From The Wall Street Journal [paywall - search Google News for "Hepatitis C Drug Derailed by Deal"] yesterday: “Sometimes drugs die not because they don’t work or are unsafe, but because they don’t make business sense.”
The article is an indictment of the medical-pharmaceutical-industrial complex: with revenues so large, and profit so often unaligned with patient outcomes … patients often lose, because the bottom line does not give way.
Where to point the finger of blame? Without a profit motive, who could afford to risk the billions of dollars necessary to bring a new drug to market? And at the same time, what evidence do we have that these billion-dollar projects are improving our health as a society? Not much.
And yes, I have my own horse in the race: I’m claiming that the book you can buy for the price of a Bloody Mary at the St. Regis will save you $6000 in footwear costs, not to mention pain, suffering, ill-health, and untold medical bills. (And, in the interest of full disclosure, you don’t need the book – just take off your shoes. That’s free)
But it’s my word, and the word of a handful of similarly heterodox barefooters, against the advertising and prestige of a multi-billion-dollar shoe industry, a multi-billion-dollar healthcare industry, and a multi-billion dollar drug (painkiller) industry, all of whom make their boat payments off of injured runners, not healthy ones. If running injuries ceased by a decree from Up There, a lot of high-powered MBAs, MDs and PhDs would be out of work. “Managed chronic disease” – that’s what they require to keep the lights on.
So what’s the solution? How can corporate incentives be aligned with good health? How can customers (in my case runners) make better rational decisions for their own long-term benefit? Will Obamacare encourage systems thinking, to optimize long-term outcomes for society? How to balance economics with human (ir)rationality?
The discussion continues …