are you satisfied that research is looking for cures and vaccines or are they more interested in treating diseases because of profitability? I look forward to your comments.
Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 2,500 member Organ Transplant Initiative and the author of most of these donation/transplantation blogs.
You may comment in the space provided or email your thoughts to me at email@example.com. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.
Please view our video “Thank You From the Bottom of my Donor’s heart” on http://www.organti.org This video was produced to promote organ donation so it is free and no permission is needed for its use.
If you want to spread the word personally about organ donation, we have another PowerPoint slide show for your use free and without permission. Just go to http://www.organti.org and click on “Life Pass It On” on the left side of the screen and then just follow the directions. This is NOT a stand-alone show; it needs a presenter but is professionally produced and factually sound. If you decide to use the show I will send you a free copy of my e-book, “How to Get a Standing “O” that will help you with presentation skills. Just write to firstname.lastname@example.org and usually you will get a copy the same day.
Also…there is more information on this blog site about other donation/transplantation issues. Additionally we would love to have you join our Facebook group, Organ Transplant Initiative The more members we get the greater our clout with decis