On Being a “Falling Down” Physician–Part 2

After complaining about the present status of physicians and health care in this country I have come to praise the physician not to bury him.
It is the best health care in the world.

I am no apologist for ‘big pharma’ the highly capitalistic enterprise which rewards profit for its shareholders. There is nothing inherently wrong with that notion. The problem is with the unnecessary redundancy of its activities.  For instance, the creation and development of two class of drugs have been particularly potent in their ability to alter the quality of life for many.

The first is the anti-cholesterol drugs which inhibit an enzyme which allows the liver to synthesize cholesterol.  They seem to clearly be able to reverse the natural history of atherosclerosis, the cardiac killer. The problem arises when the system seems to stimulate five or six companies to develop their own version of this drug. They are all essentially identical, with minor variations.  They are income generators for big drug companies and therefore they have been actively produced in the laboratory and brought to market. Billions of dollars have been used to produce these break-through in health care. But why do we need five or six of them?

A similar situation has occurred in the family of drugs which powerfully suppress gastric acid secretion.  There are at present six drugs which are proton pump inhibitors.  They offer tremendous clinical improvement in the quality of life for those who suffer from acid reflux disease.  But do we need six pharmaceutical companies pouring billions of dollars into the race to produce their own variation on a theme?

This seems dreadfully wasteful on so many levels. If the same scientific expertise was directed towards developing new compounds to treat additional conditions, that would be time and money well spent.

But how can such a system be ‘fixed’?  I confess my lack of a good solution. The profit motive does drive good science to create drugs which help safe lives. But the redundancy and waste of capital for creating slightly different drugs with the same spectrum of activity needs to be addressed. Those in the alternative health care world who easily trash ‘big pharma’ need to be aware of the tremendous  additions to the quality of life and life expectancy of us all.

A graphic demonstration is available to all.  Peruse  the tombstones of an old cemetery. Notice the ages of those who died about  one hundred years  ago.  Be shocked and dismayed by the number of children and women of childbearing age who died young.

We take for granted the quality and longevity of present day American society. Could we do better in transporting that technology to the Third World–of course.  But it was ‘big pharma’ working in the imperfect capitalistic economy which produced these great changes.

And there will be a Part 3.

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