Big Pharma

The pharmaceutical industry is (some might say amazingly) the second largest on the planet, worth over 600 billion dollars in sales every year and acting as the force behind the cutting edge of science that continues to push the science of medicine onwards as a field- and while we may never develop a cure for everything you can be damn sure that the modern medical world will have given it a good shot. In fact the pharmaceutical industry is in quite an unusual position in this regard, forming the only part of the medicinal public service, and indeed any major public service, that is privatised the world over.

The reason for this is quite simply one of practicality; the sheer amount of startup capital required to develop even one new drug, let alone form a public service of this R&D, would feature in the hundreds of millions of dollars, something that no government would be willing to set aside for a small immediate gain. All modern companies in the ‘big pharma’ demographic were formed many decades ago on the basis of a surprise cheap discovery or suchlike, and are now so big that they are the only people capable of fronting such a big initial investment. There are a few organisations (the National Institute of Health, the Royal Society, universities) who conduct such research away from the private sectors, but they are small in number and are also very old institutions.

Many people, in a slightly different field, have voiced the opinion that people whose primary concern is profit are those we should least be putting in charge of our healthcare and wellbeing (although I’m not about to get into that argument now), and a similar argument has been raised concerning private pharmaceutical companies. However, that is not to say that a profit driven approach is necessarily a bad thing for medicine, for without it many of the ‘minor’ drugs that have greatly improved the overall healthcare environment would not exist. I, for example, suffer from irritable bowel syndrome, a far from life threatening but nonetheless annoying and inconvenient condition that has been greatly helped by a drug called mebeverine hydrochloride. If all medicine focused on the greater good of ‘solving’ life-threatening illnesses, a potentially futile task anyway, this drug would never have been developed and I would be even more hateful to my fragile digestive system. In the western world, motivated-by-profit makes a lot of sense when trying to make life just that bit more comfortable. Oh, and they also make the drugs that, y’know, save your life every time you’re in hospital.

Now, normally at this point in any ‘balanced argument/opinion piece’ thing on this blog, I try to come up with another point to try and keep each side of the argument at an about equal 500 words. However, this time I’m going to break that rule, and jump straight into the reverse argument straight away. Why? Because I can genuinely think of no more good stuff to say about big pharma.

If I may just digress a little; in the UK & USA (I think, anyway) a patent for a drug or medicine lasts for 10 years, on the basis that these little capsules can be very valuable things and it wouldn’t do to let people hang onto the sole rights to make them for ages. This means that just about every really vital lifesaving drug in medicinal use today, given the time it takes for an experimental treatment to become commonplace, now exists outside its patent and is now manufactured by either the lowest bidder or, in a surprisingly high number of cases, the health service itself (the UK, for instance, is currently trying to become self-sufficient in morphine poppies to prevent it from having to import from Afghanistan or whatever), so these costs are kept relatively low by market forces. This therefore means that during their 10-year grace period, drugs companies will do absolutely everything they can to extort cash out of their product; when the antihistamine drug loratadine (another drug I use relatively regularly, it being used to combat colds) was passing through the last two years of its patent, its market price was quadrupled by the company making it; they had been trying to get the market hooked onto using it before jacking up the prices in order to wring out as much cash as possible. This behaviour is not untypical for a huge number of drugs, many of which deal with serious illness rather than being semi-irrelevant cures for the snuffles.

So far, so much normal corporate behaviour. Reaching this point, we must now turn to consider some practices of the big pharma industry that would make Rupert Murdoch think twice. Drugs companies, for example, have a reputation for setting up price fixing networks, many of which have been worth several hundred million dollars. One, featuring what were technically food supplements businesses, subsidiaries of the pharmaceutical industry, later set the world record for the largest fines levied in criminal history- this a record that persists despite the fact that the cost of producing the actual drugs themselves (at least physically) rarely exceeds a couple of pence per capsule, hundreds of times less than their asking price.

“Oh, but they need to make heavy profits because of the cost of R&D to make all their new drugs”. Good point, well made and entirely true, and it would also be valid if the numbers behind it didn’t stack up. In the USA, the National Institute of Health last year had a total budget of $23 billion, whilst all the drug companies in the US collectively spent $32 billion on R&D. This might seem at first glance like the private sector has won this particular moral battle; but remember that the American drug industry generated $289 billion in 2006, and accounting for inflation (and the fact that pharmaceutical profits tend to stay high despite the current economic situation affecting other industries) we can approximate that only around 10% of company turnover is, on average, spent on R&D. Even accounting for manufacturing costs, salaries and such, the vast majority of that turnover goes into profit, making the pharmaceutical industry the most profitable on the planet.

I know that health is an industry, I know money must be made, I know it’s all necessary for innovation. I also know that I promised not to go into my Views here. But a drug is not like an iPhone, or a pair of designer jeans; it’s the health of millions at stake, the lives of billions, and the quality of life of the whole world. It’s not something to be played around with and treated like some generic commodity with no value beyond a number. Profits might need to be made, but nobody said there had to be 12 figures of them.

