Pound of Cure
multibillion-dollar pharmaceutical industry has successfully
addressed a myriad of illnesses and inconveniences—but how
much is too much?
By William Kanapaux
the last time you heard, “An apple a day keeps the doctor
away?” Why worry about that when you can slurp down a few
chili dogs and pop the purple pill called Nexium?
Think technology and chances are that the first thing to pop
into your head won’t be prescription drugs. But there’s no
question that the pharmaceutical industry is a key player
when it comes to shaping the technological landscape. Last
year alone, drugmakers spent $32 billion on U.S.-based research
and development. That’s a lot of chemistry.
It’s no secret that modern medicine pushes drugs on us at
every turn. On TV, in magazines and at doctor’s offices, American
consumers face an onslaught of advertising. There’s Singular
for asthma, Zoloft for anxiety and depression, Vioxx to keep
seniors active and Viagra to assist aging Don Juans.
Without a doubt, these medicines serve a useful function.
But now that science has conquered a vast majority of previous
threats—polio and smallpox come to mind—an army of well-paid
lab coats have turned their attention to more specific disorders
and more precise ways of dealing with them. In the process,
it has changed our expectations about medicine’s ability to
control what ails us.
Last month’s column on artificial intelligence included a
prediction by futurist Ray Kurzweil that in the not-so-distant
future, nanobots would sit at our nerve endings, ready to
engage each of us in a virtual world of our choosing. While
the concept may seem far-fetched, a slightly modified version
of this already exists in the plethora of pharmaceutical products
available to change our mood.
A recent issue of New York magazine sang the praises
of the emerging pill- popping culture of hip urbanites. Mood-
altering pills that were originally designed to treat debilitating
disorders are now being passed around like breath mints. Stressed
out over an upcoming presentation? Take a Paxil. Scared of
flying? Thank God for Xanax.
What gets lost in the rush to self- medicate is the threat
of side effects. These can get nasty. Problems with Paxil,
for instance, have prompted a number of class-action lawsuits
that claim the drug is addictive and causes suicidal behavior.
In June, both the United States and Britain issued dire warnings
about prescribing the drug to patients under 18.
But these kinds of complications are merely speed bumps to
an industry that sold $400 billion worth of drugs worldwide
It’s a high-stakes game. Drug companies and biotechnology
firms say they spend on average $800 million to develop a
successful drug. And only 22 percent of drugs that are tested
on humans ever make it to market.
In the process, the pharmaceutical industry sits in the driver’s
seat when it comes to shaping our health-care system. The
industry’s U.S. research budget is larger than that of the
National Institutes of Health, putting it in control of the
medical-research agenda. This means some questions don’t get
answered, while others get asked over and over until they
eventually yield the desired results.
On the front end, you take pills the doc prescribes, pay lip
service to the sorts of things that would help prevent the
condition or lessen its severity and hold out until the body
fails and the only answer is expensive medical technologies
on the back end.
The ongoing upsurge in type 2 diabetes is a great example
of this, a true clash between modern life and evolution. Clearly,
the human body wasn’t designed for processed foods full of
refined sugars and saturated fats, nor for a life spent sitting
at a desk, in a car and on a couch in front of a TV. About
17 million Americans now have diabetes, a 50 percent increase
Fortunately, we have a drug for that. About 15 of them in
fact, with 24 new ones currently under development. In 2002,
Americans spent $7.3 billion on diabetes treatments.
The downside to treating disease through pharmaceutical concoctions
is an overreliance on drugs—versus an emphasis on prevention—and
unrealistic expectations for a cure. According to the Pharmaceutical
Researchers and Manufacturers of America, the “cure” for diabetes
would involve receiving a new pancreas or a mechanical equivalent.
Neither is an option yet.
Still, there’s no question that the drug industry has made
some astounding advances and continues to push the envelope
when it comes to understanding treatments and possible cures
The biotech firm Genentech has a drug now on fast-track review
at the Food and Drug Administration that has shown surprising
promise in extending the lives of patients with rapidly spreading
colon cancer. Called Avastin, the antibody chokes off the
blood supply to cancer tumors. If successful, it would be
an important step toward achieving a cure for cancer.
And just last week, AIDS researchers published a paper in
the journal Science announcing that they have discovered
how a rare antibody detects HIV-infected cells—which disguise
themselves as normal cells—and neutralizes them. The team
is hoping the discovery will lead to an HIV vaccine, a breakthrough
that would turn the tide on a virus infecting 40 million people
across the globe.
But in the other cases you have to ask, how much is too much
of a good thing? Is it really worth spending $800 million
developing a drug to prevent stroke when studies have found
that 100 milligrams of aspirin at bedtime will achieve the
The answer could very well be yes, but in the absence of real
debate, the marketplace decides. And when the drug industry
finds itself sitting on a blockbuster drug that can earn billions
a year, the debate pretty much ends with the balance sheet.
The current king of the drug world is Pfizer’s anti-cholesterol
drug Lipitor, which alone generates a whopping $8 billion
Along with the rapid growth in pharmaceuticals has come the
ability for new technology to develop drugs that are more
precisely targeted and to develop them more quickly—at least
in theory. When the SARS virus broke out across the globe
earlier this year, it took researchers only six days to sequence
its genome. To actually develop a vaccine or specific treatment
for the virus will still take years and hundreds of millions
of dollars, but the drug industry now is using the equivalent
of lasers rather than the sledgehammers of a few decades ago.
Even so, drugs can offer our frail bodies only so much protection.
In the days of air travel, one wily virus could wipe out a
significant portion of the world’s population before researchers
even begin to develop a response. In many ways, SARS served
as a wake-up call to that reality, even if the virus itself
seems to have fizzled for now.
It’s too easy to jump on the moral high horse and say that
people should change their habits and lifestyle before running
to the medicine cabinet. It’s a tough world, perhaps tougher
than it’s ever been. Technology has made our lives more fast-paced
and stressful, so why shouldn’t a person seek out a high-tech
solution for the modern world’s ills? As long as we keep these
advances in perspective, it could very well be the only way
to get by.
See you at the pharmacy.