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.

Copyright Quirks

This post is set to follow on from my earlier one on the subject of copyright law and its origins. However, just understanding the existence of copyright law does not necessarily premeditate the understanding of the various complications, quirks and intricacies that get people quite so angry about it- so today I want to explore a few of these features that get people so annoyed, and explain why and how they came to be.

For starters, it is not in the public interest for material to stay forever copyrighted, for the simple reason that stuff is always more valuable if freely in the public domain as it is more accessible for the majority. If we consider a technological innovation or invention, restricting its production solely to the inventor leaves them free to charge pretty much what they like, since they have no competition to compete with. Not only does this give them an undesirable monopoly, it also restricts that invention from being best used on a large scale, particularly if it is something like a drug or medicine. Therefore, whilst a copyright obviously has to exist in order to stimulate the creation of new stuff, allowing it to last forever is just asking for trouble, which is why copyrights generally have expiry times. The length of a copyright’s life varies depending on a product- for authors it generally lasts for their lifetime plus a period of around 70 years or so to allow their family to profit from it (expired copyright is the reason that old books can be bought for next to nothing in digital form these days, as they cost nothing to produce). For physical products and, strangely, music, the grace period is generally both fixed and shorter (and dependent on the country concerned), and for drugs and pharmaceuticals it is just ten years (drugs companies are corrupt and profit-obsessed enough without giving them too long to rake in the cash).

Then, we encounter the fact that a copyright also represents a valuable commodity, and thus something that can potentially be put up for sale. You might think that allowing this sort of thing to go on is wrong and is only going to cause problems, but it is often necessary. Consider somebody who owns the rights to a book, and wants someone to make a film out of it, partly because they may be up for a cut of the profits and will gain money from the sale of their rights, but also because it represents a massive advertisement for their product. They, therefore, want to be able to sell part of the whole ‘right to publish’ idea to a film studio who can do the job for them, and any law prohibiting this is just pissing everybody off and preventing a good film from potentially being made. The same thing could apply to a struggling company who owns some valuable copyright to a product; the ability to sell it not only offers them the opportunity to make a bit of money to cover their losses, but also means that the product is more likely to stay on the free market and continue being produced by whoever bought the rights. It is for this reason legal for copyright to be traded between various different people or groups to varying degrees, although the law does allow the original owner to cancel any permanent trade after 35 years if they want to do something with the property.

And what about the issue of who is responsible for a work at all?  One might say that it is simply the work of the author/inventor concerned, but things are often not that simple. For one thing, innovations are often the result of work by a team of people and to restrict the copyright to any one of them would surely be unfair. For another, what if, say, the discovery of a new medical treatment came about because the scientist responsible was paid to do so, and given all the necessary equipment and personnel, by a company. Without corporate support, the discovery could never have been made, so surely that company is just as much legally entitled to the copyright as the individual responsible? This is legally known as ‘work made for hire’, and the copyright in this scenario is the property of the company rather than the individual, lasting for a fixed period (70 years in the US) since the company involved is unlikely to ‘die’ in quite the same predictable lifespan of a human being, and is unlikely to have any relatives for the copyright to benefit afterwards. It is for this reason also that companies, rather than just people, are allowed to hold copyright.

All of these quirks of law are undoubtedly necessary to try and be at least relatively fair to all concerned, but they are responsible for most of the arguments currently put about pertaining to ‘why copyright law is %&*$ed up’. The correct length of a copyright for various different stuff is always up for debate, whether it be musicians who want them to get longer (Paul McCartney made some complaints about this a few years ago), critics who want corporate ones to get shorter, or morons who want to get rid of them altogether (they generally mean well, but anarchistic principles today don’t either a) work very well or b) attract support likely to get them taken seriously). The sale of copyright angers a lot of people, particularly film critics- sales of the film rights for stuff like comic book characters generally include a clause requiring the studio to give it back if they don’t do anything with it for a few years. This has resulted in a lot of very badly-made films over the years which continue to be published solely because the relevant studio don’t want to give back for free a valuable commodity that still might have a few thousand dollars to be squeezed out of it (basically, blame copyright law for the new Spiderman film). The fact that both corporations and individuals can both have a right to the ownership of a product (and even the idea that a company can claim responsibility for the creation of something) has resulted in countless massive lawsuits over the years, almost invariably won by the biggest publishing company, and has created an image of game developers/musicians/artists being downtrodden by big business that is often used as justification by internet pirates. Not that the image is inaccurate or anything, but very few companies appear to realise that this is why there is such an undercurrent of sympathy for piracy on the internet and why their attempts to attack it through law have met with quite such a vitriolic response (as well as being poorly-worded and not thought out properly).

So… yeah, that’s pretty much copyright, or at least why it exists and people get annoyed about it. There are a lot of features concerning copyright law that people don’t like, and I’d be the last to say that it couldn’t do with a bit of bringing up to date- but it’s all there for a reason and it’s not just there because suit-clad stereotypes are lighting hundred dollar cigars off the arse of the rest of us. So please, when arguing about it, don’t suggest anything should just go without thinking of why it’s there in the first place.

SCIENCE!

One book that I always feel like I should understand better than I do (it’s the mechanics concerning light cones that stretch my ability to visualise) is Professor Stephen Hawking’s ‘A Brief History of Time’. The content is roughly what nowadays a Physics or Astronomy student would learn in first year cosmology, but when it was first released the content was close to the cutting edge of modern physics. It is a testament to the great charm of Hawking’s writing, as well as his ability to sell it, that the book has since sold millions of copies, and that Hawking himself is the most famous scientist of our age.

