E-drug: Feeding the beast?
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David Henry's questions are thought provoking and important. I would like
to add another couple of thoughts (these may simply be variations on his
themes):
The advent of direct to consumer advertising in the US (and probably soon
in other countries) and the expanding development of products that have
more to do with hitherto 'lifestyle wishes' that have now been converted
into 'health need' means that R&D trends away from public health concerns
are exacerbated. Meanwhile, R&D spend explodes, and industry defends itself
by saying how much it all costs to bring a product to market.
There are two possible critiques of this:
- The James Love perspective (i.e. R&D is not as much as we think)
- The David Henry perspective (i.e. there is a law of diminishing returns
on R&D)
(apologies to both for over-simplifying, or misunderstanding, their case)
Both may be true. My own sense is that more and more money is being spent
on 'feeding the beast' (i.e. money that is devoured by the R&D monster) for
more and more products that have less and less to do with real health need.
There is 'rapture' amongst industry for the new wave of lifestyle drugs
that cater to a US-led Western middle class audience. But there is a
'rupture' between the ends served by industry and health care need.
Meanwhile, health care systems that are publically funded will be ruptured
by increasing costs. They have to then redefine themselves as catering to
the needs of (primarily) the poor and a two-tier health system is (re)born.
This may happen in the UK at least, I think.
Once I posted a note about lifestyle drugs on e-drug and the moderator let
it enter the debate but noted that she was not sure what it had to do with
essential drugs. For me, it is clear now (thanks to James Love and David
Henry et al) that they are two sides of the same coin. More of one means
less of the other.
All the best
David Gilbert
Fellow, Office for Public Management
252b Gray's Inn Road
London, WC1X 8JT
Tel: 0171 837 9600
Fax: 0171 837 7364
EMail dgilbert@opm.co.uk
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