Drug Industry Trends and Events

The pharmaceuticals seem to have a license to print money, with an average 30 percent return on equity for the top companies, yet they are crying poor. It costs anywhere from $500 to $800 million to bring a new drug to market, and there are indications that some companies may no longer be up to the challenge. Some 30 drug company mergers in the last 15 years, culminating in a frenzy over the past two or three, represents one ominous sign. The good news is genetic research will provide a steady feedstock of new drugs, and new scientific knowledge will make clinical trials less expensive - but some companies may not be around when this happens.

In the meantime, lawyers are beginning to treat the pharmaceuticals as tobacco companies. For the first time, in 2001, the maker of an antidepressant (Paxil's GlaxoSmithKline) lost in a civil damage suit. The court dockets are starting to fill up with class actions, and law firms are openly touting for clients. Whether this has a negative impact on the development of new drugs remains to be seen.

Do expect to see yet more ads: Drug company spending on direct-to-consumer advertising nearly tripled between 1997 and 2000, hitting $2.3 billion. Cynics may have some choice words, but the ads undoubtedly helped break down ignorance and stigma barriers.

The drug industry came under attack in a recent study published in JAMA, which reported 87 of 100 authors of clinical practice guidelines had relationships with drug companies. Seven thought their relationship influenced their recommendations and 19 thought their colleagues were similarly swayed. An article in The Guardian quoted Fuller Torrey MD, executive director of the Stanley Foundation, as saying: "Some of us believe that the present system is approaching a high-class form of professional prostitution."

The former editor of the New England Journal of Medicine, Marcia Angell MD, singled out the cozy ties between the makers of antidepressants and their researchers, who are typically heaped with lavish gifts and astronomical consulting fees, with many holding equity stakes in the companies they are supposed to be studying with an unbiased scientific eye.

You give medications to a child, and you're bound to stir up a controversy. One visitor to my website posted this: "Do you know how many people would diagnose a thirteen year old (or even younger) child with bipolar and put him/her on medication? More than you would think, and it's ridiculous! That kind of medication should be a choice for capable and mature adults to make."

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