The reason I bring it up now is because of one passage from it that spring to mind the other day (I haven’t read it in over a year, but my brain works like that). In this extract, Hawking claims that some 500 years ago, it would be possible for a (presumably rich, intelligent, well-educated and well-travelled) man to learn everything there was to know about science and technology in his age. This is, when one thinks about it, a rather bold claim, considering the vast scope of what ‘science’ covers- even five centuries ago this would have included medicine, biology, astronomy, alchemy (chemistry not having been really invented), metallurgy and materials, every conceivable branch of engineering from agricultural to mining, and the early frontrunners of physics to name but some. To discover everything would have been quite some task, but I don’t think an entirely impossible one, and Hawking’s point stands: back then, there wasn’t all that much ‘science’ around.

And now look at it. Someone with an especially good memory could perhaps memorise the contents of a year’s worth of New Scientist, or perhaps even a few years of back issues if they were some kind of super-savant with far too much free time on their hands… and they still would have barely scratched the surface. In the last few centuries, and particularly the last hundred or so years, humanity’s collective march of science has been inexorable- we have discovered neurology, psychology, electricity, cosmology, atoms and further subatomic particles, all of modern chemistry, several million new species, the ability to classify species at all, more medicinal and engineering innovations than you could shake a stick at, plastics, composites and carbon nanotubes, palaeontology, relativity, genomes, and even the speed of spontaneous combustion of a burrito (why? well why the f&%$ not?). Yeah, we’ve come a long way.

The basis for all this change occurred during the scientific revolution of the 16th and 17th centuries. The precise cause of this change somewhat unknown- there was no great upheaval, but more of a general feeling that ‘hey, science is great, let’s do something with it!’. Some would argue that the idea that there was any change in the pace of science itself is untrue, and that the groundwork for this period of advancing scientific knowledge was largely done by Muslim astronomers and mathematicians several centuries earlier. Others may say that the increasing political and social changes that came with the Renaissance not only sent society reeling slightly, rendering it more pliable to new ideas and boundary-pushing, but also changed the way that the rich and noble functioned. Instead of barons, dukes and the nobility simply resting on their laurels and raking in the cash as the feudal system had previously allowed them to, an increasing number of them began to contribute to the arts and sciences, becoming agents of change and, in the cases of some, agents in the advancement of science.

It took a long time for science to gain any real momentum. For many a decade, nobody was ever a professional scientist or even engineer, and would generally study in their spare time. Universities were typically run by monks and populated by the sons of the rich or the younger sons of nobles- they were places where you both lived and learned expensively, but were not the centres of research that they are nowadays. They also contained a huge degree of resistance to the ideas put forward by Aristotle and others that had been rediscovered at the start of the revolution, and as such trying to get one’s new ideas taken seriously was a severe task. As such, just as many scientists were merely people who were interested in a subject and rich and intelligent enough to dabble in it as they were people committed to learning. Then there was the notorious religious problem- whilst the Church had no problem with most scientific endeavours, the rise of astronomy began one long and ceaseless feud between the Pope and physics into the fallibility of the bible, and some, such as Galileo and Copernicus, were actively persecuted by the Church for their new claims. Some were even hanged. But by far the biggest stumbling block was the sheer number of potential students of science- most common people were peasants, who would generally work the land at their lord’s will, and had zero chance of gravitating their life prospects higher than that. So- there was hardly anyone to do it, it was really, really hard to make any progress in and you might get killed for trying. And yet, somehow, science just kept on rolling onwards. A new theory here, an interesting experiment here, the odd interesting conversation between intellectuals, and new stuff kept turning up. No huge amount, but it was enough to keep things ticking over.

But, as the industrial revolution swept Europe, things started to change. As revolutions came and went, the power of the people started to rise, slowly squeezing out the influence and control of aristocrats by sheer weight of numbers. Power moved from the monarchy to the masses, from the Lords to the Commons- those with real control were the entrepreneurs and factory owners, not old men sitting in country houses with steadily shrinking lands that they owned. Society began to become more fluid, and anyone (well, more people than previously, anyway), could become the next big fish by inventing something new. Technology began to become of ever-increasing importance, and as such so did its discovery. Research by experiment was ever-more accessible, and science began to gather speed. During the 20th century things really began to motor- two world wars prompted the search for new technologies to enter an even more frenzied pace, the universal schooling of children was breeding a new generation of thinkers, and the idea of a university as a place of learning and research became more cemented in popular culture. Anyone could think of something new, and in that respect everyone was a scientist.

And this, to me, is the key to the world we live in today- a world in which a dozen or so scientific papers are published every day for branches of science relevant largely for their own sake. But this isn’t the true success story of science. The real success lies in the products and concepts we see every day- the iPhone, the pharmaceuticals, the infrastructure. The development of none of these discovered a new effect, a new material, or enabled us to better understand the way our thyroid gland works, and in that respect they are not science- but they required someone to think a little bit, to perhaps try a different way of doing something, to face a challenge. They pushed us forward one, tiny inexorable step, put a little bit more knowledge into the human race, and that, really, is the secret. There are 7 billion of us on this planet right now. Imagine if every single one contributed just one step forward.