Monday, May 11, 2009
And on the pedestal these words appear:
`My name is Ozymandias, King of Kings:
Look on my works, ye mighty, and despair!'
Nothing beside remains. Round the decay
Of that colossal wreck, boundless and bare,
The lone and level sands stretch far away.
-Percy Bysshe Shelley
In My Top Ten Mental Health Stories that I posted here last week, I listed "The beginning of the end of drug companies." As I stated in my entry:
Everything seemed to happen at once: Patients and doctors seeing through the Pharma hype, blockbuster meds losing their patent protection, and no new meds coming out of the pipeline. No longer with any financial interest in influencing psychiatry, Pharma virtually backed out of the game. And with mega lost revenues from loss of patent protection, Pharma may lack the resources to ever get back in it.
Bottom line: Due to their arrogance and stupidity, Pharma fully deserves what's coming, but do we?
In short, how the mighty have fallen. Until just a short time ago, it seemed that Pharma would remain forever at the top of the mental health food chain. Technically, they still are, but we are clearly witnessing the beginning of the end.
I started to see the signs two or three years ago at the American Psychiatric Association's annual meetings. Certain manufacturers were not exhibiting, nor were they sponsoring symposia. The reason was clear: Their current stock of meds had gone off-patent, with no new ones on offer.
The handwriting turned up on the wall even earlier at DBSA conferences I attended. Gone were the frills, such as the canvas conference bags with the GSK logo and the ice cream breaks. A quick comparison of DBSA annual reports two years apart reveals an obvious stampede to the exits.
The DBSA 2005 report lists one $500,000-plus donor - Wyeth. The 2007 report lists none. Fortunately, over the same period, DBSA has been weaning itself off Pharma. What I'm seeing is a far more focused organization in a much better position to serve its constituents.
Psychiatry's make-over may prove far more dramatic and beneficial. Not too long ago, you couldn't throw a stone in the direction of a psychiatrist without it bouncing off at least 10 Pharma hacks. Their tentacles were everywhere: In research, in publishing, in professional education and continuing education, in universities, in hospitals, right into the very sanctity of the psychiatrist's office.
Now, on all fronts, they are disengaging. We are already beginning to see signs of reform in the profession. It's going to take time, but one hopes the final outcome translates into patients being able to take the word of their doctors at face value.
I know what you're thinking: With Pharma gone, where are all the new meds going to come from? Let's define "new," namely something that is not an updated version of an old technology. By this criteria, Pharma has not come up with a new psychiatric med in the last 50 years. To give you one example: J&J's Invega is Son of Risperdal which in turn is based on the ancient Haldol.
It's as if the people running Detroit have been moonlighting as Pharma CEOs.
So, where are the new meds going to come from? Don't bank on Pharma. They got out of drug development - assuming they were ever in it - at least a decade ago. Hopefully, new players looking to make profits based on innovation will fill the vacuum.
In the meantime, it's as if Pharma doesn't exist. Those meds you are taking right now? Probably generic from generic suppliers. Get used to them - these will be your only choices for quite some time.