E-drug: The advantages of banning drug company funding of research
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Some of you may be interested in the following article that the Australian
Financial Review newspaper commissioned me to write as one of 4 "experts".
The clash between science and commercial interests
Author: Peter Mansfield.
Page: - ( 3009 )
Section: News
Publication: Australian Financial Review
Is the profit motive too big a factor in pharmaceutical companies'
research into drugs, or is profit outweighed by the rigorous testing
applied before a new drug gets the green light? In the fourth of our
series of forums on contemporary issues, four experts debate whether
research should be left to non-profit organisations.
Peter Mansfield is a South Australian GP and director of the Medical Lobby
for Appropriate Marketing.
It would be good to test the hypothesis that everyone could benefit if
research by drug companies was prohibited in favour of university
research. I believe universities could do a better job at discovering
and testing new drugs.
Perhaps the most important medical advance during the past 100 years
was the introduction of penicillin. The development and testing of
penicillin
by Howard Florey and his team at Oxford University, without support
from drug companies, is a good example of what universities are
capable of doing very efficiently.
The fact that research funding is available from drug companies gives
governments an excuse for inadequate funding of university research.
Research funding by drug companies also gives the companies an excuse
for demanding excessive prices for drugs. The money drug companies
use to fund research really comes from the public when we buy
medicines and when our taxes are used to subsidise medicines. We pay
prices that far exceed the manufacturing costs. Some of the excess
money goes to research. More is siphoned off to often misleading
advertising and promotion, to excessive pay and bonuses for drug
company staff and to dividends for shareholders. We would get better
value for the excess money we give to drug companies for ``research"
if we spent it directly on research at universities instead.
If Australian universities were adequately funded and adequately
managed, there would be less brain drain to drug companies in other
countries. More of our top brains would be free to contribute to
medical education and to wider debates without being hampered by
obligations to vested interests. I know medical students and young
doctors who feel they need to keep their concerns about drug
companies silent for fear their dissent could jeopardise a future
possible research career.
The private sector has an advantage for tasks where profit is the best
motivator. Profit can be a good motivator when increased product sales
accurately predict increased community benefit. However, drugs are
not so simple. For example, increased sales of antibiotics for viral
infections produce no benefit but cause adverse effects including
resistance problems. The system rewards drug companies for increasing
sales of more expensive drugs regardless of the impact on health.
Also, profit alone is not the best way to motivate the type of people who
make the best research scientists. Competently managed universities are
better at giving researchers the freedom to work in areas where they are
most highly motivated. By contrast, drug companies waste talent by
limiting research to work on drugs predicted to produce the most
profitable sales. They often use experts to put misleading positive
spins on research results and have been known to delay or suppress
publication of unfavourable results.
These practices lead to many undesirable biases, which include:
* Favouring drug rather than non-drug therapies because drugs are easier
for large centralised organisations to distribute and sell.
* Making copies of existing drugs rather than discovering real
innovations, because making copies is a lower risk path to making
money.
* Making new drugs that are expensive because of monopoly patent
protection rather than better-established cost-competitive drugs.
* Favouring treatments for illnesses of the wealthy rather than the poor,
so higher prices can be charged.
* Favouring drugs that have to be taken every day for a lifetime, rather
than once-only treatments that cure, because sales will be larger.
* Concentrating on conditions that are common rather than rare, again
because sales will be larger.
* Treating Caucasians rather than Australian Aborigines, because
Caucasians are a larger market.
Another problem with drug company research is that many advances are
kept secret, so as to gain a competitive advantage. By contrast,
scientific
progress flourishes best when there is open communication enabling
cross-fertilisation of ideas. While drug companies do deserve credit
for the introduction of many useful drugs in the past 100 years, I
suspect we may have made far greater progress if they had not
dominated medical research. If so, then everyone could benefit if we
moved from less research controlled by drug companies to more
government-funded research at universities. Even drug company staff
could benefit from having better drugs to sell.
regards,
Peter
Dr Peter Mansfield
GP and consultant on marketing and appropriate therapeutics
Visiting lecturer, Universities of Adelaide, Flinders, Queensland, South
Australia, Tasmania
Action against risk checklist (ARC) project officer, Adelaide Western
Division of General Practice
Primary author, Healthy Scepticism
Director, MaLAM (Medical Lobby for Appropriate Marketing)
MaLAM aims to protect compassionate scientific health care from
marketing practices that may be detrimental to health.
peter.mansfield@flinders.edu.au
www.malam.asn.au
PO Box 172 Daw Pk SA 5041 Australia
ph/fax +61 8 8374 2245
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