Home > health, Plutonomy > “Can Pharma Thrive With a Plutonomy Strategy?”

“Can Pharma Thrive With a Plutonomy Strategy?”

from Edward Fullbrook

In May of this year The Economist had a an article http://www.economist.com/node/18743951 describing how in the United States plutonomy was causing

a shift in how big drug firms do business. For years they have relied on blockbusters that treat many people. Now they are investing in more personalised medicine: biotech drugs that treat small groups of patients more effectively.

It explained how

new cancer drugs offer small benefits at an exorbitant price. Provenge costs $93,000 for a course of treatment and extends life by an average of four months. Yervoy costs $120,000 for three-and-a-half months.

Obviously only the ultra-rich will genrally be able to afford them.

This week members of the US medical profession have reacted. The medical journal The Lancet Oncology contains the group-authored article “Delivering affordable cancer care in high-income countries” http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(11)70141-3/fulltext  The article speaks of “a declining degree of fairness for all patients with cancer,” and says

A radical shift in cancer policy is also required. Political toleration of unfairness in access to affordable cancer treatment is unacceptable.

And yesterday phily.com carried “Can Pharma Thrive With a Plutonomy Strategy?” http://www.philly.com/philly/blogs/healthcare/Can-Pharma-Thrive-With-a-Plutonomy-Strategy.html  It began

It’s widely known that the top 1% of US households own more than half the nation’s equities and control more wealth than the bottom 90%.

Referring to the first Citibank plutonomy report,

They recommend that the most effective way for companies and wealthy individuals to prosper in Plutonomies is to disregard the “mass” consumer and focus on the rich.

 Referring to the Lancet article,

Some observers claim that pharma’s concentration on cancer as a therapeutic category is tantamount to a plutonomy strategy because prices there range from $50,000 to $200,000 per patient per year, while the number of patients who can benefit from any one drug in a personalized medicine approach remains relatively small.

This article also includes a link to the first Citibank plutonomy report and which a few minutes ago was still good: https://docs.google.com/viewer?a=v&pid=explorer&chrome=true&srcid=0BzgUudifBc68ZGUyNzA0MzAtZDZkZC00ZmZjLTkwY2ItNzBlZWRmNjI1ZTNm&hl=en_US

  1. ezra abrams
    October 1, 2011 at 7:08 pm

    first of all, concern in the medical profession about very $$ pharmaceuticals is old news; I remember a story from, I think the 90s, about how SF gen hospital refused to carry a drug cause most of its patients couldn’t afford it
    And my understanding of the history of HMOs is that they came about in the 60s cause people couldn’t afford to pay doctors bills, at the time people paid the doc directly

    However, the plutonomy strategy is driven by the available science;we are finally getting to the point where we know, or think we know, enough to actually deliver personalized drug.
    Eg, to do this you might want to sequence a persons DNA (genome) a few years ago, the cost was in the miilions; today it is in the 10-100K range, depending on how you figure it; in a few years it will be in the kilobuck range

    Beyond that, the reason drugs are $$ is not because the drug companies are not trying; I know lots of people engage in hofstadter paranoia, but objectively, the worlds drug companies, in the last 20 or 30 years, have poured 10s of billions of dollars into building new labs full of the latest and most exspensive lab tools, and hiring the brightest sicentist they can find from places like MIT, and motivating those scientists with everything from options to dreams of a nobel prize (Elion, G).
    the result has not been bupkus, but it is generally conceded that the results have been very paltry.

    and why is this ?

    it is because we actually know very, very, verrry little about how the human body works, much less about how diferent people, in different conditions of food and so forth, work.
    True, our knowlege is growing rapidly (the NIH does get something for its 30 odd billion a year) and our knowledge today is incredibly advanced compared to just 10 years ago; compared to the 60s we are as giants, standing far above the Newtons and Archimedes of that time

    Yet, compared to what we need to know to make drugs cheaply and in a reasonable time period, we know maybe 1%.
    (just to show that I actually know something, you had a high res xray or nmr of all the proteins in th human body, inclding the membrane proteins, and all the glycosylation and phosphorylation variants, and all the complexes that could form, and you could do accurate in silico docking of small molecules…you’d be getting someplace)

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