General Question

jca's avatar

Do you think the pharmaceutical companies are sufficiently motivated to find a cure or vaccine for major diseases (like diabetes) when they make so much more money by keeping people maintained on medications for their lifetimes?

Asked by jca (36025points) October 9th, 2008

it seems more profitable to sell month after month of medications than to sell a one shot dose of vaccine or cure and end the influx of money.

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26 Answers

EmpressPixie's avatar

No. Not at all. That’s why we did so much better when they were run by scientists instead of businessmen.

La_chica_gomela's avatar

It doesn’t work the way you described. It’s a lot more complicated than that.

An example (you mentioned diabetes in the question):
Because insulin in relatively cheap. It’s been around FOREVER. No one is excited about it. If you could cure diabetes, then you could sell that drug for a LOT more than a drug company makes off selling insulin.

Also, the way patent laws work, any company can sell insulin, because, as I said, it’s been on the market forever. If I knew how to make insulin, I could sell it to you.

On the other hand, the first company to discover/invent a new medicine has the sole rights to it for a certain period of time (around 40 years, someone correct me if I’m wrong), so if you’re the first one, you get to sell it while it’s hot.

Pharmaceutical companies commonly spend millions on drugs that never even make it to market, they are so motivated to find new medicines.

When you’re researching a promising medicine, you don’t know if it’s going to be a cure, a vaccine, just an ameliorating treatment, or completely useless. You have to test it to find out. If the drug looks at all promising, a company will do everything they can to get it to market. Sometimes it’s great, sometimes it’s not.

Empress, I’d like to see some evidence to support your claim that “we did so much better when they were run by scientists”.

“Pharmaceutical companies are not the only people looking for cures. The federal government gives out billions in grants every year to research institutions, and I don’t see them curing cancer today either.

critter1982's avatar

Patents run 20 years from filing date.

I agree with La Chica. These companies could sell this medicine for “WAY MORE” than what they are selling these generic insulins for. If they patent it they would happen to be the only company that can produce it for 20 years until it becomes public knowledge. Additionally, they could sell rights (at another extremely high cost) to another company to help manufacture the medicine. I don’t think this happens a lot in the pharma industry but it does in the electronics industry.

cookieman's avatar

I know nothing of this first-hand, but it sounds like La chica gomela is on the money.

The general assertion that they choose not to cure certain ailments to make money always sounded like a conspiricy theory to me.

Fieryspoon's avatar

If there was one company, it wouldn’t be motivated. Because there are many, they have the motivation to find a cure before their competitors, so yes.

marinelife's avatar

No. That is why research should not be done by companies with for-profit motives.

La_chica_gomela's avatar

Marina, would you like to share with us why or how you have come to this conclusion?

critter1982's avatar

@Marina: You don’t think greater profits are to be gained by a cure?

marinelife's avatar

@critter1982 How? You cure the condition, and then what? No one gets the disease anymore. Then you have to drum up a fake condition like restless leg syndrome.

critter1982's avatar

First the margins will be incredibly higher. Assuming we are talking about diabetes, it is inherent in your family tree, so unless people stop having children, and people stop eating so much sugar you don’t cure it forever.

I have RLS by the way :). Heat works the best.

