Friday, March 27, 2009

Big Pharma: Dumber Than Detroit

More than a year ago, I wrote that Big Pharma may go the way of Detroit. Detroit, I wrote, won't be around 10 years from now. Little did I realize how prescient I was.

An opinion piece in the LA Times by author Greg Critser neatly encapsulates things the patient community has been discussing over the past 10 years:

First of all, Mr Critser notes, the meds don't work well. (Assuming the drug is reasonably safe, 50 percent of patients getting 50 percent better is all that is required for an FDA indication.) Nevertheless, even badly flawed meds have amounted to licenses to print money. Think Prozac. Think Zyprexa.

But these drugs have now ridden off into the sunset - gone generic - and there is nothing to replace them.

No new drugs. How stupid is this? Imagine if the movie industry were to announce that there were no new films in production, that holiday movie-goers were going to have to make do with the likes of "Parent Trap I."

According to the LA Times piece:

"As Bloomberg News Service recently reported, the world's pharmaceutical firms need to find replacements for $84 billion in sales now generated by products ending their patent life."

Sounds like appallingly bad management, right? No, it's always someone else's fault:

"If you ask the typical Pharma executive why sales are down, you get an alternative reality. The devil isn't in their drugs, it's in - surprise - onerous government regulation, penny-pinching insurers and, of course, that perennial boogeyman: healthcare reform."

Here's my very simplified take on what happened: In the eighties and nineties, Big Pharma got lucky with a new generation of antidepressants and antipsychotics. The drugs were hardly new - they were based on the same technology as the old ones - but they were promoted as new.

Psychiatry and patients' groups bought into the hype and the result was easy money.

As any business textbook will teach you, easy money is the greatest disincentive to sound management. Bad decisions and waste do not get penalized. Innovation and efficiency do not get rewarded. Necessary course corrections are not made.

During the easy times, the drug companies got out of the drug development business. Research went into "me-too" drugs - different versions of Prozac and Zyprexa. Corporate attention was devoted to lobbying the government (Big Pharma has way more lobbyists than any other industry) and wooing doctors (typically with drug reps who look like Heidi Klum and Russell Crowe).

The easy money, of course, ran out, but we're still stuck with the same bad management, ingrained in their easy money bad habits.

So, when, if ever, will we get meds that are a real improvement on the old ones?

Short answer: Never. Not with the current managers in place. Take my word for it - these guys are dumber than Detroit.

Much more to come ...

Further reading from mcmanweb

Blue Moon Musings

I'm not through: I'm strongly getting the impression you guys are like the auto industry. Same old engines, new fins. In case you haven't noticed, Detroit probably won’t be around ten years from now.

You are the only industry that doesn’t talk to its customers, the end users of your products, and it shows. You certainly haven't sent any Heidi Klum look-alikes to my door. ..


Lizabeth said...

First, thanks for your response to my last comment, it made me feel better about my treatment plan.

Going on to your latest comments---you've nailed it. And I have worked with both kinds of docs, the ones that see Heidi and Russel regularly and those who have the brochures left with the receptionists. You can easily tell which is which--just ask the nurses.

The ones who do their own research, instead of trusting that sponsored by the drug companies are always in a rush and usually SOBs to work with---they just don't have enough hours in their days. But they are the ones you want when you have a life threatening illness.

Hmm--now we have a life threatening illness--and the companies that should be helping are making excuses not to because they can't immmediately, right now, line their pockets with gold. I think we, as a society need to rethink our worship of profit. Didn't someone say "The LOVE of money is the root of all evil" We need to pull up some roots.

John McManamy said...

Hey, Lizabeth. You need to be writing some of these pieces. Please keep commenting. :)