NUMBERS

One of the most endlessly charming parts of the human experience is our capacity to see something we can’t describe and just make something up in order to do so, never mind whether it makes any sense in the long run or not. Countless examples have been demonstrated over the years, but the mother lode of such situations has to be humanity’s invention of counting.

Numbers do not, in and of themselves, exist- they are simply a construct designed by our brains to help us get around the awe-inspiring concept of the relative amounts of things. However, this hasn’t prevented this ‘neat little tool’ spiralling out of control to form the vast field that is mathematics. Once merely a diverting pastime designed to help us get more use out of our counting tools, maths (I’m British, live with the spelling) first tentatively applied itself to shapes and geometry before experimenting with trigonometry, storming onwards to algebra, turning calculus into a total mess about four nanoseconds after its discovery of something useful, before just throwing it all together into a melting point of cross-genre mayhem that eventually ended up as a field that it as close as STEM (science, technology, engineering and mathematics) gets to art, in that it has no discernible purpose other than for the sake of its own existence.

This is not to say that mathematics is not a useful field, far from it. The study of different ways of counting lead to the discovery of binary arithmetic and enabled the birth of modern computing, huge chunks of astronomy and classical scientific experiments were and are reliant on the application of geometric and trigonometric principles, mathematical modelling has allowed us to predict behaviour ranging from economics & statistics to the weather (albeit with varying degrees of accuracy) and just about every aspect of modern science and engineering is grounded in the brute logic that is core mathematics. But… well, perhaps the best way to explain where the modern science of maths has lead over the last century is to study the story of i.

One of the most basic functions we are able to perform to a number is to multiply it by something- a special case, when we multiply it by itself, is ‘squaring’ it (since a number ‘squared’ is equal to the area of a square with side lengths of that number). Naturally, there is a way of reversing this function, known as finding the square root of a number (ie square rooting the square of a number will yield the original number). However, convention dictates that a negative number squared makes a positive one, and hence there is no number squared that makes a negative and there is no such thing as the square root of a negative number, such as -1. So far, all I have done is use a very basic application of logic, something a five-year old could understand, to explain a fact about ‘real’ numbers, but maths decided that it didn’t want to not be able to square root a negative number, so had to find a way round that problem. The solution? Invent an entirely new type of number, based on the quantity i (which equals the square root of -1), with its own totally arbitrary and made up way of fitting  on a number line, and which can in no way exist in real life.

Admittedly, i has turned out to be useful. When considering electromagnetic forces, quantum physicists generally assign the electrical and magnetic components real and imaginary quantities in order to identify said different components, but its main purpose was only ever to satisfy the OCD nature of mathematicians by filling a hole in their theorems. Since then, it has just become another toy in the mathematician’s arsenal, something for them to play with, slip into inappropriate situations to try and solve abstract and largely irrelevant problems, and with which they can push the field of maths in ever more ridiculous directions.

A good example of the way mathematics has started to lose any semblance of its grip on reality concerns the most famous problem in the whole of the mathematical world- Fermat’s last theorem. Pythagoras famously used the fact that, in certain cases, a squared plus b squared equals c squared as a way of solving some basic problems of geometry, but it was never known as to whether a cubed plus b cubed could ever equal c cubed if a, b and c were whole numbers. This was also true for all other powers of a, b and c greater than 2, but in 1637 the brilliant French mathematician Pierre de Fermat claimed, in a scrawled note inside his copy of Diohantus’ Arithmetica, to have a proof for this fact ‘that is too large for this margin to contain’. This statement ensured the immortality of the puzzle, but its eventual solution (not found until 1995, leading most independent observers to conclude that Fermat must have made a mistake somewhere in his ‘marvellous proof’) took one man, Andrew Wiles, around a decade to complete. His proof involved showing that the terms involved in the theorem could be expressed in the form of an incredibly weird equation that doesn’t exist in the real world, and that all equations of this type had a counterpart equation of an equally irrelevant type. However, since the ‘Fermat equation’ was too weird to exist in the other format, it could not logically be true.

To a mathematician, this was the holy grail; not only did it finally lay to rest an ages-old riddle, but it linked two hitherto unrelated branches of algebraic mathematics by way of proving what is (now it’s been solved) known as the Taniyama-Shimura theorem. To anyone interested in the real world, this exercise made no contribution to it whatsoever- apart from satisfying a few nerds, nobody’s life was made easier by the solution, it didn’t solve any real-world problem, and it did not make the world a tangibly better place. In this respect then, it was a total waste of time.

However, despite everything I’ve just said, I’m not going to decide that all modern day mathematics is a waste of time; very few human activities ever are. Mathematics is many things; among them ridiculous, confusing, full of contradictions and potential slip-ups and, in a field whose age of winning a major prize is younger than in any other STEM field, apparently full of those likely to belittle you out of future success should you enter the world of serious academia. But, for some people, maths is just what makes the world makes sense, and at its heart that was all it was ever created to do. And if some people want their life to be all about the little symbols that make the world make sense, then well done to the world for making a place for them.

Oh, and there’s a theory doing the rounds of cosmology nowadays that reality is nothing more than a mathematical construct. Who knows in what obscure branch of reverse logarithmic integrals we’ll find answers about that one…