shilolo's avatar

To all you conspiracy theorists about the biotech and pharma industries, let me generate a short list of essentially “cured” diseases, and the how (many are infectious, but not all). This is just off the top of my head. I’m sure that there are many more.
1. Smallpox, vaccine, eradicated
2. Polio, vaccine, nearly eradicated
3. Bacterial meningitis, vaccine (and antibiotics), significantly reduced in incidence worldwide
4. Tetanus, vaccine
5. Rabies, vaccine
6. Bubonic plague, sanitation, antibiotics
7. Rheumatic fever, antibiotics
8. Hepatitis C, antivirals and interferon
9. Tuberculosis, antibiotics (Still a MAJOR worldwide problem)
10. Many, many forms of cancer -> chemotherapy
11. Stomach ulcers, antibiotics
12. Some forms of stomach cancers, antibiotics
13. Lyme disease, antibiotics
14. Gout, various medications, steroids
15. Acne, accutane
16. Typhoid fever, vaccine/antibiotics
17. Insulin dependent diabetes, insulin (FYI, modern insulin has only been around for about 20 years with the advent of molecular biology)
18. Rheumatoid arthritis, steroids, anti-TNF drugs
19. Leukemia/lymphoma, bone marrow transplant
20. Skin and soft tissue infections, antibiotics
21. Chicken pox, vaccine
22. Diptheria, vaccine
23. Malaria, drugs (though, still a MAJOR worldwide problem)
24. Measles, vaccine
25. Pertussis (whooping cough), vaccine/antibiotics
26. Pneumococcal pneumonia, vaccine/antibiotics
27. Yellow fever, vaccine
28. Scurvy, vitamin C
29. Rickets, vitamin D fortification of foods
30. Childhood blindness, vitamin A fortification of foods
These last 3 are for all you homeopaths…

The fact remains, that as our lifespan increases, so we develop more chronic diseases like diabetes, heart disease, cancers, strokes, high blood pressure, etc. Our bodies did not evolve to live to 80 (we should be dead by around 30–40, once we “finish” procreating). It is a privilege of modern existence to live long enough to develop these chronic diseases.

EmpressPixie's avatar

@La_Chica: there was a specific corporation that for years and years was run by scientists. I was trying to think of it when I made my post and I’m still coming up blank. When I figure it out, I’ll definitely post. We talked about it at length in my business ethics class.

When they had scientists running it, they rarely came out with drugs that hadn’t been tested into ridiculousness and had a lot more controls on what came out. They also worked towards many of the items described above as “cured” or nearly eradicated despite having a good hand on them in first world countries. But they weren’t focused “enough” on profit.

When they moved to their first businessmen as leaders, they came out with a number of drugs that hadn’t been vetted thoroughly enough causing problems when they turned out to have issues, it became harder inside the company to work on diseases that would cure third world problems, but wouldn’t sell for big bucks here. But the profits increased overall.

Since it was a business ethics course, our debate was both about the responsibility of the company: to come out with safe, effective drugs at what rate (fast/slow), for who, at what profit?

The business leaders did better at encouraging faster release of drugs and better profits. The science leaders did better with making sure the drugs were safer and more likely to green light things like curing malaria. As a bad business student, I fell solidly on the scientist leader side, despite there being a very real and very good argument for both sides. I WILL remember what company this was and as SOON as I do, I will post. I dislike putting generalizations into my comments as I did above, but also often mean to come back to questions like this to elaborate, then forget to.

I completely agree that as we age, we will continue to discover more and more diseases that we know nothing about currently that have to do with aging genes or whatever else. As we discover them, we’ll continue to work on them. At the same time, we don’t need companies going through the expensive work of reformulating tylenol 27 different ways so they can throw a new patent on it, re-brand it, and sell it as newer, better, more effective. Reformulating enough to do that is a lengthy, expensive process and I think they could be far more focused on new medicines.

Currently a large amount of medical research is done on government grants and in Universities and that’s great. It’s also done a lot by small start up companies who once they struggle through the first few stages of FDA approval and it looks like they might have a viable drug, they often get eaten by a larger company. That’s good too because they use grants to get to a point where they look viable, then a company takes them over. It’s a system—it’s not perfect, but it does work. It gives our large pharmaceutical companies a certain amount of leeway. And, to be fair, when brand name drugs come out, they really do need to price high. They aren’t just recouping the money spending developing that drug, but the other 99 that didn’t make it that they still had to spend on.

