"It didn't fit their business plan"

The NYTimes published an article (see article) today on an expensive drug, Cerezyme, used to treat a rare genetic disease, and the issue of dosing as drugs become more and more expensive. It brings up several interesting topics.

When it comes to technology use, it is evident that those with enough wealth in our culture, and increasingly, the globalizing and westernizing world, readily soak up the newest and most expensive technologies, perceiving them to be more effective than the old. However, the system of research and development (R&D) of new pharmaceuticals and procedures in the U.S., where much of the world's foremost medical research is produced, does not guarantee that this is always true. The series of clinical trials that a new drug must go through need only show that it is 1) safe, 2) chemically distinct, and 3) effective against a placebo trial. There is no requirement that it needs to be more effective than the best existing treatment. The article also mentions that the clinical trial for Cerezyme was based on only 12 people, again showing that FDA approval and rounds of clinical trials may lend a false sense of "betterness" to newer drugs. With this said, there are certainly advantages to having a variety of equally effective treatments for each disease -- patients who might not respond well to one treatment might find another that works better, and some new drugs may be able to achieve the same effectiveness with fewer or milder side effects. In general, however, the intense comodification of the pharmaceutical development process and the huge profits that go into the industry (supply-side), combined with consumers' sense of safety with newer drugs (demand-side), tend to skew companies' priorities towards the bottom line and result in an overproduction of expensive new drugs that may not be any more effective.

Meanwhile, the burden of skyrocketing costs fall on both public and private insurance systems, as well as on those individuals who are uninsured, ineligible for insurance, or inadequately insured. Ultimately, it is individual patient and physician choice that drive this overuse, so educating the public and doctors on appropriate drug prescribing might be beneficial. (But it seems that the pharmaceutical industry is one step ahead in recognizing this loophole in their profit-making process -- enter the massive amounts of direct consumer advertising to ensure that patients continue demanding the industry's products, and the legions of physician-salespeople hired by drug companies to "educate" their peers on the benefits of new drugs to ensure that they continue prescribing, perhaps even in higher doses than necessary, as indicated by the article.)