What Don’t We Know About the Pharmaceutical Industry? A Freakonomics Quorum

[W]e’ve gathered up some willing and able candidates – Dr. Stuart Apfel, Zola P. Horovitz, Dr. Harlan Krumholz, Ray Moynihan, and Dr. Cyril Wolf – and asked them the following question:

What’s something that most people don’t know, pro or con, about the pharmaceutical business, whether from an R&D, economic, or political perspective?

Dr. Harlan Krumholz, professor of medicine, epidemiology, and public health at Yale:

Science and the public good in a capitalist society depend on the free flow of unbiased information, but it doesn’t always work that way. Events are revealing that many pharmaceutical companies, along with their consulting academic physicians, have engaged in practices that obscure or misrepresent information about their products. Does the public realize the depth of these practices, and their implications for patient care?

Zola P. Horovitz, Ph.D, pharmaceutical and biotechnology industry consultant, and member of the board of drug companies including Biocryst Pharmaceuticals, Phyton, Genaera Corporation, and Avigen:

My answer to this question is this: that the United States is subsidizing prescription drug prices for the rest of the world. Most people do not realize that when a prescription is paid for in the U.S., the payer (the patient, his or her insurance company, or the government) is subsidizing the cost of that same prescription in most countries outside the U.S. The pharmaceutical and biotechnology companies price their products to get a return that will support research and development to discover new products. Almost all major new drugs are discovered and developed by these companies, and most are located inside the U.S.

Dr. Cyril Wolf, practicing physician and prescription sales researcher:

The best kept secret by the retail pharmaceutical industry is the obscene profits made on generic drugs by the large chain stores. Whereas brand name drugs are all purchased, and therefore sold, for around the same price, generics are obtained for a fraction of that cost. The price at which the generics are sold is determined by the sellers, who thus have the ability to make exorbitant profits on these drugs.

Dr. Stuart Apfel, founder and president of Parallax Clinical Research and chief medical officer at Elite Pharmaceuticals:

For the majority of people, the great appeal of biomedical science is the potential benefit it presents to human beings through curing disease, extending life, and improving the quality of life. As is generally well-known, biomedical science has achieved much in extending our knowledge of the complex biological processes that make up all living organisms, including ourselves. […]

Market forces will always drive the actions of pharmaceutical companies, which are, after all, businesses like any other. However, society as a whole will benefit from greater risk taking and increased efforts to bridge the divide between laboratory science and the clinic.

Ray Moynihan, co-author of Selling Sickness: How the World’s Biggest Pharmaceutical Companies Are Turning Us All Into Patients:

What a lot of people may not know is that for some time now, pharmaceutical company marketing strategies have focused on promoting illness, rather than simply promoting drugs. Underpinning many of the marketing strategies of big drug companies is a very sophisticated and comprehensive plan to widen the boundaries of illness, and create an environment in which more and more formerly healthy people are defined as ‘sick.’ The strategies have many components – the most visible being TV and newspaper ads that make us think that our ailments and inconveniences are the signs and symptoms of genuine medical conditions. A sore stomach is ‘Irritable Bowel Syndrome,’ a mild sexual difficulty is ‘Female Sexual Dysfunction,’ and overactive grown-ups now have ‘Adult Attention Deficit Disorder.’