I’ve also got something at the very fringe of my mind—the AIDS medication ethics case we looked at that I’d like to bring up as an example of a pharma company doing EXACTLY the right thing. But I can’t remember the details. I was the only liberal in the class, so a lot of my memories of it are more like “Oh, there was also that AIDS medication case where I said the company should do something, everyone else told me I was stupid, it was actually what the company did and it worked out amazingly well for them, better than anyone could have ever dreamed” than the more useful “Here was the problem, here was the solution, this is the company involved.”

jca's avatar

shilolo: i didn’t read your list too carefully, but i did see “cancer: chemotherapy.” i don’t think chemo is exactly a cure for cancer, it’s not guaranteed to eradicate it, and many who have had chemo will tell you the “cure” is as bad as the disease. i think chemo could be classified as a treatment, but it’s not a magical pill that takes the cancer away totally.

shilolo's avatar

@JCA. How do you define cure? If someone is “treated” for breast cancer with lumpectomy and chemotherapy, and the cancer never recurs, and they die of pneumonia 20 years later, weren’t they cured? Yes, cancer can recur, but so can many other diseases. That doesn’t mean you haven’t been cured. If I treat your bacterial meningitis with antibiotics, and you are cured, and then, 20 years later have meningitis again, then were you not “cured” the first time?

I think so many people who complain about biotech and pharmaceutical companies have absolutely no idea i) how hard it is to produce a new drug (it often takes 10–15 years), ii) how expensive it is (costing hundreds of millions/billions of dollars to develop), iii) how complex many diseases are and iv) how much society has already benefited from pharmaceuticals. These same people won’t think twice about the oil changes, tire changes, new transmissions, new windshields, etc. that they have to (frequently) replace on their car (or they might just get a new car altogether).

I will say it again, our bodies have not evolved to keep going as long as we do. That is why we see heart failure (the heart pumps 60–90 times/minute, nonstop), kidney failure (all the filtering of blood), diabetes (weakening of the response to insulin), dementia (loss of brain function), cancer (cells going haywire), etc. over time. There is no simple remedy or magic bullet for the wear and tear on your body, just like there is no simple remedy or magic bullet for the wear and tear on a 20 year old car (which has far fewer “moving parts”). Cars end up in the junkyard for a reason, yet, because people want to seemingly live forever, they demand magic solutions to hard-to-treat problems. So, when pharma comes up with drugs for dementia, diabetes, heart failure (that do succeed in keeping people going, but require daily use), people complain. Crazy.

EmpressPixie's avatar

@Shilolo: Don’t forget that the patent on the drug starts running the timer when they file, which is—by necessity—at the beginning of the process.

And legally, we’re not allowed to say anything cures cancer right now. “Cure” is actually is very technical, legal term when it comes to drugs and we don’t have a cure.

jca's avatar

shilolo: i’m sure you know many people who have chemo still die of the cancer. it is not an end all in and of itself.

back to the original question, using the example diabetes, there are a lot of medications diabetics take (Byeta, which i know can be over $150 per month), medications for high blood pressure are another example, that the drug companies make so much on. so much that they pay big bucks to pharmaceutical reps to push, pay doctors incentives to prescribe, give out freebies such as meals, office supplies (ever go to a doctor now – the tissues, hand lotion, other things are all emblazoned with drug logos). if they had, say, a vaccine for diabetes or hypertension, the patient might pay what we pay for other vaccines (i think probably less than $100) once in the patient’s life. being on some meds for a lifetime nets them way more than the $100 for the vaccine.

i understand what you mean about humans’ bodies not being evolved to keep going as long as we do. no disputing that.

shilolo's avatar

There will never be a “vaccine” for diabetes or hypertension. This is what I mean. Quite the contrary. Diabetes for example is failure to secrete insulin (for type I diabetics) or failure to respond to insulin for type II diabetics. That is why insulin is the treatment (or drugs that increase sensitivity to insulin). The only possible cure for diabetes will be the development of islet cell transplants (as kidney and other solid organ transplants cure chronic diseases of those organs).

