In praise of Big Pharma

With Trump vowing to bring down drug prices, ignoring the very reason they are so high in the first place (hint: it’s capitalism), and another rogue company trying to push opioids to doctors abusing the very legitimate tactic of speakers bureaus to influence physicians, I thought it time to provide some fair balance commentary. Only instead of focusing on the putative evil perpetrated on us all by the drug industry, I’m offering a counter argument for an industry that is always unfairly playing defense.

Full disclosure: I provide branding services to many companies in the pharma and biotech industry. And I’d rather do this than brand another watery beer or another soul-less sedan or another red lipstick. And because I work in this field it puts me directly in touch with the people who market the very brands that garner so much resentment. They are for the most part good people who feel that what they are doing is good work. You should meet them sometimes.  They are like you and me. Pharmaceutical brands represent a boon to society unseen in any other for-profit entityTheir companies are very profitable, and the last time I checked, this was in line with the goals of every company. But unlike every other company, their brands represent a boon to society unseen in any other for-profit entity. This statement shocks people. And they take any medical advances whatsoever for granted…as if they were an accident or an organic change brought about by the government or some nameless, beneficent force.

Healthcare is a business in the US but most people don’t think of it that way. They feel it should be a Constitutional right. When people are ill, they are often compelled to take medication that they don’t want but rather need. And they hate this. Imagine being a company where people thrive on the brands but hate the brand maker? What’s worse is that people don’t want to put a price on their wellbeing. The average cost of yearly medication for Americans is less than a Starbucks Cappuccino a dayMany believe that medication should be free. Well, in a capitalistic system, this is just naïve. And these same people won’t vote for universal healthcare—a proven way to reduce drug prices—because they feel that it is a socialistic idea and they, well, hate socialism in their philosophy, but embrace its essential principles in wanting cheap medications.

Polio, tuberculosis, AIDs and other scourges that used to kill human kind by the tens of thousands no longer pose a serious threat. For the great majority, prostate, thyroid, testicular, melanoma and breast cancers are now curable. So is Hepatitis C. Vaccines have virtually eradicated every serious childhood infection, including measles, diphtheria, pertussis, rubella, mumps, tetanus and rotavirus. Deaths from coronary heart disease have sharply declined, along with similar declines in gastrointestinal infections, pneumonia, and cerebrovascular disease. Women now have access to a wide range of safe contraception options. Even without a cure, breakthroughs in the fields of Multiple Sclerosis, psoriasis, irritable bowel disease and diabetes have diminished symptoms and significantly improved quality of life. You get my point.

Yes, you say. But Big Pharma and Biotech are taking advantage of their position in the market to force sick people to take medication they cannot afford. The fact of the matter is that this notion is not true for the overwhelming portion of the population who have access to generic drugs that are essentially as good as the branded ones with a few exceptions. These exceptions are usually remarkable brands that revolutionize the treatment paradigm. Like any breakthrough, they should command a premium price. Apple revolutionized the personal electronics paradigm, and people happily spend over $1,000 for the iPhone X, or four times the PC price for one of their computers. These days, many consider Apple an essential part of their lives, and nobody demonizes them to the degree they do Pharma even when they produce these goods using cheap childhood labor. When it comes to Big Pharma and Biotech, it’s like people want to have their cake, eat it too, and then heckle the cake maker for fulfilling the need that they have.

And what of other essential products and services? Is anyone hating on Big Death—the funeral industry that charges $20,000 – $30,000 per loved one? Or Big Food? Or Big Water, which asks people to pay $20 per gallon when you add up all of the ounces found in all the single portion servings? When it comes to Big Pharma and Biotech, it’s like people want to have their cake, eat it too, and then heckle the cake maker for fulfilling the need that they have.Put a “Big” in front of an industry’s name and you get the kind of resentment reserved for companies that do much less good than Big Pharma and Biotech. Big Oil makes your cars go, but it spills and pollutes. Big Insurance has your back when things go wrong, but it hedges its bets much like a casino, where the house always wins. Big Pharma, with its life-saving and life-altering brands, shouldn’t be in this company.

Yes, you say. But what about the opioid crisis? These drugs are addictive and cause irreparable harm when abused. However, out of the hundreds of Big and Small Pharma companies out there, only a few actually sell opioids. And opioids are not, in themselves a bad thing because they actually help manage intractable pain for people with legitimate physical conditions. Addiction sucks, no doubt. And over-prescribing is a consequence of not just the manufacturers that make the brands, but also the people who demand them and the doctors who are careless with the tenets of good medicine. But why tar the entire pharma industry for the output of only a few? Caffeine is addictive, but don’t touch my Starbuck’s at $5 for a cappuccino. For someone who consumes two cups a day, that’s a $3,650 yearly habit. According to Express Scripts data, the average cost of yearly medication for Americans is $1,370—a 62% difference! Drug prices are 11¢ of the national healthcare dollar, yet they receive 99% of the denigration.

It all comes back to my original point: people hate relying on something, so they question its value purely based on price when there is so much more in the equation than they are accounting for. The embarrassment and suffering of incontinence is neutralized by treatments for Overactive Bladder. The dangers of hypertension are mitigated by drugs that cost pennies. Cervical cancer used to be the number one cause of cancer deaths for women, but thanks in part to a vaccine for HPV (which is linked to the cancer), the related death rate has plummeted by 50% in the past 10 years.

I don’t expect this blog to change most people’s proclivity to hate on Big Pharma and Biotech. The prices can be high. But I do expect people to take pause whenever they open a prescription bottle or take an injection or use a device and maybe…maybe for a moment…give a little thanks to the industry that does so much good for so little love.

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