Likewise, hypertension is very complicated and due to a variety of factors. You cannot vaccinate against the dysregulated activity of multiple pathways.

I concede that cancer isn’t cured in all its manifestations, but we have come a long way. Look at Lance Armstrong. Years ago he would have been dead in his 20s owing to testicular cancer. Now, he is essentially cured (testicular cancer has a >90% cure rate). You pulled the one disease from my list of 30 that isn’t perfect just to suit your argument. Why don’t you comment on the rest of my list? Have you taken vaccines to prevent illnesses? Antibiotics for infections? Probably yes. Thus, you have benefited tremendously from the work of pharmaceutical companies.

Finally, drug companies are not making huge profits on diabetes and hypertension (contrary to what you might think). They may reformulate insulin in ways to make it easier to deliver, or combine anti-hypertensive drugs, but many of the best medicines are off patent (like hydrochlorothiazide for hypertension).

shilolo's avatar

@EmpressPixie. I beg to differ about cures and cancer. We use those terms all the time. Here is a discussion of testicular cancer cure rates. Another article on cure rates for colon cancer. Yet another on breast cancer. Some people use the terminology survival rate, but when the survival rate approaches 100%, you can say that a majority of people will be cured with the treatment.

jca's avatar

shilolo: i pulled that from your list because i’m at work and don’t have time to read everything carefully. i didn’t use that example to be malicious or anything like that. i saw other vaccines and drugs on your list that were discovered years ago (penicillin). i also don’t think smallpox is totally eradicated. (i just scrolled up quickly and looked at your list again). i don’t want to argue about it, just posted the question, and maybe we’ll agree to disagree. other people feel the same way i do. other people feel the same way you do.

shilolo's avatar

Suit yourself. You clearly know more about medicine, biology, and the complexities of drug development than I.

FYI, penicillin was discovered years ago, but companies continue to develop new antibiotics and antifungals because of drug resistance. Also, smallpox has been eradicated (in its native form). Russia and the US have kept stockpiles, unfortunately, but there has not been a case of smallpox since 1977.

jca's avatar

i don’t claim to know more about anything than anybody. it’s my opinion, that’s all. no hard feelings. don’t have an attitude about it.

shilolo's avatar

No hard feelings at all. Its just that you can’t accuse companies of nefarious plots to keep people attached to their medicines without some proof other than that people with chronic diseases take medicines chronically.

jca's avatar

ok. glad there’s no hard feelings.

casheroo's avatar

Sorry to bump an old thread..I just found this one fascinating.

When I took a Pharmacy Techn program, my professor (a pharmacist) was very vocal on her opinion on this subject matter. She never presented us with concrete proof, but she’d always make little comments on pharmaceutical companies, and how they make so much on products like Viagra, but there’s no money in curing AIDS, so they don’t bother. I understand where she was coming from, and I’m sure there are plenty of businessmen who could give a damn, but I truly believe there are scientist out there trying to make a difference, not for the money, possibly for the recognition…but also to just cure something, to do something great. I think big companies are evil, but that’s just a personal opinion ;)

La_chica_gomela's avatar

@casheroo, wow, it sounds like your prof. wasn’t very well-versed in the history of her field.

Viagra was actually originally developed as a blood pressure medication. No one set out looking for a boner pill.

The story began in 1985 when two scientists at Pfizer wrote a proposal to find new drugs for the treatment of high blood pressure and angina….The results were disappointing. However, further phase I trials carried out at the same time with high doses of the drug revealed some interesting side-effects, including frequent erections in the male participants.

It so happens that complications from these two conditions are pretty serious. In fact, ”Heart disease is the leading cause of death for both women and men in the United States.” (according to the CDC)

So casheroo, the facts are definitely on your side in this case. If she thought that Pfizer invented viagra because they were just trying to get rich and didn’t care about helping anyone, she was completely wrong.

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